SynthesisFrontiers in pediatrics2026
Nebulized epinephrine for croup in children: an updated systematic review.
Synthesis in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To review and update the clinical evidence on the use of nebulized epinephrine for croup in children. Methods: The protocol was registered with PROSPERO (CRD420251160013). Our search encompassed PubMed (MEDLINE), Embase, Web of Science, Scopus, the Cochrane Library databases for randomized controlled trials (RCTs) investigating epinephrine for the treatment of croup. The search covered the period from database inception to July 3, 2026. We also searched two clinical trials registries: the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and clinicaltrials.gov (searched 03 July 2026). We included studies that reported epinephrine in the treatment of croup in children. This systematic review was reported in accordance with the PRISMA 2020 guidelines. Results: A total of 12 studies were included in the analysis, with 325 patients in the treatment group and 347 in the control group. The meta-analysis revealed that nebulised epinephrine significantly improved croup severity score at 30 min post-administration (SMD = -1.48, 95% CI [-2.83, -0.13]). However, this effect was not sustained. At 2 h, the between group difference was no longer statistically significant (SMD = -0.51, 95% CI [-1.11, 0.09]). Regarding hospital stay, although the point estimate suggested a clinically meaningful reduction (MD = -25.1 h, 95% CI [-52.34, 2.15]), the wide confidence interval crossed zero and the difference did not reach statistical significance ( Conclusion: Nebulized epinephrine significantly improved croup score at 30 min, but its sustained effect at 2 h remains inconclusive due to unstable sensitivity analysis. No significant reduction in hospital stay was observed ( Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/recorddashboard, PROSPERO CRD420251160013.
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