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Friday, 16. May 2014

Nebulised epinephrine for croup in children

A current Cochrane review assessed the applicability of nebulised epinephrine versus placebo for practice in children with croup.

Mädchen inhaliert mit dem PARI XLent

Croup is a common disease in childhood characterized by barky cough, stridor, hoarseness and respiratory distress. Children with severe croup are at risk for intubation. Nebulised epinephrine may prevent intubation.

A current Cochrane review assessed the applicability of nebulised epinephrine versus placebo for practice in children with croup.
Eight studies (225 participants) were included. Epinephrine was nebulised alone or as concurrent medication.  In general, children less than two years, were included.

Authors' conclusion:

  • Nebulized epinephrine may be used to treat obstructive airway symptoms associated with moderate to severe croup.
  • The clinical effect of nebulized epinephrine is apparent at 30 minutes post-treatment.
  • There is no evidence to suggest that croup symptoms, on average, worsen after the treatment effect of nebulized epinephrine dissipates.


Bjornson et al. Cochrane Database Syst Rev. 2013 Oct 10;10:CD006619


For an optimal drug deposition in the upper airways tract, extra large particles are needed. The new PARI XLent can optimize the treatment with an average particle size of 7.3 µm and is thus especially suitable for the treatment of croup.
The PARI XLent is the latest device of the well-proven PARI product family and is now available!