THE CAUSAL FACTORS
OF ACUTE ASTHMA EXACERBATION IN CHILDREN
Najberg E, Piontek E, Wasaznik G
Children's Memorial Health Institute, Warsaw,
Poland
The
study we tried to determine triggers of severe acute asthma episodes. We
analysed patients admitted to our Allergology. Department with severe
asthma exacerbation during three last years. The study group consisted of 218 children (142 boys and
76 girls) from 10 months to 18 years of age. 189 had atopic and 29
non-atopic bronchial asthma. We divided our patients into two groups: 1)
younger group - 150 children aged 10 months to 6 years, and 2) older group
- 68 children aged 7 to 18 years. At the time of admission to hospital all
patients had clinical symptoms of acute asthma exacerbation, abnormal blood
gas measurements, poor lung function tests. Some of them had symptoms
suggestive acute infection (fever, headache, sore of throat, cough,
rhinitis). 65 (30%) our patients were treated with antibiotics. 11 children
were admitted to Intensive Care Unit for 2-6 days because of poor response
to treatment with oxygen, bronchodilatators and glicocorticoids. Results:
1) in younger group, in 134 (90%) patients acute episodes of asthma were
unequivocally connected with respiratory infection and in 3 patients exposure
to allergen was suggested. 7 patients received to low dose of long-term
treatment. In 6 cases we couldn't define causal factor of asthma
exacerbation. 2) In older group symptoms of respiratory infection have been
found in 40 (59%) children. Emotional stress, exposure to allergen or
excessive exercises was associated with acute attacks of asthma in 10
patients. 9 children didn't receive long-term treatment. In 9 cases the cause of
exacerbation was difficult to define. We concluded that respiratory infections
play the most important role in the induction of severe asthma exacerbation
in children. Introducing of antibiotic therapy can reduce severity of
bronchial asthma in children with bacterial infection.