Assessment of problematic severe asthma in children
Assessment of problematic severe asthma in children
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DOI：
10.1183/09031936.00091410
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发表时间：
2011-02-01
影响因子：
24.3
通讯作者：
Carlsen, K. H.
中科院分区：
文献类型：
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作者：
Carlsen, K. C. Lodrup;Hedlin, G.;Carlsen, K. H.
对儿童严重哮喘问题的评估应逐步进行，以确保采取最佳方法。提出了四步评估方案。首先，进行全面的诊断检查以排除其他类似哮喘的疾病。其次，进行多学科评估，以确定可能需要注意的问题，包括合并症。第三，评估炎症模式，最后记录类固醇反应性。根据这四个步骤，制定最佳的个体化治疗计划。本文强调了我们目前在所有这些步骤中的知识差距，并对当前的临床实践和未来的研究提出了建议。缺乏良好的数据和有问题的严重哮喘的异质性仍然限制了我们在这一小而具有挑战性的患者群体中优化个体管理的能力。
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.