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Management of Preschool Wheezing: Guideline from the Emilia-Romagna Asthma (ERA) Study Group

Valentina Fainardi1, Carlo Caffarelli1, Michela Deolmi1

  • 1Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

Journal of Clinical Medicine
|August 26, 2022
PubMed

Insights

This study provides updated guidelines for managing preschool wheezing, a complex condition in children up to 5 years old. It aims to standardize care by addressing key clinical questions and offering evidence-based recommendations for pediatricians.

Area of Science:

  • Pediatrics
  • Respiratory Medicine
  • Clinical Guidelines

Background:

  • Preschool wheezing is an umbrella term for various conditions with distinct phenotypes.
  • Current knowledge gaps exist regarding the optimal management of preschool wheezing.
  • Standardized approaches are needed for effective pediatric care.

Purpose of the Study:

  • To define and standardize the management of wheezing disorders in preschool children (up to 5 years).
  • To address key clinical questions concerning preschool wheezing through expert consensus and evidence-based reviews.

Main Methods:

  • A multidisciplinary expert panel formulated 12 PICO (Patients, Intervention, Comparison, Outcomes) questions.
  • Systematic reviews of PubMed were conducted to answer these questions.
  • The GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach was used to assess evidence quality and recommendation strength.

Main Results:

  • The guidelines offer a comprehensive collection of recommendations for managing preschool wheezing.
  • Evidence quality and recommendation strength were systematically evaluated for each clinical question.
  • The guidelines aim to standardize management approaches for pediatricians.

Conclusions:

  • These guidelines represent a comprehensive and up-to-date resource for pediatricians managing preschool wheezing.
  • Further research is essential to identify objective biomarkers and understand underlying mechanisms for personalized treatment.
  • Standardized management based on defined phenotypes and endotypes is crucial for improving patient outcomes.

Keywords:
allergen sensitizationepisodic viral wheezingmultiple trigger wheezingpediatric pulmonologywheezing

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