Elsevier

The Lancet

Volume 340, Issue 8822, 26 September 1992, Pages 745-748
The Lancet

ORIGINAL ARTICLES
Placebo-controlled trial of prednisolone in children intubated for croup

https://doi.org/10.1016/0140-6736(92)92293-OGet rights and content

Abstract

Many studies have attempted to find out whether steroid treatment is beneficial in children with croup, but the results have been inconclusive. We have done a prospective placebo-controlled study of the effect of prednisolone on two clinical endpoints— the duration of intubation and the need for reintubation.

Reasons for exclusion were age under 6 months, congenital airway anomalies, and previous intubation. 70 eligible children were randomly assigned treatment with prednisolone 1 mg/kg (n=38) or placebo (n=32) every 12 h given by nasogastric tube until 24 h after extubation. 11 (34%) placebo-treated and only 2 (5%) prednisolone-treated patients required reintubation after accidental or elective extubation (p=0·004, Fisher's exact test; odds ratio 8·9, 95% confidence interval 1·7-59·3). Survival analysis with log-normal regression showed that the duration of intubation was shorter with steroid therapy (p<0·003) and increasing age (p < 0·02), but was not influenced by endotracheal tube size or abnormality on chest radiograph. The median duration of intubation was 138 (95% Cl 118-160) h in children who received placebo and 98 (85-113) h in the prednisolone group.

Steroid therapy reduces the duration of intubation and the need for reintubation in children intubated for croup.

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