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May 1978

Nebulized Racemic Epinephrine by IPPB for the Treatment of Croup: A Double-Blind Study

Author Affiliations

From the Department of Pediatrics, University of Colorado Medical Center, Denver. Dr Westley is currently with the US Public Health Service, Phoenix Indian Medical Center, Phoenix.

Am J Dis Child. 1978;132(5):484-487. doi:10.1001/archpedi.1978.02120300044008

• Racemic epinephrine has been advocated for the treatment of croup, but controlled studies have not proved it more effective than saline. Twenty patients (aged 4 months to 5 years) hospitalized with acute croup and persistent inspiratory stridor at rest were randomly assigned to one of two treatment groups: saline or racemic epinephrine, both nebulized and delivered by intermittent positive pressure breathing. Clinical scores were significantly improved (P <.01) at ten and 30 minutes following the treatment with racemic epinephrine but not at 120 minutes. Racemic epinephrine was significantly more effective than saline at 10 (P <.01) and 30 minutes (P <.05) but not at 120 minutes after the treatment. We conclude that nebulized racemic epinephrine is effective treatment for the acute signs of croup.

(Am J Dis Child 132:484-487, 1978)