응급실을 방문한 아나필락시스 환자의 임상 양상 및 에피네프린 사용의 나이대별 특성
Age group characteristics of clinical features and use of epinephrine in children with anaphylaxis who visited emergency department
백남성, 이종승, 류정민,
소속 상세정보
백남성 ( Baek Nam-Sung )
울산대학교 의과대학 서울아산병원 응급의학교실
이종승 ( Lee Jong-Seung )
울산대학교 의과대학 서울아산병원 응급의학교실
류정민 ( Ryu Jeong-Min )
울산대학교 의과대학 서울아산병원 응급의학교실
Abstract
Purpose: Diagnosis of anaphylaxis depends on clinical manifestations and a high index of suspicion, and a misdiagnosis can lead to a preventable death. We aimed to investigate age group characteristics of clinical features and epinephrine use in children with anaphylaxis who visited the emergency department (ED).
Methods: We performed a retrospective chart review of 138 children who visited a tertiary care hospital ED from January through December 2018, and were discharged with anaphylaxis as the diagnosis. Anaphylaxis was defined according to the National Institutes of Allergy and Infectious Disease criteria. The children were divided into 4 age groups; infants (< 1 year), preschoolers (1-5 years), schoolers (6-11 years), and adolescents (12-18 years). Clinical features and epinephrine use were compared among the age groups.
Results: Of the 138 children with presumed anaphylaxis, 108 met the criteria. The most common cause was food (74%), followed by drugs (10.2%). Epinephrine was used in 82 children (75.9%). The infants and preschoolers reported less frequent cardiovascular symptoms (0%-3.6% vs. 26.5%, P = 0.020) and epinephrine use (33.3%-70.9% vs. 91.2%, P = 0.037) compared to the adolescents. The former 2 age groups reported food as triggers more frequent, and often reported food-associated and respiratory or gastrointestinal symptoms.
Conclusion: Infants and preschoolers with anaphylaxis may undergo less frequent cardiovascular symptoms and epinephrine use compared to adolescents. This feature prompts to increased epinephrine use in the former age groups even without age-adjusted hypotension.
키워드
Age Groups; Anaphylaxis; Child; Emergency Service, Hospital; Epinephrine
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