Written by Kimi Dunbar
Spoon Feed
Updates to pediatric asthma literature in 2023 highlight the importance of social drivers of health and mental health on asthma outcomes and the efficacy of single maintenance and reliever therapy (SMART) on asthma control.
Synopsis
This review summarizes key findings from recent pediatric asthma research, focusing on social determinants of health, novel diagnostic tools, and treatment advancements. Studies highlighted the impact of neighborhood factors, language barriers, and mental health on asthma outcomes, underscoring the need for integrated care approaches. Innovations in diagnostics include RNA sequencing for frequent exacerbations and impulse oscillometry for early detection of lung function impairment. In treatment, SMART and biologics like dupilumab showed promise for improving control. The review emphasizes addressing disparities and adopting new technologies to enhance asthma care in pediatric populations. (AI-generated)
It’s not easy being wheezy
This is a review of publications from 2023 that are likely to impact management of pediatric asthma. Here are some highlights:
- Social determinants of health remain a critical factor in asthma outcomes. Pollack et al. found that children had an adjusted 2.37 fewer asthma symptom days in a 2-week period after moving to a neighborhood with less poverty. Aris et al. found that children living in “very low-opportunity neighborhoods” (a measure of education, health/environment, social/economic domains) as young children have a higher incidence of asthma.
- Communication about asthma in a patient’s own language is of critical importance. Emmanuel et al. found that non-English language preference was associated with higher ED visits and hospital admissions.
- RSV infection remains a risk factor for the development of asthma. Rosas-Salazar et al. found that term infants who had an RSV infection prior to 1 year of age were significantly more likely to have asthma at 5 years old (21% vs. 16%).
- As we covered Friday, Yu et al. found SMART – decreases severe exacerbations and improves lung function.
- High-flow nasal cannula (HFNC) remains controversial for the management of asthma. Rogerson et al. found that HFNC use in asthma had a statistically longer length of stay; however, patients were also more likely to require noninvasive ventilation, suggesting that those who receive HFNC have more severe symptoms.
Editor’s note: SMART means the short-acting beta-agonist and inhaled steroid are combined in one inhaler. For years, it has been drilled into my head that inhaled steroids are only for prevention. It turns out, this combo really works. ~Clay Smith
Source
Pediatric pulmonology 2023 year in review: Asthma. Pediatr Pulmonol. 2024 Oct 16. doi: 10.1002/ppul.27321. Epub ahead of print. PMID: 39412413
