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In Reply: Dr Gabor argues that because our study shows that humidity is ineffective in patients with mild croup, patients could be discharged after the administration of aerosolized epinephrine and steroids without the burden of a 2- or 3-hour observation period. Even if administration of aerosolized epinephrine to patients in this category is safe from the point of view of a rebound after this form of therapy, it would be inaccurate to draw this conclusion from our study, which in no way tested this hypothesis.

In addition, Gabor refers to cool mist. Our study did not examine the effect of temperature and therefore did not rule out the possibility that cool mist may be beneficial.

Financial Disclosures: None reported.

Dennis Scolnik, MB, ChB
dennis.scolnik@sickkids.ca

Allan L. Coates, MD; Derek Stephens, MSc; Zelia Da Silva, RRT; Elana Lavine, MD; Suzanne Schuh, MD
The Hospital for Sick Children
Toronto, Canada

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;296:394.

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