Porcaro Federica, Ullmann Nicola, Di Marco Antonio, Allegorico Annalisa, Cherchi Claudio, Paglietti Maria Giovanna, Cutrera Renato
Pediatric Pulmonology and Cystic Fibrosis Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Pediatr Pulmonol. 2023 Jun;58(6):1640-1650. doi: 10.1002/ppul.26387. Epub 2023 Mar 17.
Asthma is a common disease in childhood with a minority of affected children suffering from severe asthma. Patients with severe asthma require high dose inhaled glucocorticoids plus a second controller and/or systemic corticosteroids to be well-controlled or remain uncontrolled despite such treatment. Although only a small subset of children and adolescents falls in this category, the management of affected patients represents a major concern for pediatricians. Guidelines and recommendations have been designed to guide the management of this group of patients. Though the terms "recommendations" and "guidelines" are often used interchangeably, it should be noted that the first one should be used more narrowly to identify specific actions and the second one to broadly refer to the umbrella under which multiple recommendations for a specific condition are provided. Moreover, the availability of several and sometimes-conflicting documents on severe asthma management both in adult and pediatric age could generate confusion among health care professionals. The manuscript analyses seven papers addressing severe asthma, comparing any key aspects and differences. Finally, we tried to create a more practical document for physicians to simplify the interpretation of the several available documents on severe asthma management focusing the pediatric age.
哮喘是儿童期的常见疾病，少数患病儿童患有重度哮喘。重度哮喘患者需要高剂量吸入糖皮质激素加用第二种控制药物和/或全身用糖皮质激素才能得到良好控制，或者尽管接受了此类治疗仍无法得到控制。虽然只有一小部分儿童和青少年属于这一类别，但对患病患者的管理是儿科医生的主要关注点。已经制定了指南和建议来指导这组患者的管理。尽管“建议”和“指南”这两个术语经常互换使用，但应该注意的是，前者应更狭义地用于确定具体行动，而后者应更广泛地指代针对特定病症提供多项建议的总体框架。此外，关于成人和儿童重度哮喘管理的几份文件，有时相互冲突，这可能会在医疗保健专业人员中造成困惑。本文分析了七篇关于重度哮喘的论文，比较了关键方面和差异。最后，我们试图为医生创建一份更实用的文件，以简化对几份现有重度哮喘管理文件的解读，重点关注儿童年龄段。
