Abstract
There is little evidence that any medication is helpful in acute viral croup but few studies have attempted objective measurement of the stridor before and after treatment. We have devised a small microphone which can be easily attached to the child's neck by double sided adhesive tape. The microphone predominantly responds to vibration and is unresponsive to external sounds. Tape recordings were made before and 15 minutes after nebulised therapy. The response to nebulised adrenaline, ipratropium bromide, xylometazoline clemastine and placebo were observed in a double blind manner. Inspiratory and expiratory components were separated by listening to the tape whilst concurrently viewing the output on a BBC microcomputer vide display unit (VDU). The measurement was expressed by integrating the sound amplitude over the period of inspiratory noise. There was little response to any medication in children under 2 years of age but the response increased with age. Improvement in the microphone trace correlated well with clinical improvement. Conclusion - We present evidence to show that medications (especially adrenaline) can be helpful in acute viral croup in children over 2 years of age.
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