Fainardi Valentina, Caffarelli Carlo, Deolmi Michela, Skenderaj Kaltra, Meoli Aniello, Morini Riccardo, Bergamini Barbara Maria, Bertelli Luca, Biserna Loretta, Bottau Paolo, Corinaldesi Elena, De Paulis Nicoletta, Dondi Arianna, Guidi Battista, Lombardi Francesca, Magistrali Maria Sole, Marastoni Elisabetta, Pastorelli Silvia, Piccorossi Alessandra, Poloni Maurizio, Tagliati Sylvie, Vaienti Francesca, Gregori Giuseppe, Sacchetti Roberto, Mari Sandra, Musetti Manuela, Antodaro Francesco, Bergomi Andrea, Reggiani Lamberto, Caramelli Fabio, De Fanti Alessandro, Marchetti Federico, Ricci Giampaolo, Esposito Susanna
Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Paediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy.
J Clin Med. 2022 Aug 15;11(16):4763. doi: 10.3390/jcm11164763.
Preschool wheezing should be considered an umbrella term for distinctive diseases with different observable and measurable phenotypes. Despite many efforts, there is a large gap in knowledge regarding management of preschool wheezing. In order to fill this lack of knowledge, the aim of these guidelines was to define management of wheezing disorders in preschool children (aged up to 5 years). A multidisciplinary panel of experts of the Emilia-Romagna Region, Italy, addressed twelve different key questions regarding the management of preschool wheezing. Clinical questions have been formulated by the expert panel using the PICO format (Patients, Intervention, Comparison, Outcomes) and systematic reviews have been conducted on PubMed to answer these specific questions, with the aim of formulating recommendations. The GRADE approach has been used for each selected paper, to assess the quality of the evidence and the degree of recommendations. These guidelines represent, in our opinion, the most complete and up-to-date collection of recommendations on preschool wheezing to guide pediatricians in the management of their patients, standardizing approaches. Undoubtedly, more research is needed to find objective biomarkers and understand underlying mechanisms to assess phenotype and endotype and to personalize targeted treatment.
学龄前喘息应被视为具有不同可观察和可测量表型的独特疾病的统称。尽管付出了诸多努力，但在学龄前喘息的管理知识方面仍存在很大差距。为了填补这一知识空白，这些指南的目的是明确学龄前儿童（5岁及以下）喘息性疾病的管理方法。意大利艾米利亚 - 罗马涅地区的一个多学科专家小组针对学龄前喘息的管理提出了12个不同的关键问题。专家小组采用PICO格式（患者、干预措施、对照、结局）制定了临床问题，并在PubMed上进行了系统评价以回答这些具体问题，旨在制定相关建议。对每篇入选论文都采用了GRADE方法，以评估证据质量和建议程度。我们认为，这些指南是关于学龄前喘息最完整、最新的建议集合，可指导儿科医生管理患者，使方法标准化。毫无疑问，还需要更多研究来寻找客观生物标志物，了解潜在机制，以评估表型和内型，并实现靶向治疗的个性化。
