Managing an acute asthma exacerbation in children

Abstract Children and youth with acute asthma exacerbations frequently present to an emergency department with signs of respiratory distress. The most severe episodes are potentially life-threatening. Effective treatment depends on the accurate and rapid assessment of disease severity at presentation. This statement addresses the assessment, management, and disposition of paediatric patients with a known diagnosis of asthma who present with an acute asthma exacerbation. Guidance includes the assessment of asthma severity, treatment considerations, proper discharge planning, follow-up, and prescription for inhaled corticosteroids to prevent exacerbation and decrease chronic morbidity.

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Increased expression of serum periostin and YKL40 in children with severe asthma and asthma exacerbation

Journal of Investigative Medicine ◽

10.1136/jim-2017-000680 ◽

2018 ◽

Vol 66 (8) ◽

pp. 1102-1108 ◽

Cited By ~ 7

Author(s):

Noussa Ragab El Basha ◽

Hanan Mohsen Osman ◽

Amaal Abdo Abdelaal ◽

Salma Mohamed Saed ◽

Hala Hamdy Shaaban

Keyword(s):

Asthma Exacerbation ◽

Acute Asthma ◽

Serum Levels ◽

Asthma Severity ◽

P Value ◽

Children With Asthma ◽

Acute Asthma Exacerbation ◽

Healthy Control ◽

Acute Asthma Exacerbations ◽

Serum Periostin

Children with severe asthma or acute asthma exacerbation may encounter difficulties in performing pulmonary function tests. In this situation, serum biomarkers can play a great role in evaluation of such patients. The aim of this study was to estimate the serum levels of human chitinase-3-like protein 1 (YKL40) and periostin in a group of Egyptian children with asthma during acute asthma exacerbation and in stable asthmatics compared with healthy control, and to correlate these findings with the severity of asthma. This cross-sectional study enrolled 120 childrenwith asthma with different degrees of asthma severity, according to the Global Initiative for Asthma guidelines, along with 60 age-matched and sex-matched healthy control. A complete blood count and an estimation of serum periostin and YKL40 levels were performed for all cases and control. Individual and mean values of periostin and YKL40 were significantly higher during acute asthma exacerbations, p<0.001. A highly significant relation between serum levels of periostin and YKL40 and asthma severity, p value for each was <0.001. Absolute eosinophil count was significantly correlated with the serum periostin levels in stable asthmatic group (p=0.01) only. There was significantly positive correlation (P<0.001) between both markers in stable asthmatic group. Spearman’s correlation coefficient shows a statistically significant positive correlation between both markers and patient’s age and duration of asthma, p value for each was 0.001. These findings highlight the importance of periostin and YKL40 as serum biomarkers for assessment of asthma severity and acute asthma exacerbations in children with asthma.

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