Modul Respirologi Junior, 5 Desember 2018

CROUP

Supervisor :
Prof. Dr. M. Sidhartani Zain, MSc, SpAK
Dr. Dwi Wastoro Dadiyanto, SpAK
Dr. MS Anam, MSi. Med, SpA
 DEFINITION

• CROUP IS A COMMON CAUSE OF UPPER AIRWAY OBSTRUCTION IN YOUNG CHILDREN.1 IT IS

USUALLY MILD AND SELF-LIMITING, THOUGH OCCASIONALLY IT MAY CAUSE SEVERE
RESPIRATORY OBSTRUCTION
• CROUP, ALSO KNOWN AS “LARYNGOTRACHEOBRONCHITIS”, IS THE CLINICAL SYNDROME OF
A HOARSE VOICE, BARKING COUGH AND INSPIRATORY STRIDOR.1
• IT IS USUALLY CAUSED BY A VIRAL INFECTION OF THE UPPER AIRWAY THAT RESULTS IN
INFLAMMATION OF THE LARYNX, TRACHEA AND BRONCHI

Acute management of croup in the emergency department. Oliva Ortiz-Alvarez MD. Canadian Paediatric Society.
2017. 166–169
 ETIOLOGI

viral infections

most commonly by parainfluenza types 1

and 3 viruses
Other implicated viruses are influenza
A and B, adenovirus, respiratory syncytial
virus and metapneumovirus
Acute management of croup in the emergency department. Oliva Ortiz-Alvarez MD. Canadian Paediatric Society. 2017.
166–169
 PATOFISIOLOGI

• INFEKSI  INFLAMASI SUBGLOTIS + TRAKEA  INFILTRASI SEL – SEL INFLAMASI

 EDEMA + PRODUKSI EKSUDAT  MOBILITAS PITA SUARA TERGANGGU 
PENYEMPITAN SALURAN NAFAS  SUARA SERAK / KASAR, BATUK
MENGONGGONG, DISTRESS RESPIRASI

Ynagtjik K, Dadiyanto DW. Croup. In: Rahajoe NN, Supriyatno B, Setyanto DB, editors. Buku Ajar Respirologi Anak IDAI.
Jakarta : Badan Penerbit IDAI; 2018 : 296-305
 GEJALA KLINIS

- BATUK / PILEK NON SPESIFIK

- DEMAM
- BATUK MENGGONGGONG  (HILANG DALAM 48 JAM)
- STRIDOR INSPIRASI
- SERAK
- DISTRES RESPIRASI

SELF LIMITED (3- 7 HARI)

Ynagtjik K, Dadiyanto DW. Croup. In: Rahajoe NN, Supriyatno B, Setyanto DB, editors. Buku Ajar Respirologi Anak IDAI.
Jakarta : Badan Penerbit IDAI; 2018 : 296-305
 PEMERIKSAAN KLINIS DAN PENUNJANG

Stridor bifasik ( inspirasi, ekspirasi )

Retraksi
Takipneu , bradipneu
Tanda dehidrasi
Sianosis
Radiologis : Stepple sign
Ynagtjik K, Dadiyanto DW. Croup. In: Rahajoe NN, Supriyatno B, Setyanto DB, editors. Buku Ajar Respirologi Anak IDAI.
Jakarta : Badan Penerbit IDAI; 2018 : 296-305
CROUP SEVERITY

Acute management of croup in the emergency department. Oliva Ortiz-Alvarez MD. Canadian Paediatric Society. 2017.
166–169
CROUP WESTLEY SCORE

• MILD CROUP—0–2;
• MODERATE CROUP—3–5;
• SEVERE CROUP—6–11;
• IMPENDING RESPIRATORY FAILURE—12–17

Alvarez O. Acute management of croup in the emergency

department. Paediatric & Child Health; 22(3): 166-9
DIFFERENTIAL DIAGNOSIS
 TATALAKSANA

Penatalaksanaan croup Nelson Canadian pediatric society

Cool mist Tidak direkomendasikan Tidak direkomendasikan
Nebulisasi epinephrine Direkomendasikan Direkomendasikan
Kortikosteroid Direkomendasikan Direkomendasikan
Antibiotik Tidak direkomendasikan Tidak direkomendasikan
Dekongestan, antitusif Tidak direkomendasikan Tidak disebutkan
Heliox Boleh diberikan tapi bukti tidak Tidak direkomendasikan
meyakinkan
SABA Tidak disebutkan Tidak direkomendasikan