Assessment of problematic severe asthma in children

被引：61

作者：

Carlsen, K. C. Lodrup ^{[1
,2
]}

Hedlin, G. ^{[3
]}

Bush, A. ^{[4
]}

Wennergren, G. ^{[5
]}

de Benedictis, F. M. ^{[6
]}

De Jongste, J. C. ^{[7
]}

Baraldi, E. ^{[8
]}

Pedroletti, C. ^{[3
]}

Barbato, A. ^{[8
]}

Malmstrom, K. ^{[9
]}

Pohunek, P. ^{[10
,11
]}

Pedersen, S. ^{[12
]}

Piacentini, G. L. ^{[13
]}

Middelveld, R. J. M. ^{[14
]}

Carlsen, K. H. ^{[2
]}

机构：

[1] Univ Oslo, Dept Paediat, Women & Childrens Div, Oslo Univ Hosp, NO-0407 Oslo, Norway

[2] Univ Oslo, Fac Med, NO-0407 Oslo, Norway

[3] Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden

[4] Royal Brompton Hosp, Dept Resp Paediat, London SW3 6LY, England

[5] Univ Gothenburg, Dept Paediat, Queen Silvia Childrens Hosp, Gothenburg, Sweden

[6] Salesi Childrens Hosp, Dept Paediat, Ancona, Italy

[7] Erasmus Univ, Med Center, Sophia Childrens Hosp, Dept Paediat, Rotterdam, Netherlands

[8] Univ Padua, Sch Med, Dept Paediat, Padua, Italy

[9] Univ Helsinki, Cent Hosp, Dept Allergy, Helsinki, Finland

[10] Charles Univ Prague, Fac Med 2, Prague, Czech Republic

[11] Univ Hosp Motol, Prague, Czech Republic

[12] Univ So Denmark, Dept Paediat, Kolding Hosp, Kolding, Denmark

[13] Univ Verona, Dept Paediat, I-37100 Verona, Italy

[14] Karolinska Inst, Inst Environm Med, Ctr Allergy Res, S-10401 Stockholm, Sweden

来源：

EUROPEAN RESPIRATORY JOURNAL | 2011年 / 37卷 / 02期

关键词：

Asthma; child; diagnostics; severe; QUALITY-OF-LIFE; EXERCISE-INDUCED BRONCHOCONSTRICTION; EXHALED BREATH CONDENSATE; LUNG-FUNCTION; AIRWAY HYPERRESPONSIVENESS; SPUTUM INDUCTION; BRONCHIAL RESPONSIVENESS; CHRONIC SINUSITIS; INDOOR ALLERGENS; CHILDHOOD ASTHMA;

D O I：

10.1183/09031936.00091410

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Assessment of problematic severe asthma in children should be performed in a stepwise manner to ensure an optimal approach. A four-step assessment scheme is proposed. First, a full diagnostic work-up is performed to exclude other diseases which mimic asthma. Secondly, a multi-disciplinary assessment is performed to identify issues that may need attention, including comorbidities. Thirdly, the pattern of inflammation is assessed, and finally steroid responsiveness is documented. Based upon these four steps an optimal individualised treatment plan is developed. In this article the many gaps in our current knowledge in all these steps are highlighted, and recommendations for current clinical practice and future research are made. The lack of good data and the heterogeneity of problematic severe asthma still limit our ability to optimise the management on an individual basis in this small, but challenging group of patients.

引用

页码：432 / 440

页数：9

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