Consenso para el abordaje del asma grave pediátrica en la práctica clínica habitual
- A. M. Plaza
- Mª Dolores Paloma Ibáñez Sandín
- M. Sánchez Solís
- M. Bosque García
- María Jesús Cabero Pérez
- José Luis Corzo Sierra
- G. García Hernández
- Belén de la Hoz Caballer
- José Javier Korta Murua
- Carlos Alberto Sánchez Salguero
- Javier Torres Borrego
- Miguel Tortajada Girbés
- José Valverde Molina
- L. Zapatero Remón
- A. Nieto
ISSN: 1695-4033, 1696-4608
Year of publication: 2016
Volume: 84
Issue: 2
Pages: 122-122
Type: Article
More publications in: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Abstract
Introduction Accurate identification of paediatric patients with severe asthma is essential for an adequate management of the disease. However, criteria for defining severe asthma and recommendations for control vary among different guidelines. Material and methods An online survey was conducted to explore expert opinions about the definition and management of severe paediatric asthma. To reach a consensus agreement, a modified Delphi technique was used, and practice guidelines were prepared after the analysis of the results. Results Eleven paediatric chest disease physicians and allergy specialists with wide expertise in severe asthma responded to the survey. Consensus was reached in 50 out of 65 questions (76.92%). It was considered that a patient has severe asthma if during the previous year they have required 2 or more cycles of oral steroids, required daily treatment with medium doses of inhaled corticosteroids (with other controller medication) or high doses (with or without other controller medication), did not respond to optimised conventional treatment, or if the disease threatened the life of the patient or seriously impairs their quality of life. The definition of severe asthma may also include patients who justifiably use health resources on a regular basis, or have psychosocial or environmental factors impeding control. For monitoring, the use of questionnaires designed specifically for paediatric population, such as CAN or ACT, is recommended. As regards treatment, the use of omalizumab should be considered prior to the use of oral corticosteroids. Conclusions This paper provides consensus recommendations that may be useful in the management of severe paediatric asthma.