Current Approach to Asthma Treatment in Children Aged Five Years and Younger

Yıl 2018, Cilt: 10 Sayı: 2, 33 - 37, 06.03.2018

Prof. Dr. Zeynep Tamay

Öz

Abstract

Asthma is one of the most common chronic diseases of childhood characterized by airway hyperresponsiveness and chronic airway inflammation. Diagnosis of asthma inchildren aged five years and younger is mostly based on the symptom pattern, the presence of risk factors for asthma development and the benefit of therapeutic treatment.The goals of asthma management are to achieve good symptom control, to minimize complaints and rescue medication requirements, to improve quality of life, to maintain respiratory functions at normal levels. According to asthma guidelines, low-dose inhaled corticosteroid (ICS) therapy is the first recommended treatment in patients with asthma and early treatment provides a more pronounced improvement in lung function.

Anahtar Kelimeler

asthma, treatment, youngchildren

Beş Yaş ve Altı Çocuklarda Astım Tedavisine Güncel Yaklaşım

Öz

Öz

Astım, havayolu aşırı duyarlılığı ve kronik solunum yolu inflamasyonu ile karakterize olan çocukluk çağının en sık kronik hastalıklarından biridir. Beş yaş ve altı çocuklarda astım tanısı çoğunlukla semptomlar, astım için risk faktörlerinin varlığı ve, astımtedavisine verilen yanıta dayanır. Astım tedavisinde amaç hastalığı kontrol altında tutmak, yakınmaları ve kurtarıcı ilaç gereksinimini en aza indirmek, yaşam kalitesini artırmak, solunum fonksiyonlarını normal düzeyde tutmaktır. Astım rehberlerine göre tanıkonulan tüm  hastalarda koruyucu tedavide ilk önerilen düşük doz inhale kortikosteroid (İKS) tedavisidir ve tedaviye mümkün olduğunca erken başlanması akciğer fonksi-yonunda daha belirgin iyileşme sağlamaktadır.

Anahtar Kelimeler

astım, tedavi, küçük çocuklar

Kaynakça

• Kaynaklar 1. Lougheed MD, Lemiere C, Ducharme FM, et al. Canadian Thoracic So-ciety 2012 guideline update: Diagnosis and management of asthma inpreschoolers, children and adults. Can Respir J 2012;19:127-64. 2.Bisgaard H, Szefler S. Prevalence of asthma-like symptoms in youngchildren. Pediatr Pulmonol 2007;42:723-8. 3. Heikkinen T, Jarvinen A. The common cold. Lancet 2003;361:51-9. 4.Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Mor-gan WJ. Asthma and wheezing in the first six years of life. The Gro-up Health Medical Associates. N Engl J Med 1995;332:133-8. 5. Brand PL, Caudri D, Eber E, Gaillard EA, Garcia-Marcos L, Hed-lin G, Henderson J, et al. Classification and pharmacological tre-atment of preschool wheezing: changes since 2008. Eur Respir J2014;43:1172-7. 499. 6. Cano Garcinuno A, Mora Gandarillas I, Group SS. Early patternsof wheezing in asthmatic and nonasthmatic children. Eur Respir J2013;42:1020-8.500. 7. Just J, Saint-Pierre P, Gouvis-Echraghi R, Boutin B, Panayotopou-los V, Chebahi N, Ousidhoum-Zidi A, et al. Wheeze phenotypes inyoung children have different courses during the preschool period.Ann Allergy Asthma Immunol 2013;111:256-61.e1. 8. Global Initiative for Asthma (GINA). Global strategy for astham ma-nagement and prevention. Revised 2018.www.ginasthma.org 9.Guevara JP, Wolf FM, Grum CM, Clark NM. Effects of educationalinterventions for self management of asthma in children and adoles-cents: systematic review and meta-analysis. BMJ 2003;326:1308-9. 10. N. G. Papadopoulos, H. Arakawa, K.-H. Carlsen, A. Custovic, J. Gern,R. Lemanske, et al. International consensus on (ICON) pediatric asth-ma. Allergy 2012; 67: 976–997. 11. British Thoracic Society and Scottish Intercollegiate Guidelines Net-work. British Guideline on the Management of Asthma: A NationalClinical Guideline. British Thoracic Society and Scottish Intercol-legiate Guidelines Network, 2016. 12. Pedersen SE, Hurd SS, Lemanske RF, Jr., et al. Global strategy forthe diagnosis and management of asthma in children 5 years and yo-unger. Pediatr Pulmonol 2011;46:1-17. 13. Gibson PG, Chang AB, Glasgow NJ, et al. CICADA: Cough in Child-ren and Adults: Diagnosis and Assessment. Australian cough gui-delines summary statement. Med J Aust 2010;192:265-71. 14. Bisgaard H, Hermansen MN, Loland L, Halkjaer LB, Buchvald F.Intermittent inhaled corticosteroids in infants with episodic whee-zing. N Engl J Med 2006;354:1998-2005. 15.Guilbert TW, Morgan WJ, Zeiger RS, Mauger DT, Boehmer SJ, Szef-ler SJ, Bacharier LB, et al. Long-term inhaled corticosteroids in presc-hool children at high risk for asthma. N Engl J Med 2006;354:1985-97. 16. Knorr B, Franchi LM, Bisgaard H, Vermeulen JH, LeSouef P, San-tanello N, Michele TM, et al. Montelukast, a leukotriene receptor an-tagonist, for the treatment of persistent asthma in children aged 2to 5 years. Pediatrics 2001;108:E48. 520. 17. Brodlie M, Gupta A, Rodriguez-Martinez CE, Castro-Rodriguez JA,Ducharme FM, McKean MC. Leukotriene receptor antagonists asmaintenance and intermittent therapy for episodic viral wheeze inchildren. Cochrane Database Syst Rev 2015:Cd008202. 18. Papi A, Nicolini G, Baraldi E, Boner AL, Cutrera R, Rossi GA, Fabb-ri LM, et al. Regular vs prn nebulized treatment in wheeze prescho-ol children. Allergy 2009;64:1463-71. 19. Expert Panel Report 3: Guidelines for the Diagnosis and Manage-ment of Asthma. National Asthma Education and Prevention Prog-ram, Third Expert Panel on the Diagnosis and Management of Asth-ma. Bethesda, MD, USA: National Heart, Lung, and Blood Institu-te (US), 2007. 20. Szefler SJ, Baker JW, Uryniak T, Goldman M, Silkoff PE. Compa-rative study of budesonide inhalation suspension and montelukast inyoung children with mild persistent asthma. J Allergy Clin Immunol2007;120:1043-50. 21. Fitzpatrick AM, Jackson DJ, Mauger DT, Boehmer SJ, Phipatana-kul W, Sheehan WJ, Moy JN, et al. Individualized therapy for per-sistent asthma in young children. J Allergy Clin Immunol2016;138:1608-18.e12. 22. Castro-Rodriguez JA, Rodrigo GJ. Beta-agonists through metered-doseinhaler with valved holding chamber versus nebulizer for acute exa-cerbation of wheezing or asthma in children under 5 years of age: asystematic review with meta-analysis. J Pediatr 2004;145:172-7. 23. Goksor E, Amark M, Alm B, Gustafsson PM, Wennergren G. Asth-ma symptoms in early childhood--what happens then? Acta Paedi-atr 2006;95:471-8.