Summary
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- symptoms increasing with agitation
- distinctive seal-like barky cough
- age 6 months to 6 years
Другие диагностические факторы
- male sex
- peak season late autumn (North America)
- prodromal symptoms
- abrupt onset of symptoms
- symptoms worse at night
- hoarse voice
- respiratory distress (sternal/intercostal indrawing, stridor)
- persistent agitation
- lethargy
- asynchronous chest wall and abdominal movement
- fatigue
- signs of hypoxia (pallor or cyanosis)
- signs of hypercapnia (decreased level of consciousness secondary to rising PaCO₂)
Факторы риска
- age 6 months to 6 years
- male sex
- prior intubation
Диагностические исследования
Исследования, которые показаны в первую очередь
- clinical exam
Tests to avoid
- viral panel testing
- x-ray neck
Алгоритм лечения
mild (no stridor at rest)
moderate (stridor at rest; no agitation or lethargy)
severe (stridor at rest with agitation or lethargy)
Составители
Авторы
Candice Bjornson, MSc, MD, FRCPC
Associate Professor
University of Calgary
Calgary
Canada
Раскрытие информации
CB declares that she has no competing interests. CB is the author of several references in this topic.
David Johnson, MD
Professor
Department of Pediatrics and Physiology and Pharmacology
University of Calgary
Calgary
Canada
Раскрытие информации
DJ declares that he has no competing interests. DJ is the author of several references in this topic.
Рецензенты
Ken Farion, MD
Assistant Professor
Pediatrics and Emergency Medicine
University of Ottawa
Ottawa
Canada
Disclosures
KF declares that he has no competing interests.
Doreen Matsui, MD, FRCPC
Associate Professor
Departments of Paediatrics and Medicine
Children's Hospital of Western Ontario
London
Ontario
Canada
Disclosures
DM declares that she has no competing interests.
Jeremy Hull, MBBS
Consultant Paediatrician
Children's Hospital and West Wing
John Radcliffe Hospital
Oxford
UK
Disclosures
JH declares that he has no competing interests.
Steve Cunningham, MBBS, PhD
Consultant Respiratory Paediatrician
Department of Respiratory & Sleep Medicine
Royal Hospital for Sick Children
Edinburgh
UK
Disclosures
SC declares that he has no competing interests.
Donna J. Lee, MD
Pediatric Pulmonology,
Joseph M. Sanzari Children's Hospital,
Hackensack Meridian Health
Hackensack
NJ
Disclosures
DL declares that he has no competing interests.
Deepak Mehta, MD, FRCS ( Oto)
Professor of Otolaryngology,
Director Pediatric Aerodigestive Center,
Baylor College of Medicine,
Texas Children’s Hospital,
Houston
TX
Disclosures
DM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Johnson D, Klassen T, Kellner J. Diagnosis and management of croup: Alberta Medical Association clinical practice guidelines. Alberta: Alberta Medical Association; 2015 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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