Division of Pediatric Pulmonology, Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Division of Pediatric Pulmonology, Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India. Correspondence to: Dr Jagdish Goyal, Division of Pediatric Pulmonology, Department of Pediatrics, AIIMS, Jodhpur, Rajasthan, India.
Indian Pediatr. 2024 Aug 15;61(8):781-786. Epub 2024 Jul 23.
Asthma poses significant challenges in pediatric care, particularly in resource-limited settings. The Global Initiative for Asthma (GINA) 2024 guidelines represents a crucial step forward in addressing these challenges. This review critically evaluates the guidelines, focusing on their implementation and impact in developing countries like India. There have been certain key updates including a revised diagnostic flow chart and emphasis on alternative tools like peak flow meters. Challenges related to bronchodilator reversibility and interpreting FEV1/FVC are also explored. The article further addresses the implications of bronchial provocation testing in pediatric asthma. Detailed insights into cough-variant asthma highlight its rising recognition and management strategies. The GINA 2024 guidelines reflect updated criteria for commencing a particular step of therapy, aiming to optimize management and outcomes in pediatric asthma care. The guidelines have updated the role of allergen immunotherapy in pediatric asthma based on emerging evidence of efficacy and safety. Overall, the GINA 2024 guidelines offer a realistic approach to pediatric asthma care, with a potential for broader applications pending further research and adaptation.
哮喘在儿科护理中带来重大挑战，特别是在资源有限的环境中。2024 年全球哮喘倡议（GINA）指南代表着应对这些挑战的重要一步。本综述批判性地评估了这些指南，重点关注它们在印度等发展中国家的实施和影响。其中有一些关键更新，包括修订后的诊断流程图和强调替代工具，如峰流速仪。还探讨了与支气管扩张剂可逆性和解释 FEV1/FVC 相关的挑战。文章进一步探讨了支气管激发试验在儿科哮喘中的应用。详细介绍了咳嗽变异性哮喘，突出了其日益被认识和管理策略。2024 年 GINA 指南反映了开始特定治疗步骤的更新标准，旨在优化儿科哮喘管理和结果。该指南根据过敏原免疫疗法在儿科哮喘中的疗效和安全性的新证据更新了其在儿科哮喘中的作用。总的来说，2024 年 GINA 指南为儿科哮喘护理提供了一种现实的方法，在进一步研究和适应的基础上，具有更广泛应用的潜力。
