Croup is one of the most common and potentially serious viral respiratory infections in kids. It’s typically treated with humidified air to sooth the airways.
But does that treatment really work?
In kids, croup is the most common cause of difficulty breathing due to airway obstruction in kids. In fact, it’s diagnosed in up to five percent, or one in twenty kids under the age of six.
19 month old Angelina Molina is healthy now, but a month ago, she was suddenly one sick kid.
“At four in the morning she woke up and was she couldn’t breathe and coughing, like a bark, like a barking dog,” says Veronica Molina, Angelina’s mom.
Angelina had a classic case of croup.
It’s a viral infection of the larynx, or voice box, and the trachea, or windpipe, that causes inflammation of the tissues, swelling, and obstruction…which is why when air passes through, the child has a seal-like sounding cough.
Dr. Adam Vella, a pediatric emergency specialist at Mt. Sinai Medical Center, “Typically it is very frightening for the parent because a child will be well and then all of a sudden will develop a barking sort of a high pitched like cough, and then they will go to bed comfortably and then all of a sudden wake up with this high pitched cough and they may have difficulty moving the area in and out during the episode.”
Steam, which provides humidity, has been thought to be helpful, because it, in theory, soothes the inflamed larynx and decreases the thickness of secretions.
This steam is delivered either in a nebulizer form like this, or with a face mask, or by simply using humidifiers.
“She felt like she couldn’t breathe, she was gasping for air, so I started up the shower with the steam, obviously that didn’t help much,” recalls Veronica.
And neither did nebulizer treatment like this in the emergency room.
But now, new research in the Journal of the American Medical Association shows all that water vapor is just a bunch of hot air, figuratively speaking.
The researchers looked at the use of humidity for children with moderate to severe croup.
The kids studied, who were admitted to the E.R., got varying degrees of intensity of humidified air.
Regardless of the technique or the amount of humidity, there was no difference in terms of clinical improvement. The kids didn’t get any better with the high humidity.
That means using humidifiers at home also isn’t going to do a bit of good.
Dr. Vella used to recommend humidified air, but what about now? “It just changes our management. As far as actually treating the upper airway and inflammation there is no effect from humidified air so at this point I wouldn’t recommend using it,” he says.
According to the researchers, one percent of all kids with croup are hospitalized.
Croup usually is not fatal…
It will peak in severity around 3-5 days into the illness, and it’s usually over and done with in about a week or less.
A dose of steroids can help, all kids pretty much are given this, and patients who are in severe distress can get steamed adrenaline, or epinephrine; that can reverse a serious situation.