Smith Nadine, Giordano Kathryn, Thompson Amy, DePiero Andrew
1 Division of Emergency Medicine, Nemours/AI duPont Hospital for Children, Wilmington, DE, USA.
Clin Pediatr (Phila). 2018 Jun;57(6):706-710. doi: 10.1177/0009922817737075. Epub 2017 Oct 16.
Observation is necessary following racemic epinephrine (RE) for patients with croup. The ideal length of this observation period is unclear.
To compare the rate of failed outpatient management utilizing different observation times after RE administration for croup.
We performed a retrospective chart review of children with croup who required RE. Failure of treatment was defined as requiring a second RE treatment and/or returning to the pediatric emergency department for croup symptoms within 24 hours of discharge.
The primary analysis considered patients observed between 2.1 and 3 hours compared with those observed for 3.1 to 4 hours. The patients in the 2.1- to 3-hour group had a higher rate of treatment failure (16.7% vs 7.1%, OR = 2.44, P < .01).
Patients requiring RE for croup are more likely to have treatment failure if observed for between 2.1 and 3 hours as opposed to 3.1 to 4 hours.
对于患有哮吼的患者，在使用消旋肾上腺素（RE）后进行观察是必要的。但这一观察期的理想时长尚不清楚。
比较在使用RE治疗哮吼后采用不同观察时间的门诊治疗失败率。
我们对需要RE治疗的哮吼患儿进行了回顾性病历审查。治疗失败定义为在出院后24小时内需要再次使用RE治疗和/或因哮吼症状返回儿科急诊科。
初步分析将观察时间在2.1至3小时的患者与观察时间在3.1至4小时的患者进行了比较。2.1至3小时组的患者治疗失败率更高（16.7%对7.1%，OR = 2.44，P < .01）。
与观察3.1至4小时相比，因哮吼需要使用RE的患者若观察2.1至3小时，治疗失败的可能性更大。
