TUESDAY, Aug. 1, 2023 -- A 30-minute exposure to outdoor cold air is beneficial for reducing clinical symptoms in children with croup as an adjunct to oral dexamethasone, according to a study published online Aug. 1 in Pediatrics. Johan N. Siebert, M.D., from Geneva Children's Hospital in Switzerland, and colleagues conducted an open-label, single-center, randomized trial enrolling children aged 3 months to 10 years with croup and a Westley Croup Score (WCS) ≥2 attending a tertiary pediatric emergency department. Immediately after triage and administration of single-dose oral dexamethasone, patients were randomly assigned to a 30-minute exposure to outdoor cold ( The researchers found that at 30 minutes, 49.2 and 23.7 percent of the participants in the outdoor and indoor groups, respectively, showed a decrease in WCS ≥2 points from baseline (risk difference, 25.4 percent). The greatest benefit from the intervention at 30 minutes was seen for patients with moderate croup (risk difference, 46.1 percent).
"This randomized controlled trial supports the benefits of exposure to outdoor cold air on croup symptoms in children with mild to moderate croup in the first 30 minutes before the onset of action of steroids," the authors write.