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[Consensus asthma in children]
1Academisch Ziekenhuis Rotterdam-Sophia Kinderziekenhuis, Rotterdam.
Insights
Early detection and treatment of childhood asthma are key to managing symptoms and preventing long-term respiratory issues. This consensus outlines a step-by-step approach for diagnosis and management, focusing on lung function tests and environmental controls.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Asthma in children is defined by reversible bronchial obstruction and hyperreactivity.
- Chronic inflammation is the pathological basis for asthma symptoms like dyspnea, cough, and wheezing.
- The working hypothesis emphasizes early recognition and treatment to mitigate future respiratory problems.
Framework:
- Diagnosis relies on simple lung function tests: expiratory peak flow and forced expiratory volume in one second.
- Allergological examination is recommended for recurrent or persistent symptoms.
- Management framework includes preventive measures, environmental control, pharmacotherapy, patient education, and psychosocial support.
Implementation:
- A step-by-step pharmacotherapy approach is recommended, categorized by disease severity.
- Preventive measures involve environmental modifications and allergen avoidance.
- Monitoring treatment efficacy involves regular assessment of symptoms and lung function tests.
Implications:
- Optimal long-term evolution and maximal symptom control are the primary goals of asthma management.
- Early and adequate intervention can significantly reduce the impact of asthma in later life.
- This consensus provides a structured approach for healthcare providers in managing pediatric asthma.
Abstract:
The conclusions are presented of a consensus meeting of the Central Advisory Committee for Peer Review concerning detection and treatment of asthma in children. The aims of the management of asthmatic patients are maximal control of symptoms and optimal long-term evolution. Asthma was defined as a disease characterized by reversible bronchial obstruction and bronchial hyperreactivity (i.e. increased sensitivity of the respiratory tract to aerogenic stimuli with the symptoms of dyspnoea, cough and/or wheezing owing to increased sensitivity of the respiratory tract to allergenic and non-allergenic stimuli with as the pathological substrate a chronic inflammatory reaction. The working hypothesis was that early recognition of asthma and adequate treatment can prevent or reduce respiratory problems at later ages. For the diagnosis, the follow-up of the disease and monitoring of the treatment, a few simple lung function tests suffice: determination of the expiratory peak flow and of the forced expiratory one-second volume. If the symptoms recur or are of a permanent nature, allergological examination is indicated. Basic elements of intervention are preventive measures, including cleaning up the living environment, drug treatment, attention for the experience of the disease and information. A specific recommendation is made for drug treatment, in the form of a step-by-step approach based on a division of the severity of the disease into four categories.