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Diagnosis, management, and prognosis of preschool wheeze

Francine M Ducharme1, Sze M Tse2, Bhupendrasinh Chauhan3

  • 1Clinical Research and Knowledge Transfer on Childhood Asthma Unit, Research Centre, Sainte-Justine University Health Centre, Montreal, QC, Canada; Department of Paediatrics, University of Montreal, Montreal, QC, Canada; Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada.

Lancet (London, England)
|May 6, 2014
PubMed

Insights

Preschool wheeze is a significant health challenge, impacting lung function long-term. Early interventions and validated treatments are crucial for managing this condition in young children.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Child Health

Background:

  • Preschool wheeze presents a diagnostic challenge and high healthcare burden compared to older populations.
  • Existing phenotype classifications lack validation for guiding therapeutic decisions.
  • Genetic, prenatal, and postnatal factors are linked to preschool wheezing, with potential for persistent lung function deficits.

Purpose of the Study:

  • To review current understanding of preschool wheeze, including risk factors, diagnostic challenges, and therapeutic approaches.
  • To highlight the long-term implications of preschool wheeze on lung function.
  • To identify research priorities for improving outcomes in preschool wheeze.

Main Methods:

  • Review of cohort studies and clinical trials concerning preschool wheeze.
  • Analysis of risk factors, diagnostic criteria, and treatment efficacy.
  • Synthesis of evidence regarding short-term and long-term outcomes.

Main Results:

  • Preschool wheeze is associated with persistent lung function deficits from early childhood into adulthood.
  • Daily inhaled corticosteroids are effective for recurrent wheezing with interim symptoms or atopy.
  • Intermittent high-dose inhaled corticosteroids benefit moderate-to-severe viral-induced wheezing without interim symptoms.

Conclusions:

  • Preschool wheeze necessitates focused research for effective interventions.
  • Validated diagnostic and therapeutic strategies are needed to address this condition.
  • Early management may mitigate long-term respiratory sequelae.

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