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Published on: November 4, 2010
[Special considerations in children under five years with asthma]
Francisco J Cuevas Schacht1, Maria del Carmen Cano Salas
1Instituto Nacional de Pediatría, SSA, México D.F. pacoc@prodigy.net.mx
Insights
Diagnosing and managing asthma in children under five requires special attention due to cooperation challenges. Understanding disease progression and phenotypes is key for effective asthma control.
Area of Science:
- Pediatric Respiratory Medicine
- Asthma Pathophysiology
- Clinical Guideline Development
Context:
- Current asthma guidelines often lack specific considerations for children under five.
- Young children's limited cooperation for respiratory function tests leads to underdiagnosis and delayed treatment.
- This age group experiences frequent respiratory morbidity, complicating asthma assessment.
Purpose:
- To highlight the need for tailored diagnostic and management strategies for early childhood asthma.
- To emphasize understanding the natural history and phenotypes of asthma in infants and toddlers.
- To guide clinical considerations for classifying, monitoring, and treating asthma in young children.
Summary:
- Effective asthma management in young children necessitates considering personal/family history, symptoms, and comorbidities.
- Asthma control, not a cure, is achievable through comprehensive strategies.
- Key elements include doctor-patient-family interaction, education, risk factor control, and continuous monitoring.
Impact:
- Improved early diagnosis and timely treatment of asthma in children under five.
- Better assessment of asthma severity, control levels, and treatment response.
- Enhanced long-term asthma management and improved quality of life for pediatric patients.
Abstract:
Currently, clinical practice guidelines and international guidelines on diagnosis and management of asthma, including special considerations in patients under five years old, given the frequent respiratory morbidity associated with this age group and poor or no cooperation from the child for testing respiratory function, favoring the underdiagnosis, delaying treatment and affecting the proper assessment of severity, level of control, and adequate clinical response to treatment. That is why the proper understanding of the natural history and the different phenotypes in infants and toddlers, allow for functional and clinical considerations on the progression of asthma from early childhood to adulthood, being necessary to make a special deal considering personal and family history, symptoms and progression of comorbidities exist which in turn will classify, monitor and plan treatment to achieve and maintain control of the disease, so far as asthma is not cured but their control is achieved in most patients. The doctor-patient interaction, family, education, control of risk factors and comorbidities, assessment, treatment and monitoring of the development of asthma are the foundation for success in the management of asthmatic patients.
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