How should severe respiratory distress or compromise from croup be treated?

Updated: Oct 09, 2019
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Answer

Infants and children with severe respiratory distress or compromise may require oxygenation with ventilation support, initially with a bag-valve-mask device. If the airway and breathing require further stabilization due to increasing respiratory fatigue and hence, worsening hypercarbia, (as evident by ABG), the patient should be intubated with an endotracheal tube. Intubation should be accomplished with an endotracheal tube that is 0.5-1 mm smaller than predicted. Once airway stabilization is achieved, these patients are transferred for their ongoing care to a pediatric intensive care unit.


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