Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- symptoms increasing with agitation
- distinctive seal-like barky cough
- age 6 months to 6 years
Otros factores de diagnóstico
- 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)
Factores de riesgo
- age 6 months to 6 years
- male sex
- prior intubation
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- clinical exam
Tests to avoid
- viral panel testing
- x-ray neck
Algoritmo de tratamiento
mild (no stridor at rest)
moderate (stridor at rest; no agitation or lethargy)
severe (stridor at rest with agitation or lethargy)
Colaboradores
Autores
Candice Bjornson, MSc, MD, FRCPC
Associate Professor
University of Calgary
Calgary
Canada
Divulgaciones
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
Divulgaciones
DJ declares that he has no competing interests. DJ is the author of several references in this topic.
Revisores por pares
Ken Farion, MD
Assistant Professor
Pediatrics and Emergency Medicine
University of Ottawa
Ottawa
Canada
Divulgaciones
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
Divulgaciones
DM declares that she has no competing interests.
Jeremy Hull, MBBS
Consultant Paediatrician
Children's Hospital and West Wing
John Radcliffe Hospital
Oxford
UK
Divulgaciones
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
Declarações
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
Declarações
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
Declarações
DM declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Johnson D, Klassen T, Kellner J. Diagnosis and management of croup: Alberta Medical Association clinical practice guidelines. Alberta: Alberta Medical Association; 2015 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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