Approach to young wheezers

Jessie Anne de Bruyne
Universiti Malaya Medical Centre, Kuala Lumpur​, Malaysia

Wheezing is common in young children primarily because of their relatively smaller airways and also due to their Increased peripheral airway resistance and decreased elastic recoil pressure. It is also often confused with other respiratory sounds and the approach to young wheezers should include identifying the sound accurately.

It may not be possible to make an accurate diagnosis. The following factors should be considered:
- the pattern of wheezing – acute, persistent, recurrent
- age at onset
- severity
- family and personal history of asthma and atopy
- trigger factors if any
- association with other symptoms like failure to thrive

Management includes inhaled bronchodilators for acute episodes plus or minus inhaled corticosteroids or leukotriene antagonists as maintenance therapy in those with more troublesome symptoms.

Patient and care-giver education is crucial to ensure understanding of the condition and acceptance and compliance with appropriate treatment as well as appropriate medication delivery.