Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- sintomas que aumentam com agitação
- tosse ladrante tipo "latido de foca" distinta
- 6 meses a 6 anos de idade
Outros fatores diagnósticos
- sexo masculino
- intensidade máxima no final do outono
- sintomas prodrômicos
- início abrupto dos sintomas
- os sintomas pioram à noite
- rouquidão
- dificuldade respiratória (retração esternal/intercostal, estridor)
- agitação persistente
- letargia
- movimento assíncrono da parede torácica e abdominal
- fadiga
- sinais de hipóxia (palidez ou cianose)
- sinais de hipercapnia (diminuição do nível de consciência em decorrência do aumento de PaCO₂)
Fatores de risco
- 6 meses a 6 anos de idade
- sexo masculino
- intubação prévia
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- exame clínico
Investigações a serem consideradas
- radiografia anteroposterior e lateral do pescoço
Algoritmo de tratamento
leve (sem estridor em repouso)
moderado (estridor em repouso; sem agitação ou letargia)
grave (estridor em repouso com agitação ou letargia)
Colaboradores
Autores
Candice Bjornson, MSc, MD, FRCPC
Associate Professor
University of Calgary
Calgary
Canada
Declarações
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
Declarações
DJ declares that he has no competing interests. DJ is the author of several references in this topic.
Revisores
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.
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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