The management of recurrent croup in children (original) (raw)
Related papers
Gastroesophageal reflux disease in children with recurrent croup
New Medicine, 2016
Introduction. Episodic croup occurs most often in children between 0.5 and 3 years of age. Recurrent croup presents most often in older children. It shows an association with gastroesophageal reflux disease, allergy and laryngeal abnormalities. Aim. The aim of this study was to explore the relationship between recurrent croup and gastroesophageal reflux disease in children with the history of at least one episode of severe croup. Material and methods. The study included 22 children with recurrent croup admitted to the Department of Pediatric Otolaryngology of the Medical University of Warsaw between the years 2013 and 2016. Information concerning leading symptoms and medical history was obtained from the medical documentation of the patients. All the patients underwent rigid laryngoscopy and were diagnosed using 24-hours, single probe esophageal pH monitoring. Results. 22 children aged between 1.5 year to 7.5 years were examined and their medical records were analyzed. An acid reflux was diagnosed in fourteen patients (63.6%) and the mean Reflux Index was 11.6. On endoscopic examination of the larynx, 15 patients (61.8%) had normal findings, 7 patients (31.8%) were diagnosed with an airway abnormality including: 3 cases of laryngeal cleft (type I), 2 cases of laryngomalacia, 1 case of subglottic stenosis, 1 case of vocal fold nodules. In 5 cases (22.7%), GERD coexisted with larynx abnormalities. Conclusions. All the children with recurrent croup should be diagnosed for both gastroesophageal reflux disease and laryngeal abnormalities. Therefore, ENT specialists, as well as gastroenterologists, should take part in diagnostic procedures to reveal primary conditions responsible for recurrent croup.
Recurrent croup presentation, diagnosis, and management
American Journal of Otolaryngology, 2007
The lack of clinical insight into recurrent croup often leads to underdiagnosis of an upper airway lesion, and subsequently, inadequate treatment. This study examined the underlying etiology, diagnosis, treatment, and clinical outcome of patients with a history of recurrent croup identified at initial presentation. The aim was to present common diagnostic features and suggest new diagnostic and management recommendations. Materials and methods: A retrospective chart review of 17 children diagnosed with recurrent croup. Demographic, historical, and intraoperative data as noted in clinic charts were collected. Specific collected data included age, sex, chief complaint, presenting symptoms, past medical history, previous medication history, number of emergency room visits and inpatient admissions, tests/ procedures performed and corresponding findings, current treatment given, and posttreatment clinical outcome. Results: Six (35.3%) patients presented initially with a past medical history of gastroesophageal reflux disease. Fourteen (82.3%) patients had positive endoscopic evidence of gastroesophageal reflux. For these 14 patients, 44 laryngopharyngeal reflux lesions were noted, with 32 (72.7%) occurring in the subglottis. All 14 patients demonstrated various degrees of subglottic stenosis ranging from 30% to 70% (Cotton-Myer grade I-II). All 17 patients (100%) demonstrated subglottic stenosis ranging from 15% to 70% airway narrowing. Conclusions: History suggestive of recurrent croup requires close monitoring and expedient direct laryngoscopy/bronchoscopy for diagnosis. Long-term follow-up and antireflux treatment are necessary as well as endoscopic documentation of significant reflux resolution.
Management of croup in children
2018
Laryngotracheobronchitis, commonly known as croup, is a respiratory illness, often mild, which occurs most frequently in children between six months and three years of age. It is characterised by a seal-like ‘barking’ cough, hoarseness of the voice and inspiratory stridor which is preceded by fever, rhinorrhoea and a non-specific cough. Respiratory distress and lethargy are uncommon exacerbations of croup which may be potentially life threatening. This article provides an overview of croup, including the epidemiology and clinical manifestations and the management thereof.
Updates in Diagnosis and Management of Croup
Journal of Pharmaceutical Research International
Croup is a common respiratory disease that affects 3% of children aged six months to three years. It represents 7% of annual hospital admissions for fever and/or acute respiratory disease in children under the age of five. Boys are more susceptible than girls to the condition, with an overall male/female predominance of 1.4/1. Viruses are detected in up to 80% of patients with croup with identifiable pathogens. The onset of symptoms is usually sudden and usually occurs at night: stridor, hoarse voice and respiratory distress are often seen due to upper airway obstruction. Croup is a clinical diagnosis, children with an uncertain diagnosis, anterior and lateral soft-tissue neck radiographs may be useful to support an alternative diagnosis. Management includes: general care, humidified air, heliox, corticosteroids, and epinephrine, Objective: This study aimed to discuss croup in terms of its etiology, pathogenesis, clinical features, diagnosis, assessment, and finally management.
Croup - assessment and management
Australian family physician, 2010
Croup is a common childhood disease characterised by sudden onset of a distinctive barking cough that is usually accompanied by stridor, hoarse voice, and respiratory distress resulting from upper airway obstruction. The introduction of steroids in the treatment of croup has seen a significant reduction in hospital admissions and improved outcomes for children. This article discusses the key aspects of diagnosing croup and the evidence supporting the different treatment strategies. The assessment of airway, breathing and circulation, focusing on airway, is paramount in treating croup. However, it is important to take care not to cause the child undue distress. In mild to moderate croup, give prednisolone 1.0 mg/kg and review in 1 hour. In severe or life threatening croup, give 4 mL of adrenaline 1:1000 (undiluted) via nebuliser and send immediately to hospital via ambulance.
Croup: assessment and evidence-based management
The Medical journal of Australia, 2003
Croup affects about 2% of preschool-aged children every year. Most children have mild croup and are managed at home, often after review by a general practitioner, who may decide that a single dose of oral corticosteroid is indicated (eg, if a risk factor for hospital admission exists). A minority of children develop moderate or severe croup. They should be reviewed in an emergency department and may need hospital admission. More liberal use of systemic corticosteroids for croup (in both primary care and emergency department settings) has been associated with reduced rates of hospital admission, reduced admissions to the intensive care unit and a reduced need for endotracheal intubation. We discuss the assessment and evidence-based management of a child with mild croup presenting to a GP and a child with moderately severe croup presenting to an emergency department. We present a flow chart summarising an approach to assessing and treating croup in the emergency department.
American family physician, 2011
Croup is a common illness responsible for up to 15 percent of emergency department visits due to respiratory disease in children in the United States. Croup symptoms usually start like an upper respiratory tract infection, with low-grade fever and coryza followed by a barking cough and various degrees of respiratory distress. In most children, the symptoms subside quickly with resolution of the cough within two days. Croup is often caused by viruses, with parainfluenza virus (types 1 to 3) as the most common. However, physicians should consider other diagnoses, including bacterial tracheitis, epiglottitis, foreign body aspiration, peritonsillar abscess, retropharyngeal abscess, and angioedema. Humidification therapy has not been proven beneficial. A single dose of dexamethasone (0.15 to 0.60 mg per kg usually given orally) is recommended in all patients with croup, including those with mild disease. Nebulized epinephrine is an accepted treatment in patients with moderate to severe c...
The Cochrane Library and the treatment of croup in children: an overview of reviews
Evidence-Based Child Health: A Cochrane Review Journal, 2010
Croup is an illness characterized by barky cough, stridor, hoarseness, and occasionally respiratory distress. It is a relatively mild and short-lived illness for the majority of children. However, a small proportion of children have moderate to severe symptoms and are at risk of hospital admission, and in the most severe cases, intubation.