Humidified air inhalation for treating croup: a systematic review and meta-analysis

Abstract

Moore M, Little P. Humidified air inhalation for treating croup: a systematic review and metaanalysis. Family Practice 2007; 24: 295-301. Background. Croup (laryngotracheobronchitis) is a common cause of upper airway obstruction in children. Treatment with humidified air was previously widely used and is still commonly recommended as home treatment.Objective. To assess the efficacy of humidified air in the treatment of croup. Design. Systematic review and meta-analysis.Data sources. We searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE. Review methods. We included randomized controlled trials with or without blinding. All studies treating children with a clinical diagnosis of croup with warm or cool humidified air delivered by steam or humidified tent whether inpatients, attenders at the Emergency Department or in the community were eligible.Main results. Three studies in emergency settings provided data on 135 patients with moderate croup for the main outcome (croup score). The combined results from 20 to 60 minutes in the three studies marginally favoured the treatment group with a weighted standardized mean difference of -0.14 (95% confidence interval = -0.75 to 0.47). No outcomes were significantly different between the groups.Conclusions. The croup score of children managed in an emergency setting with mild to moderate croup probably does not improve greatly with inhalation of humidified air. There is insufficient evidence to exclude either a small beneficial or a harmful effect.

Subglottic laryngitis – Changes in therapy approach over the past 20 years

“…In this particular case it was combined with other treatment and neither ENT nor paediatricians used it as the only treatment option. Current literature shows no evidence that humidification therapy alone could be useful in the treatment of moderate to severe subglottic laryngitis [3][4][5]31].…”

Infectious Diseases in Children

“…A recent Cochrane review concluded that croup score in children with mild to moderate croup does not improve greatly with inhalation of humidified air [15].…”

Viral croup: Diagnosis and a treatment algorithm

“…Humidified air has been used historically to treat hospitalized children with croup. In a meta‐analysis of three randomized controlled trials, which assessed the efficacy of humidified air relative to room air, there was no improvement in cases of mild‐to‐moderate croup …”