Management of croup in children

Croup or laryngitis is the most common cause of acute stridor in childhood. It accounts for 15% of pediatric respiratory admission in the emergency department (ED). Most children presenting with an acute onset of barky cough, stridor and indrawing have croup. The differential diagnosis, among other forms of acute obstruction of the larynx (e.g., epiglottitis, foreign body, angioneurotic oedema of the epiglottis), is essential and lifesaving. Corticosteroids are the mainstay of treatment in children with croup of all levels of severity. Nebulized epinephrine is an accepted treatment in patients with moderate to severe croup. Patient management remains of fundamental importance, is necessary to keep children calm by ensuring a relaxed and reassuring atmosphere to minimize oxygen demand and respiratory muscle fatigue.