Outdoor cold air versus room temperature exposure for croup symptoms : a randomized controlled trial

Article Article scientifique Article Outdoor cold air versus room temperature exposure for croup symptoms : a randomized controlled trial eng 2023-09-01 author Siebert Johan 0000-0002-2871-3382 Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 507348 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Salomon Coralie Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland. 585899 author Taddeo Ilaria Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland. 848239 author Gervaix Alain Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 31715 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Combescure Christophe 0000-0003-2631-4780 Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva and Geneva University Hospital, Geneva, Switzerland. 670542 Centre de recherche clinique HUG-FACMED (CRCHF) author Lacroix Laurence Elisabeth Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 84201 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) e2023061365 10.1542/peds.2023-061365 37525974 0031-4005 https://publications.aap.org/pediatrics/article/152/3/e2023061365/193257/Outdoor-Cold-Air-Versus-Room-Temperature-Exposure Objectives: Croup is the most common cause of acute upper airway obstruction in children. The benefits of treating croup with steroids are well established, with an onset of effect 30 minutes after administration. We investigated whether a 30-minute exposure to outdoor cold air might improve mild to moderate croup symptoms before the onset of action of steroids. Methods: This open-label, single-center, randomized controlled trial, enrolled children aged 3 months to 10 years with croup and a Westley Croup Score (WCS) ≥2 attending a tertiary pediatric emergency department. Participants were randomized (1:1) to either a 30-minute exposure to outdoor cold (<10°C) atmospheric air or to indoor ambient room air immediately after triage and administration of a single-dose oral dexamethasone. The primary endpoint was a decrease in WCS ≥2 points from baseline at 30 minutes. Analyses were intention to treat. Results: A total of 118 participants were randomly assigned to be exposed to outdoor cold air (n = 59) or indoor room temperature (n = 59). Twenty-nine of 59 children (49.2%) in the outdoor group and 14 of 59 (23.7%) in the indoor group showed a decrease in WCS ≥2 points from baseline at 30 minutes after triage (risk difference 25.4% [95% confidence interval 7.0-43.9], P = .007). Patients with moderate croup benefited the most from the intervention at 30 minutes (risk difference 46.1% [20.6-71.5], P < .001). Conclusions: A 30-minute exposure to outdoor cold air (<10°C), as an adjunct to oral dexamethasone, is beneficial for reducing the intensity of clinical symptoms in children with croup, especially when moderate. Child Humans Infant Croup / drug therapy Croup / etiology Temperature Dexamethasone / therapeutic use Glucocorticoids / therapeutic use Emergency Service, Hospital Dewey 618 217 Centre de recherche clinique 201 58 Département de pédiatrie, gynécologie et obstétrique 223 false 88 Epidémiologie clinique et biostatistique 115 149 Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile 183 Pediatrics 152 3 21b9686b-53af-43a1-8ab2-6006c301c0d9 Article (Published version) Public Combescure_Pediatrics_sept23.pdf 875632 application/pdf ed09ae53740117f281e89a725e55b42348e1c4edeaae2a5d5d0229be0a59aad7 1807b634-6b1b-4a89-8571-90b7cc7196c6 Supplemental data Public peds.2023-061365supplementarydata.pdf 482382 application/pdf 0ecc61afdc5ab68ac2f55b7f9b4bfdcbc63a8afddaaf8264482494a5ee143dce 1c3eaf94-5645-4a2d-8697-1f40f0a42e76 Erratum Public peds.2023-065508.pdf 440405 application/pdf 9555cc47d77b7faab95bf936044f317162235ca0ecd082783fe1d84b31d39206 Statement of Correction: Outdoor Cold Air Versus Room Temperature Exposure for Croup Symptoms: A Randomized Controlled Trial. Pediatrics. 2024 Mar 1;153(3):e2023065508. doi: 10.1542/peds.2023-065508. Erratum for: Pediatrics. 2023 Sep 1;152(3): PMID: 38415304. 10.1542/peds.2023-065508 38415304 openAccess Faculté de médecine / Centre de recherche clinique Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

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