I have been getting a lot of search hits lately for the search "Croup and Albuterol." To justify my presence on the search engines, here's my opinion on it, but first here is a disclaimer: I am not a physician. I am no longer a practicing Respiratory Therapist. Take any advice here with a huge grain of salt and remember to consult a real doctor before you make any decisions about anything. Moving on.
Croup, which we all know and love as that barky sound that kids make, is caused by swelling in the airway. The trachea and air passages are swollen and inflamed, and it makes kids feel tight and wheezy and sound scary.
Albuterol is an overprescribed Beta-2 agonist. It works very well for bronchospasm, and is sometimes used to lower serum Potassium. But that is all it does. Read this again: it is a BRONCHODILATOR. It does not cause swelling to go down: it causes the bronchioles to dilate if the muscles that control them are tightening up. I cannot emphasize enough that it does NOT reduce swelling: it simply relaxes the smooth muscles around the bronchioles.
Now, let's apply logic: bronchodilators work when someone has bronchospasm, usually asthmatic or emphesematic in nature. Croup is a problem with swelling in the airways. It is not a problem of bronchospasm, although it can cause it in asthmatic children. Albuterol will NOT....repeat, NOT...cause airway swelling to go down. Racemic Epinephrine, the usual prescription for croup, will cause airway swelling to go down.
So is it smart to use albuterol for croup? No. Unless the child with croup is asthmatic or has a history of some sort of RAD, it is unacceptable and bordering on malpractice to prescribe albuterol for croup. Racemic epinephrine and steroids will cure croup. Albuterol will not.
To conclude, I would just like to say this: the only physicians I have ever seen prescribe albuterol for croup on a routine basis have been, without exception, ignorant, old-school, unchanging buffoons who should not be practicing medicine in the first place because it's been thirty years since the bothered to read a medical journal. Seriously, these guys are the kind of doctors who are likely to order trepanning and bloodletting for headaches and infections.
Albuterol is NOT a cure-all. Do not prescribe it unless the child has asthma. It will do nothing and it will make the respiratory therapist despise you and think you are an idiot. End of discussion.