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Inpatient use of racemic epinephrine for children admitted with croup

World Journal of Pediatrics 2019年第6期15卷 586-594页

作者： elaine chiang Omar Afandi Sang Hoon Lee Srinivasan Suresh Raymond DPitetti Sriram Ramgopal Division of Pediatric Emergency Medicine Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA Department of Pediatrics University of Pittsburgh School of MedicinePittsburghPAUSA Department of Pediatrics University of CincinnatiCollege of MedicineCincinnatiOHUSA Division of Emergency Medicine Cincinnati Children's Hospital Medical CenterCincinnatiOHUSA Division of Health Informatics Department of PediatricsUniversity of Pittsburgh School of MedicineChildren's Hospital of PittsburghPittsburghPAUSA UPMC Children's Hospital of Pittsburgh PittsburghPAUSA

Background Pediatric patients with croup are frequently admitted if they require two doses of racemic epinephrine(RE)in the emergency department(ED).We aimed to identify factors associated with the need for additional therapy(>2 RE doses)among pediatric patients with *** We performed a single-center retrospective study of consecutive patients admitted from the ED with a diagnosis of croup between January 1,2011 and December 31,*** outcome was need for>2 doses of *** out-comes included time to third RE and 72-hour return *** performed logistic regression to identify factors associated with use of>2 RE doses during hospitalization,and survival analysis to identify time to dosing of 3rd RE from 2nd *** Of 353 included admissions[250(70.8%)males,median age 1.48,interquartile range 0.97-2.51 years],106/353(30.0%)required>2 *** univariate logistic regression,only recent use of steroids within 1 day prior to presentation(4.18,1.48-11.83;P=0.007)was associated with need for>2 *** from third RE was 0.74(95%CI 0.69-0.78),which was similar to the survival at 12 hours(0.70,95%CI 0.65-0.75).Return visits occurred in 19(5.4%)patients,of whom 12/19(63.2%)were given *** Patients hospitalized for croup with recent use of steroids prior to ED presentation have a greater need for>2 RE during *** majority who require inpatient RE will do so within 8-12 *** data provide informa-tion for risk stratification and duration of monitoring for patients hospitalized with croup.

关键词： Laryngotracheobronchitis Racemic epinephrine Spasmodic croup Steroids Viral croup

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