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Asthma in children and adolescents - Prognosis
- Highlights
- Introduction
- Causes
- Risk Factors
- Prognosis
- Symptoms
- Diagnosis
- Treatment
- Quick-Relief Medications
- Long-Term Relief Medications
- Other Treatments
- Managing Asthma At Home
Description
An in-depth report on how asthma is diagnosed, treated, and managed in children and adolescents.Prognosis:
Asthma is the third major cause of hospitalization in children under age 15. The condition can be very serious in children, particularly those younger than age 5, because their airways are very narrow.
Risk Factors for Life-Threatening Asthma
Asthma death rates have steadily declined and it now is rarely fatal in children Even low mortality numbers are unacceptable, however, since asthma deaths are largely preventable.
Factors associated with an increased risk of death from asthma in children include:
- Previous life-threatening episodes of asthma
- Two or more hospitalizations or more than three emergency visits in the past year
- Using two or more short-acting beta2-agonist inhalers per month
- Lack of adequate and ongoing health care. (Most likely the reason for the higher fatalities rates in minority children.)
- Significant behavioral or psychosocial problems
- Underestimating the severity of an acute attack poses the greatest threat
African-American children have more than six times the death rate of Caucasians in the age groups of 4 years and younger and 15 - 24 years. Hispanic children also have a higher risk.
Long-Term Outlook
Some children outgrow their asthma by adulthood. In general, the more severe the childhood asthma, the greater the likelihood that it will persist. There is evidence that severe asthma can cause long-lasting damage and possibly permanent scarring in some patients. The risk for such injury is highest when asthma strikes children in their first 3 - 5 years. There does not appear to be any significant risk for long-term lung damage for children who develop mild-to-moderate persistent asthma between ages 5 - 12. Children adapt well to living with asthma, and even with severe asthma they can function as well as healthy children in virtually all areas of life.
Resources
- www.lungusa.org -- The American Lung Association
- www.acaai.org -- American College of Allergy, Asthma & Immunology
- www.aaaai.org -- American Academy of Allergy, Asthma, and Immunology
- www.nhlbi.nih.gov -- National Heart, Lung, and Blood Institute
- www.aafa.org -- Asthma and Allergy Foundation of America
- www.aanma.org -- Allergy and Asthma Network, Mothers of Asthmatics
References
American Lung Association Asthma Clinical Research Centers, Peters SP, Anthonisen N, Castro M, Holbrook JT, Irvin CG, et al. Randomized comparison of strategies for reducing treatment in mild persistent asthma. N Engl J Med. 2007 May 17;356(20):2027-39.
Bateman E, Nelson H, Bousquet J, Kral K, Sutton L, Ortega H, Yancey S. Meta-analysis: effects of adding salmeterol to inhaled corticosteroids on serious asthma-related events. Ann Intern Med. 2008 Jul 1;149(1):33-42. Epub 2008 Jun 3.
Castro-Rodriguez JA, Rodrigo GJ. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Pediatrics. 2009 Mar;123(3):e519-25.
Fanta CH. Asthma. N Engl J Med. 2009 Mar 5;360(10):1002-14.
Greer FR, Sicherer SH, Burks AW; American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008 Jan;121(1):183-91.
Kukkonen K, Savilahti E, Haahtela T, Juntunen-Backman K, Korpela R, Poussa T, et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol. 2007 Jan;119(1):192-8. Epub 2006 Oct 23.
National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publications 08-4051.
Stern DA, Morgan WJ, Halonen M, Wright AL, Martinez FD. Wheezing and bronchial hyper-responsiveness in early childhood as predictors of newly diagnosed asthma in early adulthood: a longitudinal birth-cohort study. Lancet. 2008 Sep 20;372(9643):1058-64.
Vliagoftis H, Kouranos VD, Betsi GI, Falagas ME. Probiotics for the treatment of allergic rhinitis and asthma: systematic review of randomized controlled trials. Ann Allergy Asthma Immunol. 2008 Dec;101(6):570-9.
- Reviewed last on: 6/1/2009
- Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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