Transcutaneous carbon dioxide pressure for monitoring patients with severe croup

In a prospective investigation of 17 children with severe croup, we analyzed the effect of epinephrine inhalations and mild sedation with chloral hydrate on transcutaneous carbon dioxide pressure (tcPco 2 ), pulse oximetry measurements, and croup scores. There was a highly significant reduction ( p 2 values and croup scores after inhalation of epinephrine. The changes in the tcPco 2 values correlated with the clinical findings. Mild sedation also significantly improved the croup scores but failed to influence the tcPco 2 values. There was not statistically significant difference in pulse oximetry saturation, fraction of administered oxygen, heart rate, or respiratory rate before and after inhalation of epinephrine or chloral hydrate adminstration. Monitoring tcPco 2 appears to be a reliable and objective tool for managing patients with upper airway obstruction, whereas croup scores may be misleading.