From the Guidelines
Croup typically affects children between 3 months and 8 years old, with the age range being inclusive of these values as per the most recent studies 1.
Age Range and Management
The management of croup depends on the severity of the condition but generally includes supportive care and medications to reduce airway inflammation.
- For mild croup, home management with cool mist humidification and keeping the child calm is often sufficient.
- For moderate to severe cases, a single oral dose of dexamethasone is the mainstay of treatment, as it reduces inflammation and improves symptoms.
Key Considerations
- The age range of 3 months to 8 years old is based on the inclusion criteria of recent studies 1, which aimed to reduce hospital admissions for croup.
- These studies excluded patients with direct or ICU admissions, complex chronic conditions, or concurrent asthma, pneumonia, or bronchiolitis, indicating that the management strategies are tailored for a specific subset of patients.
Treatment Approaches
- The use of a clinical guideline and orderset has been shown to reduce hospital admissions for croup 1, highlighting the importance of standardized management approaches.
- The treatment of croup may involve nebulized epinephrine in severe cases requiring emergency care, with patients needing observation for at least 2-3 hours after treatment due to potential rebound symptoms.
- Supplemental oxygen should be provided if oxygen saturation falls below 92%, emphasizing the need for close monitoring of patients with croup.
From the Research
Age Group for Croup
- Croup typically affects children between the ages of 6 months and 3 years, with 75% of infections caused by parainfluenza virus 2.
- The age range of 6 months to 3 years is consistently reported across various studies as the typical age group for croup 2, 3.
- Children in this age group are more susceptible to upper airway obstruction, which is a characteristic of croup 2, 3.
Management of Croup
- The management of croup typically involves the use of corticosteroids, such as dexamethasone, to reduce inflammation and improve symptoms 2, 3.
- Nebulised epinephrine (adrenaline) may also be used in moderate to severe cases to help relieve respiratory distress 2, 3.
- Heliox, a mixture of helium and oxygen, has been shown to have some benefit in the short-term management of moderate to severe croup, particularly when used in conjunction with dexamethasone 4, 5, 6.
- The use of heliox may be similar in effectiveness to 100% oxygen given with one or two doses of adrenaline 5, 6.