| Title | Recurrent wheezing illness in preschool-aged children: assessment and management in primary care practice. | | Author(s) | Bloomberg GR | | Institution | Department of Pediatrics, St. Louis Children's Hospital, St. Louis, MO 63110, USA. bloomberg@kids.wustl.edu | | Source | Postgrad Med 2009 Sep; 121(5):48-55. | | MeSH | Acetates
Administration, Inhalation
Adolescent
Adrenal Cortex Hormones
Adrenergic beta-Agonists
Anti-Asthmatic Agents
Asthma
Causality
Child
Child, Preschool
Comorbidity
Diagnosis, Differential
Europe
Female
Humans
Hypersensitivity
Infant
Infant, Newborn
Male
Predictive Value of Tests
Prednisolone
Primary Health Care
Quinolines
Recurrence
Respiratory Sounds
Risk Assessment
Terminology as Topic
United States
| | Abstract | Recurrent wheezing is common in preschool-aged children, with 1 in 3 children experiencing at least 1 acute wheezing illness before the age of 3 years. These children represent a diverse group, with some going on to present with asthma at school age and others experiencing complete resolution of symptoms. The primary care physician is faced with a dilemma of when to recommend daily therapy. He or she must also answer parents' concerns, often expressed as, "Does my child have asthma?" and "Will my child have to take medication the rest of his or her life?" This article presents recent studies and recommendations that can guide the physician in approaching the child and the parent with rational management. The emphasis is on viewing recurrent wheezing as a continuum requiring a plan of monitoring that starts with the very first episode. Using background information from the parents and a history of the child's allergic disposition, one can discuss with parents the risks of developing asthma and, together with planned monitoring, prescribe appropriate management. The primary care physician can plan management by using the Asthma Predictive Index and employing specific questions for features present during the intervals between acute episodes. Together with close monitoring, the physician will have a compass that effectively directs rational management. | | Language | eng | | Pub Type(s) | Case Reports
Journal Article
Review
| | PubMed ID | 19820274 |
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