- Children with croup improved about as well with a reduced L-epinephrine dose as with a standard dose in this small trial.
Why this matters
- Previous dose studies were conducted in a population with postextubation stridor.
- A smaller effective dose would presumably curb drug-related climbs in heart rate and BP.
- Change in croup score, low- vs standard-dose groups: −1.85 (±1.08) vs −2.08 (±1.53) (95% CI, −0.36 to 0.82; P=.420).
- Groups also had similar BPs, heart rates, admission rates, and emergency department (ED) return rates.
- No side effects attributed to epinephrine in either group.
- Randomized controlled double-blind trial at the pediatric EDs of 3 teaching hospitals (n=84).
- Children aged 6 months to 5 years with moderate-to-severe croup were randomly assigned to low-dose (0.1 mg/kg, maximum 1 mg) vs standard-dose (0.5 mg/kg, maximum 5 mg) nebulized 1:1000 L-epinephrine.
- All also received dexamethasone.
- Outcome: 30-minute change in Westley croup score.
- Funding: National Research Foundation of Korea.
- Low-dose group mean croup score was better than standard-dose group score at baseline (3.68±0.84 vs 4.30±1.24; P=.012).
- Few patients had severe croup.