Asthma Diagnosis and Management in Pediatric Populations

Asthma in children is a chronic inflammatory disorder of the airways, marked by variable airflow obstruction and bronchial hyper-reactivity. Accurate diagnosis combines a thorough clinical history—focusing on recurrent wheezing, cough, exertional breathlessness and diurnal symptom variation—with objective assessments such as spirometry, bronchodilator reversibility testing and measurement of airway inflammation. In very young children, where standard lung function tests may be impractical, diagnosis often relies on symptom patterns and therapeutic response. Management adopts a stepwise approach: inhaled corticosteroids form the cornerstone of controller therapy, short-acting β2-agonists provide relief, and adjuncts such as leukotriene receptor antagonists or biologic agents are reserved for poorly controlled or severe cases. Central to effective management are written asthma action plans, regular review of control and inhaler technique, assessment of adherence, and avoidance of environmental triggers. International guidelines offer a framework for care, yet practice varies globally. Recent advances emphasise personalised treatment, validation of novel biomarkers and implementation of self-management programmes and telehealth, particularly in resource-limited settings, to reduce paediatric morbidity and optimise long-term outcomes.

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Asthma Diagnosis and Management in Pediatric Populations publication trend

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Technical terms

Spirometry: A lung function test measuring volumes and flow rates, including FEV₁ and FVC.

Forced expiratory volume in one second (FEV₁): The volume of air expelled in the first second of a forced exhalation.

Forced vital capacity (FVC): The total volume of air expelled during a complete forced exhalation.

Bronchodilator reversibility: The change in spirometric parameters following inhalation of a bronchodilator.

Fractional exhaled nitric oxide (FeNO): A non-invasive biomarker of eosinophilic airway inflammation.

Asthma action plan: A personalised, written guide to daily management and recognition of worsening symptoms.

Biologic therapy: Targeted treatments that interfere with specific immune pathways, such as anti-IgE or anti-IL-5 antibodies.

References

1. Asthma. Allergy, Asthma & Clinical Immunology (2018).
2. Assessment of Airway Bronchodilation by Spirometry Compared to Airway Obstruction in Young Children with Asthma. Canadian Respiratory Journal (2016).
3. Asthma under/misdiagnosis in primary care setting: an observational community-based study in Italy. Clinical and Molecular Allergy (2015).
4. Sensitivity of FEV1 and Clinical Parameters in Children With a Suspected Asthma Diagnosis. The Journal of Allergy and Clinical Immunology In Practice (2022).
5. Implementation of an intervention to improve the adoption of asthma self-management practices in Peru: Asthma Implementation Research (AIRE) randomized trial study protocol. Trials (2020).