Japanese clinical guidelines for juvenile orthostatic dysregulation version 1

被引:52
作者
Tanaka, Hidetaka [1 ]
Fujita, Yukihiko [2 ]
Takenaka, Yoshito [3 ]
Kajiwara, Souhei [4 ]
Masutani, Satoshi [5 ]
Ishizaki, Yuko [6 ]
Matsushima, Reiko [7 ]
Shiokawa, Hirosato [8 ]
Shiota, Madoka [9 ]
Ishitani, Nobuo [10 ]
Kajiura, Mitsugu [11 ]
Honda, Kazuo [12 ]
机构
[1] Osaka Med Coll, Dept Pediat, Takatsuki, Osaka 5698686, Japan
[2] Nihon Univ, Dept Pediat, Tokyo, Japan
[3] Takenaka Kids Clin, Sakai, Osaka, Japan
[4] Natl Io Hosp, Dept Pediat, Kanazawa, Ishikawa, Japan
[5] Saitama Med Coll, Omiya, Saitama, Japan
[6] Kansai Med Univ, Dept Pediat, Moriguchi, Osaka 570, Japan
[7] Saiseikai Suita Hosp, Osaka, Japan
[8] Jichi Med Coll, Dept Pediat, Tochigi, Tochigi, Japan
[9] Tottori Prefectural Rehabil Ctr, Tottori, Japan
[10] Ishitani Pediat Clin, Tottori, Japan
[11] Osaka Rosai Hosp, Dept Pediat, Osaka, Japan
[12] Tottori Univ, Honda Inst Psychosomat Med, Tottori 680, Japan
关键词
clinical guidelines; instantaneous orthostatic hypotension; neurally mediated syndrome; orthostatic dysregulation; postural tachycardia syndrome; POSTURAL TACHYCARDIA SYNDROME; VASOVAGAL SYNCOPE; CHRONIC-FATIGUE; BLOOD-PRESSURE; HEART-RATE; YOUNG-PATIENTS; DOUBLE-BLIND; HYPOTENSION; CHILDREN; INTOLERANCE;
D O I
10.1111/j.1442-200X.2008.02783.x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
This clinical practice guideline provides recommendations for the assessment, diagnosis and treatment of school-aged children and juveniles with orthostatic dysregulation (OD), usually named orthostatic intolerance in USA and Europe. This guideline is intended for use by primary care clinicians working in primary care settings. The guideline contains the following recommendations for diagnosis of OD: (i) initial evaluation composed of including and excluding criteria, the assessment of no evidence of other disease including cardiac disease and so on; (ii) a new orthostatic test to determine four different subsets: instantaneous orthostatic hypotension, postural tachycardia syndrome, neurally mediated syncope and delayed orthostatic hypotension; (iii) evaluation of severity; and (iv) judgment of psychosocial background with the use of rating scales. The guideline also contains the following recommendations for treatment of OD on the basis of the result of an orthostatic test in addition to psychosocial assessment: (i) guidance and education for parents and children; (ii) non-pharmacological treatments; (iii) contact with school personnel; (iv) use of adrenoceptor stimulants and other medications; (v) strategies of psychosocial intervention; and (vi) psychotherapy. This clinical practice guideline is not intended as a sole source of guidance in the evaluation of children with OD. Rather, it is designed to assist primary care clinicians by providing a framework for decision making of diagnosis and treatments.
引用
收藏
页码:169 / 179
页数:11
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