Related Experiment Video
Updated: Feb 20, 2026
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Evaluation of infants and children with refractory lower respiratory tract symptoms
1Capital Allergy and Respiratory Center, Sacramento, California 95819, USA. bchipps@capitalallergy.com
Insights
Recurrent wheezing in young children often leads to an asthma diagnosis. If asthma treatment fails, consider other conditions like reflux or cystic fibrosis for accurate diagnosis and management.
Area of Science:
- Pediatric Pulmonology
- Diagnostic Medicine
Background:
- Recurrent wheezing is a common presentation in young children.
- Asthma is frequently diagnosed, but treatment is not always effective.
Purpose of the Study:
- To outline diagnostic considerations for recurrent wheezing in children.
- To identify differential diagnoses when asthma therapy is unsuccessful.
Main Methods:
- Literature review.
- Analysis of 30 years of clinical experience.
Main Results:
- Initial workup includes asthma risk factors and symptom assessment.
- Consider gastroesophageal reflux, protracted bacterial bronchitis, tracheobronchomalacia, and cystic fibrosis if asthma treatment fails.
- Perform appropriate diagnostic testing for these conditions.
Conclusions:
- In young children with recurrent lower airway symptoms and a negative modified Asthma Predictive Index, consider these alternative diagnoses.
- A systematic diagnostic approach is crucial for effective management.
Objective:
To define the diagnostic possibilities for young children who present with recurrent wheeze.
Data Sources:
Review of medical literature and 30 years of practice experience.
Study Selection:
Relevant medical literature.
Results:
When evaluating an infant or child presenting with recurrent respiratory symptoms, several diagnoses must be considered. The workup should include assessment of the risk factors for asthma and careful investigation into the specific symptoms. Recurrent or persistent wheezing and/or coughing often result in a diagnosis of asthma with therapeutic trials of asthma treatment. When the therapy is ineffective, other diagnoses should be considered, including gastroesophageal reflux, protracted bacterial bronchitis, tracheobronchomalacia, and cystic fibrosis. Appropriate testing should be performed in these pediatric patients.
Conclusion:
In young children with recurrent lower airway symptoms who have a negative modified Asthma Predictive Index result, the described diagnostic possibilities should be considered.
Related Concept Videos
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:17Pulmonary Cycle: Exhalation
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include: