***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To determine whether dexamethasone prevents postextubation airway obstruction in young children . DESIGN Prospect i ve , r and omized , double-blind , placebo-controlled study . SETTING Pediatric intensive care unit of a university teaching hospital . PATIENTS Sixty-six children , < 5 yrs of age , intubated and mechanically ventilated for > 48 hrs . INTERVENTIONS Patients were r and omized to receive intravenous dexamethasone ( 0.5 mg/kg , maximum dose 10 mg ) or saline , every 6 hrs for six doses , beginning 6 to 12 hrs before elective extubation . MEASUREMENTS AND MAIN RESULTS Dependent variables included the presence of stridor , Croup Score , and pulsus paradoxus at 10 mins , 6 , 12 , and 24 hrs after extubation ; need for aerosolized racemic epinephrine and reintubation . The dexamethasone and placebo groups were similar in age ( median 3 months [ range 1 to 57 ] vs. 4 months [ range 1 to 59 ] , p = .6 ) , frequency of underlying airway anomalies ( 3/33 vs. 3/33 , p = 1.0 ) , and duration of mechanical ventilation ( median 3.3 days [ range 2.1 to 39 ] vs. 3.5 days [ range 2.1 to 15 ] , p = .7 ) . The dexamethasone group had a lower frequency of stridor , Croup Score , and pulsus paradoxus measurement at 10 mins and at 6 and 12 hrs after extubation . Fewer dexamethasone-treated patients required epinephrine aerosol ( 4/31 vs. 22/32 , p < .0001 ) and reintubation ( 0/31 vs. 7/32 , p < .01 ) . Three patients exited the study early-one patient in the dexamethasone group had occult gastrointestinal hemorrhage and one patient in each group had hypertension . CONCLUSION Pretreatment with dexamethasone decreases the frequency of postextubation airway obstruction in children STUDY OBJECTIVE To identify patients with croup who after treatment with nebulized racemic epinephrine , oral dexamethasone , and mist  may be safely discharged home after a period of observation . DESIGN Prospect i ve interventional . SETTING Urban children 's hospital emergency department . PARTICIPANTS Children with croup who received racemic epinephrine for the treatment of stridor at rest . INTERVENTIONS After treatment with .5 mL racemic epinephrine , .6 mg/kg dexamethasone PO , and mist , patients who were assessed as being safe for discharge after 3 hours of observation were discharged home and contacted for 48-hour follow-up . RESULTS Fifty-five patients with croup were treated with racemic epinephrine . Thirty patients ( 55 % ) had sustained responses and were discharged home after 3 hours of observation . No recurrence of respiratory distress and no return visits for medical care were reported ( 95 % confidence interval , 0 % to 8.0 % ) . CONCLUSION Patients with croup who are treated with racemic epinephrine , oral dexamethasone , and mist may be safely discharged home if the patient is assessed as ready for discharge after 3 hours of observation BACKGROUND Although previous studies have shown that dexamethasone is useful in croup , the optimal dosage has not been clarified yet . The aim of this study was to investigate the effectiveness of dexamethasone 0.15 mg/kg single dose compared with the recommended dose of 0.6 mg/kg for treatment of hospitalized children with moderate to severe croup . METHOD Forty-one children aged 6 months to 5 years admitted from March 2001 to October 2003 at the pediatric ward of Hatyai Hospital with moderate to severe croup were recruited for the study . After r and om allocation , each child received a single intravenous injection of either dexamethasone 0.6 mg/kg ( maximum dose 12 mg ) or 0.15 mg/kg ( maximum dose 3 mg ) . All children were given a single dose of epinephrine nebulization at the beginning of the study . The croup scores were measured at 0 , 1 , 2 , 3 , 4 , 6 , 8 , 10 and 12 h after the dexamethasone injection . RESULTS One hour following the injection , the mean croup scores were significantly reduced from baseline values in both groups ( p<0.01 ) . There was no difference in the mean croup scores between the two groups at any time . Median times to croup scores equal or less than two in both high- and low-dose groups were 8 and 7.9 h , respectively . No patient required intubation or was removed from the study because of a rising croup score after enrollment . There was no significant adverse reaction from dexamethasone treatment in either group . CONCLUSION Dexamethasone 0.15 and 0.6 mg/kg are equally effective in the treatment of moderate to severe croup Abstract Objective : To assess the efficacy of a single dose of oral dexamethasone 0.15 mg/kg in children with mild croup not admitted to hospital . Design : Double blind , r and omised , placebo controlled clinical trial . Setting : The emergency department of a tertiary paediatric hospital . Subjects : 100 children aged 4 - 122 months presenting with mild croup . Intervention : A single oral dose of dexamethasone 0.15 mg/kg or placebo . Main outcome measure : Return to medical care with ongoing croup . Results : Baseline characteristics of the two treatment groups were similar . Eight children ( all from the placebo group ) returned to medical care with ongoing croup , one being admitted . There was no reported difference in duration of croup symptoms , duration of viral symptoms , or rate of return to medical care for other reasons . Conclusion : Oral dexamethasone in a dose of 0.15 mg/kg is effective in reducing return to medical care with ongoing croup in children with mild croup . Key messages The benefits of steroids for children admitted to hospital are now well estab- lished Most children with croup may be sent home , though up to one fifth may return with croup A small single dose of oral dexamethasone ( 0.15 mg/kg ) dramatically reduces the chance of reattending All children presenting with croup should be considered for The objective of this study was to compare the efficacy of a single dose of oral dexamethasone of varying sizes in 120 children hospitalized with croup in two sequential double blind , r and omized , controlled clinical trials ( Trials A and B ) . The study was conducted in the Emergency Department Observation Ward of a tertiary pediatric hospital . One hundred and twenty children ( age range 6 to 160 months ) hospitalized with croup participated . Baseline characteristics for the two groups in each trial were similar . In Trial A 60 children received either 0.6 or 0.3 mg/kg dexamethasone syrup ; in Trial B 60 children received either 0.3 or 0.15 mg/ kg dexamethasone syrup .  Duration of hospitalization , reduction in croup scores , and adrenaline usage were evaluated . Median duration of hospitalization was similar for children in Trial A ( 7 and 8 hr ) , and in Trial B ( 9 and 9 hr ) . Croup scores following treatment did not differ and were significantly lower than initial scores for all groups and in each trial . Other outcome measures were similar for the two groups in each trial , including need for nebulized adrenaline , numbers of patients admitted to intensive care , rate of return to medical care with reoccurrence of croup , and readmission to hospital with croup following discharge from hospital . We conclude that oral dexamethasone in a dose of 0.15 mg/kg is as effective as 0.3 or 0.6 mg/kg in relieving symptoms and results in a similar duration of hospitalization in children with croup AIMS Croup is a clinical syndrome which included inspiratory stridor , coughing with a dog-like sound , noise obstruction and respiratory distress symptoms . This present study was conducted to compare the effects of cold drink and dexamethasone , and the effects of their co-administration on children 's croup . MATERIAL S AND METHODS In this study , all patients with croup admitted to the emergency ward of Madani Hospital Khorramabad were divided through the simple r and omized method into 3 groups after informed consents were taken from their parents . The first group was given cold drink , second group with dexamethasone ( DM ) , and the third group were given the combined treatment simultaneously . The patients in the first and second groups who did not show signs of improvement received the simultaneous treatment similar to the third group . The data were analyzed using the SPSS software through descriptive statistics and inferential statistics including multi-field variance analysis and co-variance analysis . RESULT The results of the study indicated a statistically significant between the 3 group in terms of improvement time-scale of croup clinical symptoms ( P=0.001 ) . There was no significant difference observed between the effects of other variables on improvement time-scale of croup clinical symptoms . CONCLUSION The cold drink has less treating effect than DM and combined simultaneous treatment method . Also , DM had more influence than simultaneous treatment method . In addition , other variables including age , sex , birth weight , BMI , respiratory allergy and previous croup history did not influenced improvement time-scale and only type of intervention influenced improvement time-scale of croup clinical symptoms Objective : To evaluate the effect of adding inhaled budesonide ( 2 mg ) to oral dexamethasone 0.15 mg/kg in children hospitalized with croup . Setting : Observation ward of a Tertiary Paediatric Hospital Emergency Department . Subjects : Seventy-two children ( age range 3 to 126 months ) hospitalized with croup . Intervention : Children r and omized to receive either 2 mg of nebulized budesonide or placebo , with all children receiving a single oral dose of 0.15 mg/kg dexamethasone . Outcome measures : Primary outcome was duration of hospital stay . Other measures included croup scores from 0 to 12 hours , use of nebulized epinephrine , duration of croup symptoms , duration of viral symptoms , and return to medical care for croup or for any other reason following discharge from hospital . Results : Baseline characteristics for the 2 groups were similar . There was no difference in time to discharge for the 2 groups or for other outcome measures with a risk ratio of 1.3 ( 95 % confidence intervals of 0.82 and 2.1 ) . Conclusions : The addition of inhaled budesonide ( 2 mg ) to oral dexamethasone ( 0.15 mg/kg ) offers no advantage in the treatment of children hospitalized with croup OBJECTIVE To investigate the efficacy and tolerance of 12-hourly dosing with 2 mg 4 mL-1 of inhaled budesonide versus placebo in patients admitted to hospital with moderate/severe croup . METHOD Eighty-two children hospitalised with croup received either 2 mg 4 mL-1 of budesonide or placebo 12 hourly ( maximum four doses ) via Ventstream nebuliser in a r and omised , double-blind manner . Croup scores were performed at 0 , 2 , 6 , 12 , 24 , 36 and 48 h from initial nebulisation whilst the patient remained hospitalised . Follow-up assessment s were made 1 and 3 days after discharge . RESULTS Improvement was observed in the budesonide group over the 12-h dosing interval when compared to placebo ( P = 0.04 ) . Time to attain a significant clinical improvement was superior in the budesonide group ( P = 0.01 ) . Three days after discharge seven of 32 placebo-treated patients and one of 34 budesonide-treated patients had sought further medical follow-up ( P = 0.02 ) . CONCLUSION Twelve-hourly dosing with inhaled budesonide significantly improved symptoms of croup as well as decreased relapse rates when compared with placebo OBJECTIVES Croup or acute laryngotracheobronchitis is the most common cause of the upper airway obstruction . Cool mist , nebulized racemic epinephrine and steroids are commonly used for therapy . Although steroid treatment can be applied orally , in nebulized form , or parenterally , no study has compared these three regimens yet . In this study , the efficacy of nebulized budesonide , and oral and intramuscular dexamethasone are compared for treatment of croup . STUDY DESIGN Sixty children aged 6 - 36 months were r and omly allocated into four groups . The first three study groups ( 15 children in each ) took nebulized budesonide , oral dexamethasone and intramuscular dexamethasone , respectively , in addition to salbutamol and other supportive measures and these were compared with the placebo group . All patients were evaluated with " Westley Croup Score " on admission to pediatric emergency department ( 0h ) and at 24 , 48 and 72h . RESULTS At the end of the study , the croup scores of all steroid treatment groups were significantly lower than the placebo group , but there was no statistical difference among them . CONCLUSIONS Nebulized budesonide , oral and parenteral dexamethasone have the same effectiveness for treatment of croup and the choice depends on conditions of the patient and the physician ABSTRACT . Seventy‐two children hospitalized for croup received on admission a 
    Output:
    
AUTHORS ' CONCLUSIONS Glucocorticoids  reduced symptoms of croup at two hours , shortened hospital stays , and reduced the rate of return visits to care .
Our conclusions have changed , as the previous version of this review reported that glucocorticoids reduced symptoms of croup within six hours