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논문 기본 정보

자료유형
학술저널
저자정보
장윤영 (대구가톨릭대학교 의과대학 대구가톨릭대학교병원 소아청소년과) 정혜리 (대구 가톨릭의과대학 소아청소년과학교실)
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대한의사협회 대한의사협회지 대한의사협회지 제64권 제7호
발행연도
2021.1
수록면
501 - 507 (7page)

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Background: Croup is a respiratory illness usually caused by acute viral infection of the larynx, trachea, and bronchi, and characterized by the abrupt onset of a barking cough, inspiratory stridor, hoarseness, and respiratory distress due to upper airway obstruction. Croup commonly affects children younger than 6 years of age, with peak incidence between 7 and 36 months. Although the disease is usually self-limited, it may occasionally become life threatening, and can, on rare occasion, lead to respiratory failure. Current Concepts: Treatment of viral croup depends on the severity of symptoms as denoted by Westley croup score (i.e., mild, moderate, or severe). A single dose of oral or intramuscular dexamethasone (0.15-0.6 mg/kg) is the mainstay of treatment for viral croup, irrespective of severity. A single dose of nebulized budesonide (2 mg) is equally effective as systemically administered dexamethasone, and is considered when a patient is unable to take a medicine orally. Nebulized L-epinephrine (1:1,000, 3-5 mL) causes vasoconstriction in the mucosa, rapidly reducing airway edema. Addition of nebulized L-epinephrine is indicated in the patients with croup of at least moderate severity, displaying chest retraction and signs of labored breathing. Discussion and Conclusion: The most effective pharmacological treatments for patients with viral croup are oral or intramuscular dexamethasone, and nebulized L-epinephrine. Especially, corticosteroids can significantly decrease the intensity of croup symptoms and reduce hospital admissions, return visits to emergency department and length of stay in the hospital.

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