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Fifteen-minute consultation: An evidence-based approach to the child with preschool wheeze
Renu Khetan1, Matthew Hurley1,2, Abraham Neduvamkunnil1
1Department of Paediatrics, Nottingham Children's Hospital, Nottingham, UK.
Insights
Wheezing in preschoolers is common and costly. This study focuses on history, examination, and management to improve care for noisy breathing in young children.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Clinical Diagnosis
Background:
- Preschool wheeze is a prevalent condition with increasing incidence.
- It significantly impacts healthcare resources and family well-being due to acute episodes.
- Accurate diagnosis is challenging due to a wide differential diagnosis and conditions mimicking wheeze.
Abstract:
Preschool wheeze is very common and its prevalence is increasing. It consumes considerable healthcare resources and has a major impact on children and their families due to significant morbidity associated with acute episodes.History taking is the main diagnostic instrument in the assessment of preschool wheeze. Diagnosis and management is complicated by a broad differential and associations with many other diseases and conditions that give rise to noisy breathing, which could be misinterpreted as wheeze. Several clinical phenotypes have been described but they have limitations and do not clearly inform therapeutic decisions. New insights in aetiopathogenesis modify treatment options and lay foundation for further research. An understanding of the approach and available evidence to assess and manage wheeze informs best patient care and use of resources.Our objective is to demonstrate a focused history, examination and management options in a preschool child with wheeze.
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