Key articles

Johnson D, Klassen T, Kellner J. Diagnosis and management of croup: Alberta Medical Association clinical practice guidelines. Alberta: Alberta Medical Association; 2015 [internet publication].Full text

Reference articles

1. Denny FW, Murphy TF, Clyde WA Jr, et al. Croup: an 11-year study in a pediatric practice. Pediatrics. 1983 Jun;71(6):871-6. Abstract

2. Tong MC, Chu MC, Leighton SE, et al. Adult croup. Chest. 1996 Jun;109(6):1659-62.Full text  Abstract

3. Marx A, Torok TJ, Holman RC, et al. Pediatric hospitalizations for croup (laryngotracheobronchitis): biennial increases associated with human parainfluenza virus 1 epidemics. J Infect Dis. 1997 Dec;176(6):1423-7. Abstract

4. Chapman RS, Henderson FW, Clyde WA Jr, et al. The epidemiology of tracheobronchitis in pediatric practice. Am J Epidemiol. 1981 Dec;114(6):786-97. Abstract

5. Williams JV, Harris PA, Tollefson SJ, et al. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Engl J Med. 2004 Jan 29;350(5):443-50. Abstract

6. Van der Hoek L, Sure K, Ihorst G, et al. Human coronavirus NL63 infection is associated with croup. Adv Exp Med Biol. 2006;581:485-91. Abstract

7. D'Souza RM, D'Souza R. Vitamin A for preventing secondary infections in children with measles - a systematic review. J Trop Pediatr. 2002 Apr;48(2):72-7. Abstract

8. Hussey GD, Klein M. A randomized, controlled trial of vitamin A in children with severe measles. N Engl J Med. 1990 Jul 19;323(3):160-4. Abstract

9. Havaldar PV. Dexamethasone in laryngeal diphtheritic croup. Ann Trop Paediatr. 1997 Mar;17(1):21-3. Abstract

10. Kapustian VA, Boldyrev VV, Maleev VV, et al. The local manifestations of diphtheria [in Russian]. Zh Mikrobiol Epidemiol Immunobiol. 1994 Jul-Aug;(4):19-22. Abstract

11. Platonova TV, Korzhenkova MP. Clinical aspects of diphtheria in infants [in Russian]. Pediatriia. 1991;(6):15-20. Abstract

12. Pokrovskii VI, Ostrovskii NN, Astaf'eva NV, et al. Croup in toxic forms of diphtheria in adults [in Russian]. Ter Arkh. 1985;57(5):119-22. Abstract

13. Russell K. Risk factors for predicting severe croup and bacterial tracheitis (master's thesis). 2006. Edmonton, AB: University of Alberta.

14. Cherry J. Croup (laryngitis, laryngotracheitis, spasmodic croup, laryngotracheobronchitis, bacterial tracheitis, and laryngotracheobronchopneumonitis). In: Feigin R, ed. Textbook of pediatric infectious diseases, 5th ed. Philadelphia, PA: Elsevier, 2004:252-65.

15. Davis G. An examination of the physiological consequences of chest wall distortion in infants with croup. Calgary: University of Calgary, 1985.

16. Davis G, Cooper D, Mitchell I. The measurement of thoraco-abdominal asynchrony in infants with severe laryngotracheobronchitis. Chest. 1993 Jun;103(6):1842-8.Full text  Abstract

17. Crowe JE Jr. Current approaches to the development of vaccines against disease caused by respiratory syncytial virus (RSV) and parainfluenza virus (PIV). A meeting report of the WHO Programme for Vaccine Development. Vaccine. 1995 Mar;13(4):415-21. Abstract

18. Belshe RB, Newman FK, Anderson EL, et al. Evaluation of combined live, attenuated respiratory syncytial virus and parainfluenza 3 virus vaccines in infants and young children. J Infect Dis. 2004 Dec 15;190(12):2096-103. Abstract

19. Johnson D, Klassen T, Kellner J. Diagnosis and management of croup: Alberta Medical Association clinical practice guidelines. Alberta: Alberta Medical Association; 2015 [internet publication].Full text

20. Smith DK, McDermott AJ, Sullivan JF. Croup: diagnosis and management. Am Fam Physician. 2018 May 1;97(9):575-80.Full text  Abstract

21. Sofer S, Duncan P, Chernick V. Bacterial tracheitis - an old disease rediscovered. Clin Pediatr (Phila). 1983 Jun;22(6):407-11. Abstract

22. Jones R, Santos JI, Overall JC Jr. Bacterial tracheitis. JAMA. 1979 Aug 24-31;242(8):721-6. Abstract

23. Donnelly BW, McMillan JA, Weiner LB. Bacterial tracheitis: report of eight new cases and review. Rev Infect Dis. 1990 Sep-Oct;12(5):729-35. Abstract

24. Al-Mutairi B, Kirk V. Bacterial tracheitis in children: approach to diagnosis and treatment. Paediatr Child Health. 2004 Jan;9(1):25-30.

25. Kasian GF, Bingham WT, Steinberg J, et al. Bacterial tracheitis in children. CMAJ. 1989 Jan 1;140(1):46-50.Full text  Abstract

26. Bernstein T, Brilli R, Jacobs B. Is bacterial tracheitis changing? A 14-month experience in a pediatric intensive care unit. Clin Infect Dis. 1998 Sep;27(3):458-62. Abstract

27. Wong VK, Mason WH. Branhamella catarrhalis as a cause of bacterial tracheitis. Pediatr Infect Dis J. 1987 Oct;6(10):945-6. Abstract

28. Brook I. Aerobic and anaerobic microbiology of bacterial tracheitis in children. Pediatr Emerg Care. 1997 Feb;13(1):16-8. Abstract

29. Midwinter K, Hodgson D, Yardley M. Paediatric epiglottitis: the influence of the Haemophilus influenzae b vaccine, a ten-year review in the Sheffield region. Clin Otolaryngol. 1999 Sep;24(5):447-8. Abstract

30. Gonzalez Valdepena H, Wald E, Rose E, et al. Epiglottitis and Haemophilus influenzae immunization: the Pittsburgh experience - a five-year review. Pediatrics. 1995 Sep;96(3 Pt 1):424-7. Abstract

31. Gorelick M, Baker M. Epiglottitis in children, 1979 through 1992. Effects of Haemophilus influenzae type b immunization. Arch Pediatr Adolesc Med. 1994 Jan;148(1):47-50. Abstract

32. Tunnessen W. Respiratory system: stridor - signs and symptoms in pediatrics. Philadelphia: JB Lippincott, 1983.

33. Innes-Asher M. Infections of the upper respiratory tract. In: Taussig L, Landau L, eds. Pediatric respiratory medicine. St Louis: Mosby, 1999: 530-47.

34. Westley CR, Cotton EK, Brooks JG. Nebulized racemic epinephrine by IPPB for the treatment of croup: a double-blind study. Am J Dis Child. 1978 May;132(5):484-7. Abstract

35. Yang WC, Lee J, Chen CY, et al. Westley score and clinical factors in predicting the outcome of croup in the pediatric emergency department. Pediatr Pulmonol. 2017 Oct;52(10):1329-34. Abstract

36. Chan AKJ, Langley JM, LeBlanc JC. Interobserver variability of croup scoring in clinical practice. Paediatr Child Health. 2001 Jul;6(6):347-51.

37. Ortiz-Alvarez O. Acute management of croup in the emergency department. Paediatr Child Health. 2017 Jun;22(3):166-73.Full text  Abstract

38. Rizos JD, DiGravio BE, Sehl MJ, et al. The disposition of children with croup treated with racemic epinephrine and dexamethasone in the emergency department. J Emerg Med. 1998 Jul-Aug;16(4):535-9. Abstract

39. Johnson DW, Jacobson S, Edney PC, et al. A comparison of nebulized budesonide, intramuscular dexamethasone, and placebo for moderately severe croup. N Engl J Med. 1998 Aug 20;339(8):498-503. Abstract

40. Ledwith C, Shea L, Mauro R. Safety and efficacy of nebulized racemic epinephrine in conjunction with oral dexamethasone and mist in the outpatient treatment of croup. Ann Emerg Med. 1995 Mar;25(3):331-7. Abstract

41. Kunkel NC, Baker MD. Use of racemic epinephrine, dexamethasone, and mist in the outpatient management of croup. Pediatr Emerg Care. 1996 Jun;12(3):156-9. Abstract

42. Prendergast M, Jones JS, Hartman D. Racemic epinephrine in the treatment of laryngotracheitis: can we identify children for outpatient therapy? Am J Emerg Med. 1994 Nov;12(6):613-6. Abstract

43. Kelley PB, Simon JE. Racemic epinephrine use in croup and disposition. Am J Emerg Med. 1992 May;10(3):181-3. Abstract

44. Corneli H, Bolte R. Outpatient use of racemic epinephrine in croup. Am Fam Physician. 1992 Sep;46(3):683-4. Abstract

45. Kaditis AG, Wald ER. Viral croup: current diagnosis and treatment. Pediatr Infect Dis J. 1998 Sep;17(9):827-34. Abstract

46. Klassen TP. Croup. A current perspective. Pediatr Clin North Am. 1999 Dec;46(6):1167-78. Abstract

47. Brown JC. The management of croup. Br Med Bull. 2002 Mar;61(1):189-202.Full text  Abstract

48. Geelhoed GC. Croup. Pediatr Pulmonol. 1997 May;23(5):370-4. Abstract

49. Sofer S, Dagan R, Tal A. The need for intubation in serious upper respiratory tract infection in pediatric patients (a retrospective study). Infection. 1991 May-Jun;19(3):131-4. Abstract

50. Sendi K, Crysdale WS, Yoo J. Tracheitis: outcome of 1,700 cases presenting to the emergency department during two years. J Otolaryngol. 1992 Feb;21(1):20-4. Abstract

51. Tan AK, Manoukian JJ. Hospitalized croup (bacterial and viral): the role of rigid endoscopy. J Otolaryngol. 1992 Feb;21(1):48-53. Abstract

52. Dawson KP, Mogridge N, Downward G. Severe acute laryngotracheitis in Christchurch 1980-90. N Z Med J. 1991 Sep 11;104(919):374-5. Abstract

53. Tibballs J, Shann FA, Landau LI. Placebo-controlled trial of prednisolone in children intubated for croup. Lancet. 1992 Sep 26;340(8822):745-8. Abstract

54. Klassen TP, Feldman ME, Watters LK, et al. Nebulized budesonide for children with mild-to-moderate croup. N Engl J Med. 1994 Aug 4;331(5):285-9. Abstract

55. Geelhoed GC, Macdonald WB. Oral and inhaled steroids in croup: a randomized, placebo-controlled trial. Pediatr Pulmonol. 1995 Dec;20(6):355-61. Abstract

56. Geelhoed GC. Sixteen years of croup in a Western Australian teaching hospital: effects of routine steroid treatment. Ann Emerg Med. 1996 Dec;28(6):621-6. Abstract

57. Bjornson CL, Klassen TP, Williamson J, et al. A randomized trial of a single dose of oral dexamethasone for mild croup. N Engl J Med. 2004 Sep 23;351(13):1306-13. Abstract

58. Kairys SW, Marsh-Olmstead EM, O'Connor GT. Steroid treatment of laryngotracheitis: a meta-analysis of the evidence from randomized trials. Pediatrics. 1989 May;83(5):683-93. Abstract

59. Aregbesola A, Tam CM, Kothari A, et al. Glucocorticoids for croup in children. Cochrane Database Syst Rev. 2023 Jan 10;1(1):CD001955.Full text  Abstract

60. Geelhoed GC. Budesonide offers no advantage when added to oral dexamethasone in the treatment of croup. Pediatr Emerg Care. 2005 Jun;21(6):359-62. Abstract

61. Schimmer B, Parker K. Adrenocorticotropic hormone: adrenocortical steroids and their synthetic analogs - inhibitors of the synthesis and actions of adrenocortical hormones. In: Brunton L, Lazo J, Parker K, eds. Goodman and Gilman's the pharmacological basis of therapeutics. Columbus: McGraw-Hill, 2006:1587-612.

62. Klassen TP, Craig WR, Moher D, et al. Nebulized budesonide and oral dexamethasone for treatment of croup: a randomized controlled trial. JAMA. 1998 May 27;279(20):1629-32.Full text  Abstract

63. Pedersen LV, Dahl M, Falk-Petersen HE, et al. Inhaled budesonide versus intramuscular dexamethasone in the treatment of pseudo-croup [in Danish]. Ugeskr Laeger. 1998 Apr 6;160(15):2253-6. Abstract

64. Cetinkaya F, Tufekci BS, Kutluk G. A comparison of nebulized budesonide, and intramuscular, and oral dexamethasone for treatment of croup. Int J Pediatr Otorhinolaryngol. 2004 Apr;68(4):453-6. Abstract

65. Dowell SF, Bresee JS. Severe varicella associated with steroid use. Pediatrics. 1993;92:223-228. Abstract

66. Patel H, Macarthur C, Johnson D. Recent corticosteroid use and the risk of complicated varicella in otherwise immunocompetent children. Arch Pediatr Adolesc Med. 1996;150:409-414. Abstract

67. Adair JC, Ring WH, Jordan WS, et al. Ten-year experience with IPPB in the treatment of acute laryngotracheobronchitis. Anesth Analg. 1971 Jul-Aug;50(4):649-55. Abstract

68. Bjornson C, Russell K, Vandermeer B, et al. Nebulized epinephrine for croup in children. Cochrane Database Syst Rev. 2013 Oct 10;(10):CD006619.Full text  Abstract

69. Fogel JM, Berg IJ, Gerber MA, et al. Racemic epinephrine in the treatment of croup: nebulization alone versus nebulization with intermittent positive pressure breathing. J Pediatr. 1982 Dec;101(6):1028-31. Abstract

70. Taussig LM, Castro O, Beaudry PH, et al. Treatment of laryngotracheobronchitis (croup). Use of intermittent positive-pressure breathing and racemic epinephrine. Am J Dis Child. 1975 Jul;129(7):790-3. Abstract

71. Steele DW, Santucci KA, Wright RO, et al. Pulsus paradoxus: an objective measure of severity in croup. Am J Respir Crit Care Med. 1998 Jan;157(1):331-4.Full text  Abstract

72. Fanconi S, Burger R, Maurer H, et al. Transcutaneous carbon dioxide pressure for monitoring patients with severe croup. J Pediatr. 1990 Nov;117(5):701-5. Abstract

73. Corkey CW, Barker GA, Edmonds JF, et al. Radiographic tracheal diameter measurements in acute infectious croup: an objective scoring system. Crit Care Med. 1981 Aug;9(8):587-90. Abstract

74. Gardner HG, Powell KR, Roden VJ, et al. The evaluation of racemic epinephrine in the treatment of infectious croup. Pediatrics. 1973 Jul;52(1):52-5. Abstract

75. Waisman Y, Klein BL, Boenning DA, et al. Prospective randomized double-blind study comparing L-epinephrine and racemic epinephrine aerosols in the treatment of laryngotracheitis (croup). Pediatrics. 1992 Feb;89(2):302-6. Abstract

76. Janssens HM, Krijgsman A, Verbraak TF, et al. Determining factors of aerosol deposition for four pMDI-spacer combinations in an infant upper airway model. J Aerosol Med. 2004 Spring;17(1):51-61. Abstract

77. Fink JB. Aerosol delivery to ventilated infant and pediatric patients. Respir Care. 2004 Jun;49(6):653-65. Abstract

78. Schuepp KG, Straub D, Moller A, et al. Deposition of aerosols in infants and children. J Aerosol Med. 2004;17(2):153-6. Abstract

79. Wildhaber JH, Monkhoff M, Sennhauser FH. Dosage regimens for inhaled therapy in children should be reconsidered. J Paediatr Child Health. 2002 Apr;38(2):115-6. Abstract

80. Kristjansson S, Berg-Kelly K, Winso E. Inhalation of racemic adrenaline in the treatment of mild and moderately severe croup. Clinical symptom score and oxygen saturation measurements for evaluation of treatment effects. Acta Paediatr. 1994 Nov;83(11):1156-60. Abstract

81. Chub-Uppakarn S, Sangsupawanich P. A randomized comparison of dexamethasone 0.15 mg/kg versus 0.6 mg/kg for the treatment of moderate to severe croup. Int J Pediatr Otorhinolaryngol. 2007 Mar;71(3):473-7. Abstract

82. Weber JE, Chudnofsky CR, Younger JG, et al. A randomized comparison of helium-oxygen mixture (Heliox) and racemic epinephrine for the treatment of moderate to severe croup. Pediatrics. 2001 Jun;107(6):E96.Full text  Abstract

83. Zhang L, Sanguebsche LS. The safety of nebulization with 3 to 5 ml of adrenaline (1:1000) in children: an evidence based review. J Pediatr (Rio J). 2005 May-Jun;81(3):193-7.Full text  Abstract

84. Butte MJ, Nguyen BX, Hutchison TJ, et al. Pediatric myocardial infarction after racemic epinephrine administration. Pediatrics. 1999;104:e9.Full text  Abstract

85. Henry R. Moist air in the treatment of laryngotracheitis. Arch Dis Child. 1983 Aug;58(8):577.Full text  Abstract

86. Lenney W, Milner AD. Treatment of acute viral croup. Arch Dis Child. 1978 Sep;53(9):704-6.Full text  Abstract

87. Bourchier D, Dawson KP, Fergusson DM. Humidification in viral croup: a controlled trial. Aust Paediatr J. 1984 Nov;20(4):289-91. Abstract

88. Skolnik N. Treatment of croup. A critical review. Am J Dis Child. 1989 Sep;143(9):1045-9. Abstract

89. Neto GM, Kentab O, Klassen TP, et al. A randomized controlled trial of mist in the acute treatment of moderate croup. Acad Emerg Med. 2002 Sep;9(9):873-9. Abstract

90. Lavine E, Scolnik D. Lack of efficacy of humidification in the treatment of croup. Why do physicians persist in using an unproven modality? CJEM. 2001 Jul;3(3):209-12. Abstract

91. Greally P, Cheng K, Tanner MS, et al. Children with croup presenting with scalds. BMJ. 1990 Jul 14;301(6743):113.Full text  Abstract

92. Terregino CA, Nairn SJ, Chansky ME, et al. The effect of Heliox on croup: a pilot study. Acad Emerg Med. 1998 Nov;5(11):1130-3. Abstract

93. Moraa I, Sturman N, McGuire TM, et al. Heliox for croup in children. Cochrane Database Syst Rev. 2018 Oct 29;10:CD006822.Full text  Abstract

94. Gupta VK, Cheifetz IM. Heliox administration in the pediatric intensive care unit: an evidence-based review. Pediatr Crit Care Med. 2005 Mar;6(2):204-11. Abstract

95. Kemper KJ, Ritz RH, Benson MS, et al. Helium-oxygen mixture in the treatment of postextubation stridor in pediatric trauma patients. Crit Care Med. 1991 Mar;19(3):356-9. Abstract

96. Duncan PG. Efficacy of helium-oxygen mixtures in the management of severe viral and post-intubation croup. Can Anaesth Soc J. 1979 May;26(3):206-12. Abstract

97. Beckmann KR, Brueggemann WM Jr. Heliox treatment of severe croup. Am J Emerg Med. 2000 Oct;18(6):735-6. Abstract

98. McGee DL, Wald DA, Hinchliffe S. Helium-oxygen therapy in the emergency department. J Emerg Med. 1997 May-Jun;15(3):291-6. Abstract

99. DiCecco RJ, Rega PP. The application of heliox in the management of croup by an air ambulance service. Air Med J. 2004 Mar-Apr;23(2):33-5. Abstract

100. Johnson D, Williamson J. Croup: duration of symptoms and impact on family functioning. Pediatr Res. 2001;49:83A.

101. Johnson DW, Schuh S, Koren G, et al. Outpatient treatment of croup with nebulized dexamethasone. Arch Pediatr Adolesc Med. 1996 Apr;150(4):349-55. Abstract

Use of this content is subject to our disclaimer