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Related Experiment Videos

Rational approach to the wheezy infant.

Nemr S Eid1, Ronald L Morton

  • 1Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky 40202-3830, USA. nseid@louisville.edu

Paediatric Respiratory Reviews
|February 26, 2004
PubMed
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Diagnosing persistent wheezing in infants requires a thorough history and diagnostic tests. Pulmonary function testing helps identify airflow obstruction, guiding further evaluation for conditions like infantile asthma or cystic fibrosis (CF).

Area of Science:

  • Pediatrics
  • Pulmonology
  • Diagnostic Medicine

Background:

  • Infantile wheezing presents a diagnostic challenge in children under two years old.
  • Key risk factors include maternal smoking, feeding, environmental exposures, and family history of asthma or cystic fibrosis (CF).
  • A systematic diagnostic approach is crucial for accurate identification of wheezing causes.

Purpose of the Study:

  • To outline a diagnostic strategy for persistent or recurrent wheezing in infants.
  • To differentiate between various causes of airflow obstruction in young children.
  • To guide clinical decision-making for effective management of infantile respiratory symptoms.

Main Methods:

  • Comprehensive medical history focusing on risk factors.
  • Diagnostic imaging including chest radiography and upper gastrointestinal (UGI) series.

Related Experiment Videos

  • Infant pulmonary function testing (IPFT) to assess airflow obstruction (central vs. peripheral).
  • Flexible fiberoptic bronchoscopy for specific airway abnormalities.
  • Therapeutic trials with anti-inflammatory agents and bronchodilators.

    • Main Results:

    • Chest radiography is non-specific but can suggest airway anomalies.
    • IPFT differentiates central from peripheral airflow obstruction, guiding further investigations like bronchoscopy or UGI series.
    • Response to anti-inflammatory therapy suggests inflammatory conditions (asthma, CF).
    • Infantile asthma is diagnosed with peripheral obstruction and significant bronchodilator response (>25%).
    • Lack of bronchodilator response in peripheral obstruction warrants evaluation for GERD and other causes.

    Conclusions:

    • A structured diagnostic pathway utilizing history, IPFT, and targeted investigations is effective for infantile wheezing.
    • Differentiating airflow obstruction types guides appropriate interventions, including bronchoscopy, UGI series, or medical management.
    • Identifying specific causes like infantile asthma or GERD is essential for optimal patient outcomes.