Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 18;20(1):66.
doi: 10.1186/s12890-020-1101-6.

Clinical and lung function outcomes in a cohort of children with severe asthma

Patricia de Gouveia Belinelo  1   2 , Aleisha Nielsen  1   2 , Bernadette Goddard  2 , Lauren Platt  2 , Carla Rebeca Da Silva Sena  1 , Paul D Robinson  3 , Bruce Whitehead  2 , Jodi Hilton  2 , Tanya Gulliver  2 , Laurence Roddick  2 , Kasey Pearce  2 , Vanessa E Murphy  1 , Peter G Gibson  4   5 , Adam Collison  1 , Joerg Mattes  6   7
Affiliations

Clinical and lung function outcomes in a cohort of children with severe asthma

Patricia de Gouveia Belinelo et al. BMC Pulm Med. .

Abstract

Background: Uncontrolled severe asthma in children is burdensome and challenging to manage. This study aims to describe outcomes in children with uncontrolled severe asthma managed in a nurse-led severe asthma clinic (SAC).

Methods: This retrospective analysis uses data collected from children referred by a paediatric respiratory specialist to a nurse-led SAC for uncontrolled severe asthma between 2014 and 2019. The pre-clinical assessments included a home visit to assess modifiable factors that could be addressed to improve control. A comprehensive lung function analysis was conducted at each visit. Interventions were personalised and included biologic agents. Statistical analysis was performed using nonparametric, two-tailed Mann-Whitney U-test, the parametric Student's t-test, or analysis of variance (ANOVA) as appropriate.

Results: Twenty-three children with a median age of 12 years were seen once, and 16 were followed up. Compared to a non-asthmatic (NA) and asthmatic (A) age-matched cohort, children with severe asthma (SA) had a lower FEV1, and FVC% predicted before and after bronchodilator inhalation, and a higher mean Lung Clearance Index [LCI] (10.5 [SA] versus 7.3 [NA] versus 7.6 [A], p = 0.003). Almost 80% of children with SA had an abnormal LCI, and 48% had a reduced FEV1% at the first SAC visit. Asthma control and FEV1% predicted significantly improved at a follow-up visit, while LCI remained abnormal in the majority of children (83%).

Conclusion: Over time, many children with severe asthma showed improved clinical outcomes and lung function while lung ventilation inhomogeneities persisted. Future appropriately controlled studies are required to determine if a nurse-led multidisciplinary SAC is associated with better outcomes.

Keywords: Childhood asthma; Lung function; Multidisciplinary clinic; Severe asthma.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43(2):343–373. doi: 10.1183/09031936.00202013. - DOI - PubMed
    1. Mattes JSS. Mechanisms in children. In: Chung KF, Israel E, Gibson PG, editors. Severe Asthma (ERS Monograph). Sheffield: European Respiratory Society. 2019. p. 231–45.
    1. Bush A, Fleming L, Saglani S. Severe asthma in children. Respirology. 2017;22(5):886–897. doi: 10.1111/resp.13085. - DOI - PubMed
    1. Haughney J, Price D, Kaplan A, Chrystyn H, Horne R, May N, et al. Achieving asthma control in practice: understanding the reasons for poor control. Respir Med. 2008;102(12):1681–1693. doi: 10.1016/j.rmed.2008.08.003. - DOI - PubMed
    1. Haktanir Abul M, Phipatanakul W. Severe asthma in children: evaluation and management. Allergol Int. 2019;68(2):150–157. doi: 10.1016/j.alit.2018.11.007. - DOI - PubMed

Substances