Okobi Okelue E, Okoronkwo Chibuzor A, Duru Harrison, Iyayi Inelefo R, Adeakin-Dada Tinuade O, Doherty Natalie O
Family Medicine, Larkin Community Hospital Palm Springs Campus, Hialeah, USA.
Family Medicine, Medficient Health Systems, Laurel, USA.
Cureus. 2024 Aug 29;16(8):e68135. doi: 10.7759/cureus.68135. eCollection 2024 Aug.
Globally, asthma remains the most widespread chronic respiratory condition in children, with a larger proportion of children being affected by the condition. Regardless of the higher prevalence rates, the outcomes of pediatric asthma have remained inadequate, even as there are numerous preventable deaths (approximately 300 children in the United States and 250 children in Canada, annually). The characteristic symptoms of pediatric asthma include wheezing, cough, and shortness of breath that are characteristically triggered by several potential stimuli. However, several diagnostic challenges exist and have resulted in either overdiagnosis or underdiagnosis, making pediatric asthma diagnosis and management problematic. Effective management of asthma in children entails a holistic approach that encompasses non-pharmacological and pharmacological management, alongside self-management and educational aspects. Working with pediatric asthma patients and their families/caregivers is vital to promoting and realizing better asthma diagnosis and management outcomes. Educational guidelines regarding the best ways for effective treatment, avoidance of triggers, modifiable risk factors, and the actions that should be taken during chronic asthma attacks through individualized action plans are vital. Thus, the objective of this systematic review is to provide an overview of the latest guidelines on pediatric asthma diagnosis and management. In this regard, this review presents several similarities in existing pediatric asthma diagnosis and management guidelines in the United States and Canada. For instance, most guidelines and studies reviewed have proposed the use of objective tests for confirmation of asthma diagnosis, particularly in symptomatic individuals. The peak flow variability measurement, bronchodilator reversibility testing, and spirometry have also been proposed by the guidelines and studies, even as the recommendations regarding the timing and hierarchy of the objective test substantially vary between the guidelines and studies. We hope that the present review will be helpful to physicians and healthcare service providers working within pediatric health contexts.
在全球范围内,哮喘仍然是儿童中最普遍的慢性呼吸道疾病,受该疾病影响的儿童比例更高。尽管患病率较高,但儿科哮喘的治疗效果仍然不尽人意,即便存在许多可预防的死亡病例(美国每年约有300名儿童,加拿大每年约有250名儿童)。儿科哮喘的典型症状包括喘息、咳嗽和呼吸急促,这些症状通常由多种潜在刺激因素引发。然而,存在一些诊断挑战,导致了过度诊断或诊断不足,使得儿科哮喘的诊断和管理存在问题。对儿童哮喘进行有效管理需要一种全面的方法,包括非药物和药物管理,以及自我管理和教育方面。与儿科哮喘患者及其家庭/照顾者合作对于促进和实现更好的哮喘诊断和管理结果至关重要。关于有效治疗的最佳方法、避免触发因素、可改变的风险因素以及通过个性化行动计划在慢性哮喘发作期间应采取的行动的教育指南至关重要。因此,本系统综述的目的是概述儿科哮喘诊断和管理的最新指南。在这方面,本综述呈现了美国和加拿大现有儿科哮喘诊断和管理指南中的一些相似之处。例如,大多数综述的指南和研究都建议使用客观测试来确认哮喘诊断,特别是对于有症状的个体。指南和研究还提出了峰值流量变异性测量、支气管扩张剂可逆性测试和肺功能测定,尽管关于客观测试的时间和层次的建议在不同的指南和研究之间有很大差异。我们希望本综述将对在儿科健康领域工作的医生和医疗服务提供者有所帮助。