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For children with moderate to severe croup, treatment with corticosteroids and nebulized epinephrine may be suggested. Steroids are given routinely, with epinephrine used in severe cases. [4] Children with oxygen saturation less than 92% should receive oxygen, [5] and those with severe croup may be hospitalized for observation. [12]
Corticosteroids, although useful in other respiratory disease such as asthma and croup, have no proven benefit in bronchiolitis treatment and are not advised. [ 9 ] [ 8 ] [ 12 ] [ 56 ] [ 57 ] Additionally, corticosteroid therapy in children with bronchiolitis may prolong viral shedding and transmissibility. [ 9 ]
In children under five years and adults over 40 years, the fatality rate may be as much as 20%. [28] In 2013, it resulted in 3,300 deaths, down from 8,000 deaths in 1990. [ 7 ] Better standards of living, mass immunization, improved diagnosis, prompt treatment, and more effective health care have led to a decrease in cases worldwide.
The omicron Covid variant appears to be leading to croup in young children under the age of 5. Doctors share what to know about kids, omicron and croup.
Inspiratory stridor often occurs in children with croup. It may be indicative of serious airway obstruction from severe conditions such as epiglottitis, a foreign body lodged in the airway, or a laryngeal tumor. Stridor should always command attention to establish its cause.
The viruses have a tendency towards different complications: influenza is more likely to cause severe pneumonia in high-risk groups; parainfluenza is more likely to cause croup in children. Influenza has effective vaccines available and can be treated with antiviral medications like neuraminidase inhibitors.
NPPE develops as a result of significant negative pressure generated in the chest cavity by inspiration against an upper airway obstruction. These negative pressures in the chest lead to increase venous supply to the right side of the heart while simultaneously creating more resistance for the left side of the heart to supply blood to the rest of the body (). [4]
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