Journal Article Summary

The article I chose is a prospective, double-blind, non-inferiority randomized controlled trial that investigated the use of different corticosteroids and doses and their efficacy for treating croup in the emergency department. Specifically, it compared dexamethasone at 6.0 mg/kg with both low-dose dexamethasone at 0.15 mg/kg and prednisolone at 1 mg/kg. In this study, 1252 participants were enrolled and met the inclusion criteria. Patients were randomly assigned to 1 of the 3 aforementioned interventions. The primary outcome measures included the Westley Croup Score 1-hour after treatment and emergent recurrent medical attention during the 7 days after treatment. To understand the meaning of the outcomes, the articles defines the Westly Croup Score (WCS). The WCS is a clinical scoring system with a range of 0-17 points based on stridor, retractions, air entry, cyanosis and level of consciousness. The WCS was assessed at baseline, 1 hour after treatment , hourly up to 6 hours, and then again at 12 hours. The results showed no statistical significance between the 3 interventions at any time period of reassessment. There also wasn’t any statistical significance for ED-reattendance rates. The study concluded that is safe and acceptable to use any of the 3 interventions, however, those use prednisolone are more likely to need additional doses compared to those who receive dexamethasone who only need a single dose.