Comprehensive Review: Asthma Treatment Strategies for Children

This essay provides a comprehensive analysis of asthma treatment in children, focusing on a case involving a 10-year-old child. It addresses key research questions related to medical background, physical examination, lung function tests, and the effectiveness of salbutamol. The study highlights the urgency of addressing asthma in pediatric populations, noting the increasing prevalence and the importance of early detection and effective anti-inflammatory therapy. It further explores the clinical and functional features of bronchial asthma, emphasizing the significance of inpatient technologies and individualized treatment plans. The essay also discusses potential risk factors, such as atopic constitution and respiratory infections, and concludes by recommending comprehensive diagnostic approaches and nebulizer therapy as an alternative for emergency care. Desklib offers a platform to access this and many other solved assignments.

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Introduction
Asthma is usually defined as a chronic pulmonary disease which involves the lungs
airways. For asthmatic patients. The airways in the lungs are usually inflamed and sometimes
one may need induced assistance or otherwise to help them during a breathing difficulty. When
the airwaves tightens, it is because they have something that have triggered them. The research
questions in proper treatment of the 10 year old boy is to first get his medical background.
Another question that is relevant in this diagnosis is whether physical examination is necessary.
For treatment of asthma, lung function test may be needed. Other tests include the chest test or
the sinus X-ray test. Other questions to be answered in this is how effective is the prescribed
salbutamol in treatment of asthma? What is the most appropriate step down strategies with
patients with mild asthma? Does the constant use of inhaled steroids in bronchial asthma for a
long period of time cause the airway to fully depend on the steroids? Asthmatic children who
show uncontrolled symptoms on standard doses of inhaled corticosteroids (ICS), are
recommended to either increase the controller medication example LABA (long acting beta-
agonist) or increase the ICS dose (Jartti, and Gern, 2017). It is also important to follow the
stepwise approach in treatment of children with asthma which almost all the international set
rules and guidelines follow and recommend. However, in recommending the type of treatment
best suited for the child, the best method will be the one with the highest effect to help the child
breath.

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The urgency of the problem
In the pediatric population, asthma is among the most common diseases. According to
official statistics, over the past 10 years, the number of children with asthma has increased 2.5
times and exceeded a quarter of a million people. Studies performed in a number of Russian
cities have shown that the prevalence of bronchial asthma in different age groups ranges from 3
to 12%. The results of modern epidemiological studies carried out according to the unified
international program of the ISSAC (International Study of Asthma and Allergy in Childhood)
show that the true prevalence of bronchial asthma is several times higher than the recorded
prevalence. Officially, the disease is counted only in 1 of 4-5 patients (Looijmans-Van den
Akker, van Luijn,. and Verheij, 2016).
Starting in early childhood, continuing into adolescence and adulthood, bronchial asthma
often causes disability and premature mortality. Among disabled children with respiratory
diseases, 90% of patients with bronchial asthma. Of all cases of asthma, 12–14% are severe
forms of the disease. The early onset and the increase in the frequency of severe forms and
deaths determine its not only general medical, but also social and economic significance.
Adopted in 1997 (2004 revision) National Program “Bronchial Asthma in Children. The
strategy of treatment and prevention allowed us to standardize approaches to the diagnosis and
treatment of the disease. However, it is not always possible to recognize the disease in time,
adequately assess the severity of the condition, conduct an effective anti-inflammatory therapy,
and thus achieve complete control over the symptoms of the disease. Today, the organization of
outpatient care for asthma patients on the basis of modern, highly informative diagnostic and
treatment methods is one of the priority tasks of the pulmonological service of pediatrics. The

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use of inpatient technologies based on treatment-and-prophylactic and consultative-diagnostic
institutions allows for a complete clinical examination, timely diagnosis, planning tactics of
complex treatment and outpatient monitoring of patients, preventing the development of severe
forms of the disease and improving the quality of life of the patient and his family.
The severity of the disease is the fundamental criterion determining the further
therapeutic tactics. Diagnosis of severity of bronchial asthma is based on clinical symptoms and
the results of a functional study. However, in practice, a comprehensive assessment of the
severity of bronchial asthma is ambiguous and it can be difficult to draw a conclusion about the
severity of the disease in a clinical situation. This is due to the fact that the coincidence of all
recommended clinical and functional criteria within a single severity characteristic is not always
observed in a particular patient (Petsky, Li, and Chang, 2017).
It is optimal when emergency care, the development of an individualized treatment plan
and disease control are carried out sequentially, one after the other, in institutions that
simultaneously combine the functions of an inpatient and outpatient unit with sufficient
diagnostic and treatment facilities, both for providing emergency care and for conducting a full
examination. , development of tactics of complex treatment and outpatient monitoring of
patients.
Purpose of the study.
To study the modern clinical and functional features of the course of bronchial asthma in
children, to develop recommendations for the early detection and treatment of patients with the
use of inpatient technologies in the conditions of the Regional Clinical Diagnostic Center.

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Objectives of the study.
L To analyze the risk factors for the development of asthma, to study the clinical manifestations
and functional changes in the lungs, depending on the severity and course of the disease.
2. To study the features of immunological parameters in various forms of the disease.
3. Evaluate the importance of an integrated approach in the diagnosis of bronchial asthma and
develop an algorithm for examining children in a diagnostic center.
4. Justify recommendations for achieving control over the symptoms of the disease and
providing emergency care to patients in the prehospital phase.
Scientific novelty
The possibilities of modern diagnostics and treatment of the disease using inpatient
technologies in the outpatient stage are presented.Clinical manifestations and functional changes
in the lungs were studied depending on the severity and course of bronchial asthma in children.
The diagnostic significance of indicators of respiratory function was determined: PSV, OFVM
MOS50, MOS75, which play the role of functional criteria in assessing the severity of the course
and controlling symptoms of the disease (Pijnenburg, et al, 2015).
High clinical and functional efficacy (96.2%) of nebulizer therapy has been established,
its use as an alternative option to provide emergency care at the pre hospital stage has been
proposed.

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The information content of the PSV index, determined by the method of peak flow measurement,
was assessed in assessing the severity of exacerbations of bronchial asthma and the effectiveness
of emergency treatment.
High efficacy and safety of nebulizer therapy in children allows us to recommend this
method as an alternative when providing emergency care to patients with bronchial asthma at the
outpatient stage.
Potential risk factors for the development of bronchial asthma were revealed: atopic
constitution in 87%; respiratory chlamydial infection. in 50%, mycoplasma infection in 35%, and
also conditions aggravating asthma: diseases of the gastrointestinal tract in 94%, upper
respiratory tract in 88%, nervous system in 49% and the endocrine system in 30%.
Conclusion
High efficiency and safety of nebulizer therapy in children to allow to recommend this method as
an alternative when providing emergency care to patients with bronchial asthma at the outpatient
stage. Detection of bronchial asthma in children requires a comprehensive, differentiated
diagnostic approach with a detailed one. Study of internal and external risk factors, allergological
anamnesis data, evaluation of the results of clinical and functional allergological and
immunological examinations, as well as a parallel analysis of the concomitant somatic and
infectious background that aggravates the course of the underlying disease (Zahran, Bailey,
Damon, Garbe,. and Breysse, 2018).

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A number of clinical features of bronchial asthma in the form of: prolonged pertussis cough,
increased recurrence of bronchial obstruction, prolonged exacerbations, slow clinical and
laboratory dynamics, more persistent reduction in bronchial patency, lack of clinical and
laboratory signs of inflammation, and insufficient efficacy of basic anti-inflammatory,
bronchodilator drugs and improvement against etiotropic antibiotic therapy.

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References
Jartti, T. and Gern, J.E., 2017. Role of viral infections in the development and exacerbation of
asthma in children. Journal of Allergy and Clinical Immunology, 140(4), pp.895-906.
Looijmans-Van den Akker, I., van Luijn, K. and Verheij, T., 2016. Overdiagnosis of asthma in
children in primary care: a retrospective analysis. Br J Gen Pract, 66(644), pp.e152-e157.
Petsky, H.L., Li, A. and Chang, A.B., 2017. Tailored interventions based on sputum eosinophils
versus clinical symptoms for asthma in children and adults. Cochrane database of systematic
reviews, (8).
Pijnenburg, M.W., Baraldi, E., Brand, P.L., Carlsen, K.H., Eber, E., Frischer, T., Hedlin, G.,
Kulkarni, N., Lex, C., Mäkelä, M.J. and Mantzouranis, E., 2015. Monitoring asthma in
children. European Respiratory Journal, 45(4), pp.906-925.
Zahran, H.S., Bailey, C.M., Damon, S.A., Garbe, P.L. and Breysse, P.N., 2018. Vital signs:
asthma in children—United States, 2001–2016. Morbidity and Mortality Weekly Report, 67(5),
p.149.