Skip to main content
SpringerLink
Log in

Asthma bronchiale bei Kindern und Jugendlichen

Bronchial asthma in children and adolescents

  • CME Zertifizierte Fortbildung
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Asthma bronchiale ist eine der häufigsten chronischen Erkrankungen bei Kindern und Jugendlichen mit einer Prävalenz von rund 10 % in den deutschsprachigen Ländern. Typische Symptome sind pfeifende Atemgeräusche, Enge im Brustkorb und Atemnot. Die Diagnose wird klinisch gestellt; der wichtigste objektive Parameter ist der Nachweis der reversiblen Atemwegsobstruktion. Verschiedene Leitlinien stehen national und international für die Therapie zur Verfügung. Neben der medikamentösen Therapie ist das nichtmedikamentöse Management mit Allergenkarenz, Compliance-Überprüfung, Vermittlung der richtigen Inhalationstechnik und umfassender strukturierter Patientenschulung von großer Bedeutung.

Abstract

Bronchial asthma is one of the most common chronic diseases in childhood with a prevalence of approximately 10 % in German-speaking countries. Typical symptoms are wheezing, narrowing of the chest and dyspnea. The diagnosis is made based on clinical symptoms and the most important objective parameter is proof of airway obstruction. National and international guidelines provide a standardized treatment. The main pillars of management are anti-inflammatory drugs, beta- 2- agonists, compliance testing, instruction on the correct inhalation technique, comprehensively structured patient educational programs and in selected cases allergen immunotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Asher MI et al (2006) Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood. ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet 368:733–743

    Article  PubMed  Google Scholar 

  2. Eder W et al (1998) Prävalenz und Schweregrad von Asthma bronchiale, allergischer Rhinitis und atopischer Dermatitis bei Salzburger Schulkindern. Wien Klin Wochenschr 110/19:669–677

  3. Lai CK et al (2009) Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 64(6):476–483

    Article  CAS  PubMed  Google Scholar 

  4. Riedler J et al (1998) Prevalence of bronchial hyperresponsiveness to 4.5 % saline and its relation to asthma and allergy symptoms in Austrian children. Eur Respir J 11:355–360

    Article  CAS  PubMed  Google Scholar 

  5. Hamelmann E et al (2014) Asthma bronchiale. In: Mutius E von, Gappa M, Eber E, Frey U (Hrsg) Pädiatrische Pneumologie, 3. Aufl. Springer, Berlin, S 553–577

  6. Illi S et al (2006) Perennial allergen sensitisation early in life and chronic asthma in children: a birth cohort study. Lancet 368:763–770

    Article  PubMed  Google Scholar 

  7. Martinez FD et al (1995) Asthma and wheezing in the first six years of life. The Group Health Medical Associates. N Engl J Med 332(3):133–138

    Article  CAS  PubMed  Google Scholar 

  8. Sears MR et al (2003) A longitudinal, population-based, cohort study of childhood asthma followed to adulthood. N Engl J Med 349(15):1414–1422

    Article  CAS  PubMed  Google Scholar 

  9. Castro-Rodriguez JA (2011) The Asthma Predictive Index: early diagnosis of asthma. Curr Opin Allergy Clin Immunol 11(3):157–161

    Article  PubMed  Google Scholar 

  10. Guerra S et al (2004) Persistence of asthma symptoms during adolescence: role of obesity and age at the onset of puberty. Am J Respir Crit Care Med 170(1):78–85

    Article  PubMed  Google Scholar 

  11. Spahn JD et al (2008) Clinical assessment of asthma progression in children and adults. J Allergy Clin Immunol 121(3):548–557

    Article  PubMed  Google Scholar 

  12. Eder W et al (2006) The asthma epidemic. N Engl J Med 355(21):2226–2235

    Article  CAS  PubMed  Google Scholar 

  13. Riedler J et al (2001) Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet 358:1129–1133

    Article  CAS  PubMed  Google Scholar 

  14. Bisgaard H et al (2007) Childhood asthma after bacterial colonization of the airway in neonates. N Engl J Med 357(15):1487–1495

    Article  CAS  PubMed  Google Scholar 

  15. Hansen G et al (2013) Asthma bronchiale im Kindesalter. Monatsschr Kinderheilkd 161:390–398

    Article  Google Scholar 

  16. GINA Report (2014) Global strategy for asthma management and prevention. http://www.ginasthma.org

  17. Nationale Versorgungsleitlinie (2011) Asthma Langfassung, 2. Aufl. Version 1.3, Juli. http://www.versorgungsleitlinien.de/themen/asthma/pdf/nvl_asthma_lang.pdf

  18. Riedler J et al (2008) Leitlinie zur Behandlung des Asthma bronchiale bei Kindern und Jugendlichen. Wien Klin Wochenschr 120:54–60

    Article  PubMed  Google Scholar 

  19. Brand PL et al (2008) Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach. Eur Respir J 32(4):1096–1110

    Article  CAS  PubMed  Google Scholar 

  20. Götz M et al (2006) Rezidivierende obstruktive Bronchitis und Asthma bronchiale im Vorschulalter. Wien Klin Wochenschr 118/9–10:302–306

  21. Roth S et al (2009) Empfehlungen zur Behandlung der obstruktiven Atemwegserkrankungen im Kindesalter (SGPP/PIA-CH 2009). Paediatrica 20:44–51

    Google Scholar 

  22. Castro-Rodriguez JA, Rodrigo GJ (2009) Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Pediatrics 123:e519–e525

    Article  PubMed  Google Scholar 

  23. Guilbert TW et al (2011) Growth of preschool children at high risk for asthma 2 years after discontinuation of fluticasone. J Allergy Clin Immunol 128(5):956–963

    Article  PubMed Central  PubMed  Google Scholar 

  24. Kelly HW et al (2012) Effect of inhaled glucocorticoids in childhood on adult height. N Engl J Med 367(10):904–912

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Zhang L et al (2014) Inhaled corticosteroids in children with persistent asthma: effects on growth. Cochrane Database Syst Rev 8:CD009471

    Google Scholar 

  26. Nwokoro C et al (2014) Intermittent montelukast in children aged 10 months to 5 years with wheeze (WAIT trial): a multicentre, randomised, placebo-controlled trial. Lancet Respir Med 2:796–803

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  27. Guilbert TW et al (2006) Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med 354:1985–1997

    Article  CAS  PubMed  Google Scholar 

  28. Cates CJ et al (2012) Safety of regular formoterol or salmeterol in children with asthma: an overview of Cochrane reviews. Cochrane Database Syst Rev CD010005

  29. Ducharme FM et al (2010). Addition of long-acting beta2-agonists to inhaled steroids versus higher dose inhaled steroids in adults and children with persistent asthma. Cochrane Database Syst Rev 4:CD005533

    PubMed  Google Scholar 

  30. Gardia Garcia ML et al (2005) Montelukast compared with fluticasone, for control of asthma among 6- to 14-year-old patients with mild asthma. The MOSAIC Study. Pediatrics 116:360–369

    Article  Google Scholar 

  31. Szefler S et al (2005) Characterization of within-subject responses to fluticasone and montelukast in childhood asthma. J Allergy Clin Immunol 115:233–242

    Article  CAS  PubMed  Google Scholar 

  32. Lemanske RF Jr et al (2010) Step-up therapy for children with uncontrolled asthma receiving inhaled corticosteroids. N Engl J Med 362(11):975–985

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  33. Chauhan et al (2013) Addition of anti-leukotriene agents to inhaled corticosteroids in children with persistent asthma. Cochrane Database Syst Rev 10:CD009585

    PubMed  Google Scholar 

  34. Wolf F et al (2008) Educational interventions for asthma in children. Cochrane Database Syst Rev 4:CD000326

    Google Scholar 

  35. Abramson MJ et al (2010) Injection allergen immunotherapy for asthma. Cochrane Database Syst Rev 8:CD001186

    PubMed  Google Scholar 

  36. Pfarr O et al (2014) Leitlinie zur (allergen-) spezifischen Immuntherapie bei IgE-vermittelten allergischen Erkrankungen. Allergo J 23:282–319

    Article  Google Scholar 

  37. Gotzsche PC et al (2011) House dust mite control measures for asthma. Cochrane Database Syst Rev 10:CD001187

    Google Scholar 

  38. Riedler J (2014) Pediatric asthma- do we need more innovation for treatment? Pediatr Allergy Immunol 25:19–20

    Article  PubMed  Google Scholar 

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt. Chiesi: bezahlte Vorträge, Reiseunterstützung zu Kongressen; MSD: bezahlte Vorträge; Stallergen: Reiseunterstützung zu Kongressen; MEDA: bezahlte Vorträge; Fa. Pari, MEDA, Chiesi und Forest: Sponsoring von nationalen Fortbildungsveranstaltungen.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Author information

Authors and Affiliations

  1. Abteilung für Kinder- und Jugendmedizin, Kardinal Schwarzenberg’sches Krankenhaus, Kardinal-Schwarzenbergstr. 2–6, 5620, Schwarzach/Pongau, Österreich

    J. Riedler FERS

Authors
  1. J. Riedler FERS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Riedler FERS.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Riedler, J. Asthma bronchiale bei Kindern und Jugendlichen. Monatsschr Kinderheilkd 163, 833–846 (2015). https://doi.org/10.1007/s00112-015-3373-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00112-015-3373-0

Schlüsselwörter

Keywords

Search

Navigation