Related Experiment Video
Updated: Aug 24, 2026
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
[Treatment of asthma in children: more than merely 'puffing']
A F Brouwer1, R J Roorda, P L Brand
1Afd. Kindergeneeskunde, Isala Klinieken, locatie Weezenlanden, Postbus 10.500, 8000 GM Zwolle.
Insights
Persistent asthma in children may not require additional medication. Addressing inhaler technique, breathing issues, allergies, and smoke exposure can resolve symptoms, challenging current treatment guidelines.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
Background:
- Current asthma guidelines recommend escalating treatment with long-acting beta 2-agonists for children with persistent symptoms despite inhaled corticosteroids.
- This approach may overlook other contributing factors to uncontrolled asthma in pediatric patients.
Observation:
- A study examined five children (four boys, one girl, aged 6-13) with persistent asthma symptoms.
- These children were on maintenance inhaled corticosteroids and short-acting bronchodilators.
Findings:
- One child improved with the addition of a long-acting beta 2-agonist.
- The other four children achieved symptom resolution after interventions targeting inhaler technique, dysfunctional breathing, allergic rhinitis, and passive smoke exposure.
- This suggests non-pharmacological factors significantly impact asthma control.
Implications:
- Healthcare providers should comprehensively assess pediatric asthma patients for factors beyond medication adherence.
- Evaluating inhaler technique, comorbidities like allergic rhinitis, and environmental exposures is crucial before increasing medication.
- This personalized approach may prevent unnecessary escalation of asthma therapy in children.
Abstract:
Five children, four boys aged 6, 9, 12 and 13 years and one girl aged 6 years, had persistent asthmatic symptoms despite maintenance treatment with inhaled corticosteroids and short-acting bronchodilators on demand. One of them required the addition of a long-acting beta 2-agonist to become symptom-free. The other four patients did not need to step up their asthma medication after correction of poor inhaler technique, treatment of dysfunctional breathing, treatment of allergic rhinitis, and elimination of passive cigarette-smoke exposure, respectively. All current guidelines on the treatment of asthma in children advise, in case of persistent asthmatic symptoms despite inhaled corticosteroids and short-acting bronchodilators, the addition of long-acting beta 2-agonists. However, various factors may play a role in the persistence of asthma despite adequate therapy and these factors should be evaluated before stepping up the medication.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:23Inhaled Medications
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:30Asthma-IV: Nursing Management
First, in...
01:25Antiasthma Drugs: β2-Adrenoceptor Agonists
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce relaxation in these...