RT Journal Article
SR Electronic
T1 Classification and pharmacological treatment of preschool wheezing: changes since 2008
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1172
OP 1177
DO 10.1183/09031936.00199913
VO 43
IS 4
A1 Paul L.P. Brand
A1 Daan Caudri
A1 Ernst Eber
A1 Erol A. Gaillard
A1 Luis Garcia-Marcos
A1 Gunilla Hedlin
A1 John Henderson
A1 Claudia E. Kuehni
A1 Peter J.F.M. Merkus
A1 Soren Pedersen
A1 Arunas Valiulis
A1 Göran Wennergren
A1 Andrew Bush
YR 2014
UL http://erj.ersjournals.com/content/43/4/1172.abstract
AB Since the publication of the European Respiratory Society Task Force report in 2008, significant new evidence has become available on the classification and management of preschool wheezing disorders. In this report, an international consensus group reviews this new evidence and proposes some modifications to the recommendations made in 2008. Specifically, the consensus group acknowledges that wheeze patterns in young children vary over time and with treatment, rendering the distinction between episodic viral wheeze and multiple-trigger wheeze unclear in many patients. Inhaled corticosteroids remain first-line treatment for multiple-trigger wheeze, but may also be considered in patients with episodic viral wheeze with frequent or severe episodes, or when the clinician suspects that interval symptoms are being under reported. Any controller therapy should be viewed as a treatment trial, with scheduled close follow-up to monitor treatment effect. The group recommends discontinuing treatment if there is no benefit and taking favourable natural history into account when making decisions about long-term therapy. Oral corticosteroids are not indicated in mild-to-moderate acute wheeze episodes and should be reserved for severe exacerbations in hospitalised patients. Future research should focus on better clinical and genetic markers, as well as biomarkers, of disease severity. The distinction between episodic viral and multiple-trigger wheeze is unclear in many preschool children http://ow.ly/sKYZF