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A Prospective, Randomized Double-blind Study in Children Comparing Two Doses of Nebulized L-epinephrine in Postintubation Croup


Aroonwan Preutthipan, MD, FCCP*,
Preamrudee Poomthavorn, MD*, Apinya Sumanapisan, BSc**,
Benchaporn Chinrat, BSc**, Sriwanna Thasuntia, BSc**,
Adisak Plitponkarnpim, MD, MPH*, Teerachai Chantarojanasiri, MD*

* Departments of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
** Department of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University


Objective: To compare the effectiveness and side effects of nebulized l-epinephrine (NLE) at a dose of 0.05 mL/kg versus 0.5 mL/kg in the treatment of postintubation croup in children.
Material and Method: Thirty-nine children, who developed signs and symptoms of upper airway obstruction (UAO) after extubation, were randomized to receive either 0.05 mL/kg or 0.5 mL/kg of NLE. UAO scores, vital signs (VS) and possible side effects were recorded before and at 20 and 40 minutes after the treatment.
Results: Twenty-one and 18 patients were allocated to the 0.05 and 0.5 mL/kg groups, respectively. Both groups showed improvements in UAO scores over time. There were no significant differences in UAO scores and VS between the groups at all time points. Side effects of epinephrine were not observed.
Conclusion: In children with postintubation croup, the administration of NLE at the dose of 0.05 mL/kg results in similar improvements in the UAO scores, compared with the dose of 0.5 mL/kg. No complications were seen in either dose.

Keyword : Aerosol, Children, Croup, Epinephrine, Intubation, Upper airway obstruction

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