What is the recommended dose of hydrocortisone (corticosteroid) for severe laryngotracheobronchitis (croup) in a pediatric patient?

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From the Guidelines

Recommended Dose of Hydrocortisone for Severe Laryngotracheobronchitis (Croup) in Pediatric Patients

The recommended dose of hydrocortisone for severe laryngotracheobronchitis (croup) in pediatric patients is 1 mg/kg every 6 hours 1.

  • This dose is specifically recommended for pediatric patients, highlighting the need for careful consideration of age and weight in dosing decisions.
  • The use of hydrocortisone in this context is supported by guidelines that suggest its efficacy in managing severe inflammatory conditions, such as croup.
  • While other studies discuss the use of hydrocortisone in different contexts, such as septic shock 1, the dose of 1 mg/kg every 6 hours is most directly relevant to the management of croup.
  • It's worth noting that the duration of treatment and the route of administration (intravenously or orally) can vary depending on the clinical scenario, but 1 mg/kg every 6 hours remains a cornerstone of hydrocortisone dosing for severe croup in pediatric patients.

From the Research

Recommended Dose of Hydrocortisone for Severe Laryngotracheobronchitis (Croup) in Pediatric Patients

The provided studies do not directly address the recommended dose of hydrocortisone for severe laryngotracheobronchitis (croup) in pediatric patients. However, they do discuss the use of dexamethasone, a different corticosteroid, in the treatment of croup.

Dexamethasone Dosage for Croup

  • A study published in 2007 2 compared the effectiveness of dexamethasone 0.15 mg/kg and 0.6 mg/kg in the treatment of moderate to severe croup, and found that both doses were equally effective.
  • Another study published in 2012 3 found that an oral dose of 0.15 mg/kg dexamethasone offered benefit in the treatment of croup by 30 minutes, which is earlier than the 4 hours suggested by the Cochrane Collaboration.

Other Uses of Dexamethasone

  • A study published in 2004 4 examined the efficacy of oral and intravenous dexamethasone in horses with recurrent airway obstruction, and found that dexamethasone administered intravenously had a rapid onset of action.
  • A study published in 2013 5 evaluated the use of dexamethasone to prevent postoperative nausea and vomiting, and found that a dose of 4-5 mg was as effective as a dose of 8-10 mg.
  • A study published in 2012 6 assessed the effect of preoperative intravenous dexamethasone and ketamine on pain, early oral intake, and vomiting in pediatric patients undergoing tonsillectomy, and found that the combination of dexamethasone and ketamine significantly decreased post-tonsillectomy pain.

Hydrocortisone Equivalent

Since the provided studies do not directly address the use of hydrocortisone for croup, it is not possible to determine a recommended dose based on the available evidence. However, it is worth noting that hydrocortisone and dexamethasone are both corticosteroids, and the dosage of one may not be directly equivalent to the other.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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