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Auricular Acupressure as an Adjuvant Treatment for Wheezing in Stable Chronic Obstructive Pulmonary Disease
Published on: May 10, 2024
Wheezing in infancy
Yehia M El-Gamal1, Shereen S El-Sayed
1From the Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.
Insights
Infant wheezing affects 30% of children under three, often due to viral infections and airway anatomy. Early allergy testing and tailored treatments, including inhaled steroids, can help manage persistent cases and predict asthma development.
Area of Science:
- Pediatrics
- Pulmonology
- Immunology
Background:
- Wheezing affects 30% of children under three during respiratory infections.
- Infants are more susceptible to wheezing due to anatomical, immunological, and molecular factors.
- Viral infections can trigger wheezing in both immunocompetent and immunodeficient infants.
Purpose of the Study:
- To review the causes and management of wheezing in infants.
- To discuss the prediction of asthma in persistent wheezing infants.
- To outline treatment strategies for infant wheezing.
Main Methods:
- Review of population-based birth cohort studies.
- Analysis of factors contributing to infant wheezing.
- Evaluation of diagnostic and therapeutic approaches.
Main Results:
- Wheezing is common in infants, linked to viral infections and airway anatomy.
- Asthma prediction in persistent wheezers is possible.
- Allergy testing is valuable for identifying avoidable allergens.
- Treatment varies by etiology; bronchodilator response is unpredictable.
- Inhaled steroids may benefit specific infant wheezing cases.
- Specific treatments exist for Respiratory Syncytial Virus (RSV) bronchiolitis in high-risk infants.
Conclusions:
- Infant wheezing has multifactorial causes requiring individualized management.
- Early identification of allergens and appropriate treatment can improve outcomes.
- Further research into predicting and managing persistent wheezing and asthma is warranted.
Abstract:
Several population-based birth cohort studies documented that 30% of children suffer from wheezing during respiratory infections before their third birthday. Infants are prone to wheeze because of anatomic factors related to the lung and chest wall in addition to immunologic and molecular influences in comparison to older children. Viral infections lead to immunologic derangements that cause wheezing both in immunocompetent and immunodeficient infants. Anatomic causes of wheeze may be extrinsic or intrinsic to the airway. Not every wheeze is indicative of asthma but prediction of asthma in persistent wheezers is possible. Testing for allergy in these infants is worthwhile and can be of significant value in avoidable allergens. Treatment of an infant with wheezing depends on the underlying etiology. Response to bronchodilators is unpredictable and a trial of inhaled steroids may be warranted in a patient who has responded to multiple courses of oral steroids, has moderate to severe wheezing, or a significant history of atopy including food allergy or eczema. Ribavirin administered by aerosol, hyper-immune respiratory syncytial virus immunoglobulin (RSV IVIG), and intramuscular monoclonal antibody to an RSV protein have been used for RSV bronchiolitis in infants with congenital heart disease or chronic lung disease.
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