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Humidity and Viral Croup: No Value in Any Form

The commonly accepted treatment for croup was found to have no benefit.

Humidity, in various forms and delivered by various means, has long been recommended for viral croup despite a lack of proven benefit. Investigators in Toronto studied the potential benefit of humidity created to deliver water droplets sized to target the larynx. They randomized 140 children (mean age, 25 months) with moderate-to-severe viral croup to receive treatment with blow-by humidity (considered equivalent to breathing room air), controlled delivery of 40% humidity, or a special mechanism to deliver 100% humidity in 5-µm to 10-µm particles.

All patients were treated for 30 minutes after baseline assessment in an emergency department. At the end of treatment and 30 minutes later, no significant differences were found among the three groups in the changes in an overall croup score, respiratory rate, heart rate, or oxygen saturation, or in the likelihood of hospitalization, need for steroids, or need for epinephrine.

Comment: The study's authors argue emphatically that these data should end the use of humidity to treat viral croup. Whether such a time-honored approach can be stopped so easily is unclear, however.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine March 24, 2006

Citation(s):

Scolnik D et al. Controlled delivery of high vs low humidity vs mist therapy for croup in emergency departments: A randomized controlled trial. JAMA 2006 Mar 15; 295:1274-80.

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