July 25, 2006

Humidified air does little to calm kids’ croup

NEW YORK (Reuters Health) - Traditionally, humidified air
has been thought to relieve the barking, hoarse cough of
childhood croup, but a new review of studies on the topic finds
the remedy has little actual benefit.

Croup is a set of symptoms usually caused by a viral
infection that causes swelling of the voice box in the upper
part of the airway. Infants and toddlers are especially prone
to croup because their upper airways are narrower than that of
older children and adults.

For croup, "typically you get people to run a hot bath or
shower in the bathroom," or use other mean to create humidity,
lead reviewer Dr. Michael Moore said in a statement. "That's
the kind of first-aid advice that is often given at the point
of first contact with a health care professional."

Moore, a family doctor at Three Swans Surgery in Salisbury,
England, and his team reviewed three studies involving 135
children with croup who were treated in the emergency room with
humidified air or no treatment.

The combined results of these three studies only
"marginally favored" breathing humid air as a treatment for
croup, reports the latest issue of The Cochrane Library, a
publication of The Cochrane Collaboration, an international
organization that evaluates research in health care.

None of the trials evaluated humid air treatments given at
home. According to Moore, "there's no particular reason to
think that (humidified air) would work better at home."
Nonetheless, he believes more research in the community setting
is needed.

"I think that probably the successes that were attributed
to humidity in the past were due to the calming effect of the
parent believing that they were doing something, the child
taking deeper breaths, the child getting over the spasmodic
element of the croup, and then just getting better," said Dr.
Dennis Scolnik, a pediatrician from The Hospital for Sick
Children/Toronto in Ontario, Canada.

"I think humidity probably won't harm. But I think it's a
false sense of security," Scolnik said.

In cases of severe croup, children may be admitted to the
hospital where steroids given by mouth or by mist are known to
be effective.

"I think what we are saying is that there's no real place
for moist air in the emergency room as a treatment for croup,"
Moore said. If a child is unwell enough for treatment, "you
might as well go ahead with a definitive treatment," he added.

SOURCE: The Cochrane Review 2006.