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Nebulized Racemic Epinephrine by IPPB for the Treatment of Croup: A Double-Blind Study

Nebulized Racemic Epinephrine by IPPB for the Treatment of Croup: A Double-Blind Study Abstract • Racemic epinephrine has been advocated for the treatment of croup, but controlled studies have not proved it more effective than saline. Twenty patients (aged 4 months to 5 years) hospitalized with acute croup and persistent inspiratory stridor at rest were randomly assigned to one of two treatment groups: saline or racemic epinephrine, both nebulized and delivered by intermittent positive pressure breathing. Clinical scores were significantly improved (P <.01) at ten and 30 minutes following the treatment with racemic epinephrine but not at 120 minutes. Racemic epinephrine was significantly more effective than saline at 10 (P <.01) and 30 minutes (P <.05) but not at 120 minutes after the treatment. We conclude that nebulized racemic epinephrine is effective treatment for the acute signs of croup. (Am J Dis Child 132:484-487, 1978) References 1. Adair JC, Ring WH, Jordan WS: Ten-year experience with IPPB in the treatment of acute laryngotracheobronchitis . Anesth Analg 50:649-655, 1971.Crossref 2. Melnick A, Berger R, Green G: Spasmodic croup in children: Personal experiences with intermittent positive pressure breathing in therapy . Clin Pediatr 11:615-617, 1972.Crossref 3. Breivik H: Behandling av akutt laryngitt med forstøvet racemisk adrenalin . Tidsskr Nor Laegeforen 95:441-443, 1975. 4. Jordan WS, Graves CL, Elwyn RA: New therapy for postintubation laryngeal edema and tracheitis in children . JAMA 212:585-588, 1970.Crossref 5. Singer OP, Wilson WJ: Laryngotracheobronchitis: two years' experience with racemic epinephrine . Can Med Assoc J 115:132-134, 1976. 6. Taussig LM, Castro O, Beaudry PH: Treatment of laryngotracheobronchitis (croup): Use of intermittent positive pressure breathing and racemic epinephrine . Am J Dis Child 129:790-793, 1975. 7. Gardner HG, Powell KR, Roden VJ, et al: The evaluation of racemic epinephrine in the treatment of infectious croup . Pediatrics 52:52-55, 1973. 8. Dunnett CW: New tables for multiple comparisons with a control . Biometrics 20:482, 1964.Crossref 9. Ellis EF, Taylor JC Jr, Lefkowitz MS: Letter to the editor . Pediatrics 53:291-292, 1974. 10. Glezen WP, Denny FW: Epidemiology of acute lower respiratory disease in children . N Engl J Med 288:498-505, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Nebulized Racemic Epinephrine by IPPB for the Treatment of Croup: A Double-Blind Study

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1978.02120300044008
Publisher site
See Article on Publisher Site

Abstract

Abstract • Racemic epinephrine has been advocated for the treatment of croup, but controlled studies have not proved it more effective than saline. Twenty patients (aged 4 months to 5 years) hospitalized with acute croup and persistent inspiratory stridor at rest were randomly assigned to one of two treatment groups: saline or racemic epinephrine, both nebulized and delivered by intermittent positive pressure breathing. Clinical scores were significantly improved (P <.01) at ten and 30 minutes following the treatment with racemic epinephrine but not at 120 minutes. Racemic epinephrine was significantly more effective than saline at 10 (P <.01) and 30 minutes (P <.05) but not at 120 minutes after the treatment. We conclude that nebulized racemic epinephrine is effective treatment for the acute signs of croup. (Am J Dis Child 132:484-487, 1978) References 1. Adair JC, Ring WH, Jordan WS: Ten-year experience with IPPB in the treatment of acute laryngotracheobronchitis . Anesth Analg 50:649-655, 1971.Crossref 2. Melnick A, Berger R, Green G: Spasmodic croup in children: Personal experiences with intermittent positive pressure breathing in therapy . Clin Pediatr 11:615-617, 1972.Crossref 3. Breivik H: Behandling av akutt laryngitt med forstøvet racemisk adrenalin . Tidsskr Nor Laegeforen 95:441-443, 1975. 4. Jordan WS, Graves CL, Elwyn RA: New therapy for postintubation laryngeal edema and tracheitis in children . JAMA 212:585-588, 1970.Crossref 5. Singer OP, Wilson WJ: Laryngotracheobronchitis: two years' experience with racemic epinephrine . Can Med Assoc J 115:132-134, 1976. 6. Taussig LM, Castro O, Beaudry PH: Treatment of laryngotracheobronchitis (croup): Use of intermittent positive pressure breathing and racemic epinephrine . Am J Dis Child 129:790-793, 1975. 7. Gardner HG, Powell KR, Roden VJ, et al: The evaluation of racemic epinephrine in the treatment of infectious croup . Pediatrics 52:52-55, 1973. 8. Dunnett CW: New tables for multiple comparisons with a control . Biometrics 20:482, 1964.Crossref 9. Ellis EF, Taylor JC Jr, Lefkowitz MS: Letter to the editor . Pediatrics 53:291-292, 1974. 10. Glezen WP, Denny FW: Epidemiology of acute lower respiratory disease in children . N Engl J Med 288:498-505, 1973.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: May 1, 1978

References