PEDIATRICS Vol. 89 No. 2 February 1992, pp. 302-306
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Waisman, Y.
Right arrow Articles by Ochsenschlager, D. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Waisman, Y.
Right arrow Articles by Ochsenschlager, D. W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Prospective Randomized Double-Blind Study Comparing l-Epinephrine and Racemic Epinephrine Aerosols in the Treatment of Laryngotracheitis (Croup)

Yeheskel Waisman MD1, Bruce L. Klein MD1, Douglas A. Boenning MD1, Grace M. Young MD1, James M. Chamberlain MD1, Regina O'Donnell MS2, and Daniel W. Ochsenschlager MD1

1 From the Emergency Medical Trauma Center, George Washington University School of Medicine and Health Sciences, Washington, DC.
2 From the Office of the Research Director, Children's National Medical Center, and the Department of Pediatrics, George Washigton University School of Medicine and Health Sciences, Washington, DC.

Aerosolized racemic epinephrine, but not l-epinephrine, is commonly used in treating croup. The efficacy and adverse effects of nebulized racemic and l-epinephrine in the treatment of laryngotracheitis were compared. Children 6 months to 6 years of age with a croup score of 6 or above were assigned in a randomized double-blind fashion to receive either racemic (n = 16) or l-epinephrine (n = 15) aerosols. Croup score, heart rate, blood pressure, respiratory rate, fraction of inspired oxygen, and oxygen saturation were recorded before treatment and at 5, 15, 30, 60, 90, and 120 minutes after the aerosol. Patients in both groups showed significant transient reduction of the croup score and respiratory rate following the aerosol (P < .001), but there were no differences between treatment groups when croup score, heart rate, blood pressure, and respiratory rate were assessed over time. It is concluded that l-epinephrine is at least as effective as racemic epinephrine in the treatment of laryngotracheitis and does not carry the risk of additional adverse effects. l-Epinephrine is also more readily available worldwide, is less expensive, and can be recommended for this purpose.

Key Words: croup • laryngotracheitis • racemic epinephrine • epinephrine • upper airway obstruction

Submitted on February 4, 1991
Accepted on June 11, 1991


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Eur Respir JHome page
W. Lenney, A. L. Boner, L. Bont, A. Bush, K-H. Carlsen, E. Eber, B. Fauroux, M. Gotz, A. Greenough, J. Grigg, et al.
Medicines used in respiratory diseases only seen in children
Eur. Respir. J., September 1, 2009; 34(3): 531 - 551.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
J. D. Cherry
Croup
N. Engl. J. Med., January 24, 2008; 358(4): 384 - 391.
[Full Text] [PDF]

Home page
 Br Med BullHome page
J. C Brown
The management of croup
Br. Med. Bull., March 1, 2002; 61(1): 189 - 202.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
M. Ausejo, A. Saenz, B. Pham, J. D Kellner, D. W Johnson, D. Moher, and T. P Klassen
The effectiveness of glucocorticoids in treating croup: meta-analysis
BMJ, September 4, 1999; 319(7210): 595 - 600.
[Abstract] [Full Text]

Home page
 NEJMHome page
D. M. Jaffe
The Treatment of Croup with Glucocorticoids
N. Engl. J. Med., August 20, 1998; 339(8): 553 - 555.
[Full Text]

Home page
 DTBHome page
Inhaled budesonide and adrenaline for croup
DTB, March 1, 1996; 34(3): 23 - 24.
[Abstract] [Full Text] [PDF]

Home page
 JWatch GeneralHome page
RACEMIC OR L-EPINEPHRINE FOR CROUP
Journal Watch (General), February 18, 1992; 1992(218): 3 - 3.
[Full Text]