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Chronic obstructive pulmonary diseases in children
Jose Dirceu Ribeiro1, Gilberto Bueno Fischer2
1Department of Pediatrics, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil.
Insights
Chronic obstructive pulmonary diseases in children and adolescents (COPDC) can be managed effectively with guideline-based treatments and patient adherence. Early diagnosis and individualized care are key to controlling symptoms and improving quality of life.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Genetics and Environmental Health
Background:
- Chronic obstructive pulmonary diseases in children and adolescents (COPDC) present with diverse genetic and environmental origins.
- Manifestations include varied genotypes, phenotypes, and endotypes, with chronic cough as a primary symptom and potential bronchiectasis.
Purpose of the Study:
- To review and describe the key aspects of diagnosing and managing COPDC in pediatric and adolescent populations.
- To consider the interplay of physiopathology, genetics, and environmental factors in COPDC.
Main Methods:
- A comprehensive literature review of relevant studies was conducted using the PubMed database.
Main Results:
- COPDC, while incurable, is manageable through individualized treatment plans.
- Effective management relies on adherence to guidelines and treatment regimens, including corticosteroids, bronchodilators, and inhaled antibiotics.
- Pulmonary exacerbations (PE) are a critical factor in management and outcome assessment.
Conclusions:
- Accurate diagnosis, understanding risk factors, and managing comorbidities are crucial for effective COPDC management.
- Treatment strategies must be guideline-based and individualized, with patient adherence being paramount.
- Long-term outcomes are improved through interdisciplinary team monitoring in specialized centers, focusing on reduced PEs, enhanced quality of life, and preserved lung function.
Objectives:
To verify and describe the main events related to the diagnosis and management of chronic obstructive pulmonary diseases in children (COPDC) and adolescents, considering the interrelated physiopathology, genetic, and environmental characteristics.
Sources:
Relevant literature from PubMed was selected and reviewed.
Summary Of The Findings:
COPDC have an environmental and/or genetic origin and its manifestation has manifold genotypes, phenotypes, and endotypes. Although COPDC has no cure, it can be clinically controlled. Chronic cough is the main symptom and bronchiectasis can be present in several COPDC patients. The management of COPDC is more effective if based on guidelines and when treatment regimen adherence is promoted. Oral and inhaled corticosteroids, bronchodilators, inhaled antibiotics, and treatment of pulmonary exacerbation (PE) are the bases of COPDC management, and should be individualized for each patient.
Conclusions:
Correct diagnosis and knowledge of risk factors and comorbidities are essential in COPDC management. Procedures and drugs used should be based on specific guidelines for each COPDC case. Treatment adherence is critical to obtain the benefits of management. COPDC clinical control must be evaluated by the decrease in PEs, improved quality of life, reduction of pulmonary function loss, and lung structural damage. For most cases of COPDC, monitoring by interdisciplinary teams in specialized reference centers with surveillance strategies and continuous care leads to better outcomes, which must be evaluated by decreasing pulmonary function damage and deterioration, better prognosis, better quality life, and increased life expectancy.
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