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A prospective randomized double-blind study to evaluate the effect of dexamethasone in acute laryngotracheitis
193 A prosfnxtive randomiied dodkWnd study to evaluate the effect taryngotrPdreitis Super D.M., Cartelli N.A., Brooks L.J., Lembo R.M. and Kumar M.L. J. Pediurr. (1989) 115/2 (323-329)
of dexametbasone
in acute
To determine whether a single dose of dexamethasone (0.6 mg/kg) is useful in the treatment of acute laryngotracheitis (croup), 29 hospitalized patients with acute laryngotracheitis were randomly assigned in a double-blind fashion to receive either parenterally administered dexamethasone (n = 16) or a saline placebo (n ~13). Severity of the illness was assessed by a clinical croup score based on retractions, stridor, air entry, cyanosis, and level of consciousness. Twelve hours from the time of injection, the patients receiving the dexamethasone had a statistically significant decline in median croup score from 4.5 to 1.0 (p -z O.OOl),whereas the patients receiving the placebo did not. By 24 hours, a decline of two or more points in the total croup score was noted in 85% of the patients in the dexamethasone group compared with 33% of the patients in the placebo group (p = 0.027). During this same period, only 19% of patients receiving dexamethasone required two or more racemic epinephrine treatments in comparison with 62% of patients who received the placebo (p < 0.05). There was no statistical difference between the two groups in improvement in oxygen saturation, respiratory rates, or duration of hospitalization. We conclude that dexamethasone is beneficial in reducing the overall severity of moderate to severe acute laryngotracheitis during the first 24 hours after injection.
References Allen P.; Wightman F.; Kistler D.; Dolan T.; Frequency resolution in children: J. SPEECH HEAR. RES.; 32/2 (317-322)/1989/ Anand V.T.; Mann S.B.S.; Dash R.J.; Mehra Y.N.; Auditory investigations in hypothyroidism; ACTA OTO-LARYNGOL.; 108/l-2 (83-87)/1989/ Aoki S.; Dillon W.P.; Barkovich A.J.; Normal D.; Marrow conversion before pneumatization of the sphenoid sinus: Assessment with MR imaging; RADIOLOGY; 172/2 (373-375)/1989/ Behrendt W.; Auditive assessment of the voice timbre of male falsetto voices in ex-choir singers; SPRACHE STIMME GEHOR; 13/2 @O-63)/1989/ Bellussi L.; Bemocchi D.; Ciferri G.; Manini G.; Pass&i D.; Sobrerol in the treatment of secretory otitis media in childhood; J. INT. MED. RES.; 17/3 (277-286)/1989/ Benjamin B.; Inglis A.; Minor congenital laryngeal clefts: Diagnosis and classification; ANN. OTOL. RHINOL. LARYNGOL.; 98/6 (417-420)/1989/ Berridge DC.; Hitchcock A.; Bradley P.J.; Kapila L.; Second primary tumour following retinoblastoma; J. LARYlUGOL. OTOL.; 103/7 (690-691)/1989/ Biem J.; Roy L.; Hal& J.; Hoffstein V.; Infectious mononucleosis complicated by necrotizing epiglottitis, dysphagia, and pneumonia; CHEST; 96/l (204-205)/1989/ Bjerkhoel A.; Hyden D.; Ramsay-Hunt syndrome in a preschool infant; ORL; 51/4 (251-254)/1989/ Bonfils P.; Spontaneous otoacoustic emissions: Clinical interest; LARYNGOSCOPE; 99/7 I (752-756)/1989/ Booth F.A.; Haworth J.C.; Dilling L.A.; Perry T.L.; Greenberg C.R.; Seargeant L.E.; Penn A.M.; Rhead W.J.; Mitochondrial encephalomyopathy with associated aminoacidopathy in a male sibship; J. PEDIATR.; 115/l (81-88)/1989/ Bowdler D.A.; Rogers J.; The management of pseudohypacusis in school-age children; CLIN. OTOLARYNGOL. ALLIED SCI.; 14,‘3 (211-215)/1989/ Brook I.; Medical treatment of non-streptococcal recurrent tonsillitis; AM. J. OTOLARYNGOL., HEAD NECK MED. SURG.; lo,‘4 (227-233)/1989/ Brown P.M.; Lewis G.T.R.; Parker A.J.; Maw A.R.; The skull base and nasopharynx in Down’s syndrome in relation to hearing impairment; CLIN. OTOLARYNGOL. ALLIED SCI.; 14/3 (241-246)/1989/ Cavanaugh R.M. Jr.; Pediatricians and the pneumatic otoscope: Are we playing it by ear?; PEDIATRICS; 84/2 (362-364)/1989/ Cemy M.; Fara M.; Hrivnakova J.; Protective family regimen in cleft lip and palate; ACTA CHIR. PLAST.; 31/2 (108-117)/1989/
of dexametbasone
in acute
To determine whether a single dose of dexamethasone (0.6 mg/kg) is useful in the treatment of acute laryngotracheitis (croup), 29 hospitalized patients with acute laryngotracheitis were randomly assigned in a double-blind fashion to receive either parenterally administered dexamethasone (n = 16) or a saline placebo (n ~13). Severity of the illness was assessed by a clinical croup score based on retractions, stridor, air entry, cyanosis, and level of consciousness. Twelve hours from the time of injection, the patients receiving the dexamethasone had a statistically significant decline in median croup score from 4.5 to 1.0 (p -z O.OOl),whereas the patients receiving the placebo did not. By 24 hours, a decline of two or more points in the total croup score was noted in 85% of the patients in the dexamethasone group compared with 33% of the patients in the placebo group (p = 0.027). During this same period, only 19% of patients receiving dexamethasone required two or more racemic epinephrine treatments in comparison with 62% of patients who received the placebo (p < 0.05). There was no statistical difference between the two groups in improvement in oxygen saturation, respiratory rates, or duration of hospitalization. We conclude that dexamethasone is beneficial in reducing the overall severity of moderate to severe acute laryngotracheitis during the first 24 hours after injection.
References Allen P.; Wightman F.; Kistler D.; Dolan T.; Frequency resolution in children: J. SPEECH HEAR. RES.; 32/2 (317-322)/1989/ Anand V.T.; Mann S.B.S.; Dash R.J.; Mehra Y.N.; Auditory investigations in hypothyroidism; ACTA OTO-LARYNGOL.; 108/l-2 (83-87)/1989/ Aoki S.; Dillon W.P.; Barkovich A.J.; Normal D.; Marrow conversion before pneumatization of the sphenoid sinus: Assessment with MR imaging; RADIOLOGY; 172/2 (373-375)/1989/ Behrendt W.; Auditive assessment of the voice timbre of male falsetto voices in ex-choir singers; SPRACHE STIMME GEHOR; 13/2 @O-63)/1989/ Bellussi L.; Bemocchi D.; Ciferri G.; Manini G.; Pass&i D.; Sobrerol in the treatment of secretory otitis media in childhood; J. INT. MED. RES.; 17/3 (277-286)/1989/ Benjamin B.; Inglis A.; Minor congenital laryngeal clefts: Diagnosis and classification; ANN. OTOL. RHINOL. LARYNGOL.; 98/6 (417-420)/1989/ Berridge DC.; Hitchcock A.; Bradley P.J.; Kapila L.; Second primary tumour following retinoblastoma; J. LARYlUGOL. OTOL.; 103/7 (690-691)/1989/ Biem J.; Roy L.; Hal& J.; Hoffstein V.; Infectious mononucleosis complicated by necrotizing epiglottitis, dysphagia, and pneumonia; CHEST; 96/l (204-205)/1989/ Bjerkhoel A.; Hyden D.; Ramsay-Hunt syndrome in a preschool infant; ORL; 51/4 (251-254)/1989/ Bonfils P.; Spontaneous otoacoustic emissions: Clinical interest; LARYNGOSCOPE; 99/7 I (752-756)/1989/ Booth F.A.; Haworth J.C.; Dilling L.A.; Perry T.L.; Greenberg C.R.; Seargeant L.E.; Penn A.M.; Rhead W.J.; Mitochondrial encephalomyopathy with associated aminoacidopathy in a male sibship; J. PEDIATR.; 115/l (81-88)/1989/ Bowdler D.A.; Rogers J.; The management of pseudohypacusis in school-age children; CLIN. OTOLARYNGOL. ALLIED SCI.; 14,‘3 (211-215)/1989/ Brook I.; Medical treatment of non-streptococcal recurrent tonsillitis; AM. J. OTOLARYNGOL., HEAD NECK MED. SURG.; lo,‘4 (227-233)/1989/ Brown P.M.; Lewis G.T.R.; Parker A.J.; Maw A.R.; The skull base and nasopharynx in Down’s syndrome in relation to hearing impairment; CLIN. OTOLARYNGOL. ALLIED SCI.; 14/3 (241-246)/1989/ Cavanaugh R.M. Jr.; Pediatricians and the pneumatic otoscope: Are we playing it by ear?; PEDIATRICS; 84/2 (362-364)/1989/ Cemy M.; Fara M.; Hrivnakova J.; Protective family regimen in cleft lip and palate; ACTA CHIR. PLAST.; 31/2 (108-117)/1989/