Outdoor Cold Air Exposure Eases Croup Symptoms in Children, Study Finds

Outdoor cold air exposure for 30 minutes, coupled with steroid treatment, led to improved symptoms in children with mild to moderate croup, according to findings from a randomized controlled trial published in Pediatrics.

Croup, a common cause of upper airway obstruction in children, is characterized by a distinctive barking cough. Recent studies have indicated a potential link between the omicron variant of SARS-CoV-2 and croup, leading to increased hospitalizations during the omicron wave in 2022.

In this study, led by Dr. Johan N. Siebert of the University of Geneva, 118 children aged around 32 months with mild to moderate croup were enrolled. They were randomly assigned to either spend 30 minutes outdoors in cold air with blankets or indoors at room temperature, following the administration of a single dose of oral dexamethasone.

● Results showed that 49.2% of the outdoor cold air group experienced a reduction in symptoms after 30 minutes, compared to 23.7% in the indoor group.

● These findings support anecdotal reports from parents and suggest a practical, easily implementable intervention that could provide immediate relief for children with croup.

Dr. Siebert emphasized the significance of the study's results in validating a common-sense intervention that aligns with what parents have reported for years. The study underscores the role of initial exposure to outdoor cold air in enhancing croup symptom improvement, especially when combined with oral dexamethasone treatment.

“These results didn't surprise us, but rather excited us, as they were in line with what the parents reported for years, and legitimise a simple, common-sense intervention to be carried out before the child arrives in EDs, perhaps limiting the influx, or to be easily implemented in EDs if conditions allow,” Siebert said.

“This is an interesting randomized trial that supports a common practice that paediatricians and families have long used with good anecdotal effects,” Siebert said. “There is now evidence that initial exposure to outdoor cold air plays a role in improving croup symptoms, particularly in moderate cases, as an adjunct to oral dexamethasone.”

Reference:

Siebert JN, et al. Pediatrics. 2023;doi:10.1542/peds.2023-061365.