From the Guidelines
Pediatric respiratory guidelines prioritize supportive care for bronchiolitis, including nasal suctioning, adequate hydration, and monitoring oxygen saturation, as bronchodilators and corticosteroids are generally not recommended 1. For asthma management, a stepwise approach is recommended, starting with as-needed short-acting beta-agonists and adding inhaled corticosteroids for persistent symptoms. Bacterial pneumonia typically requires antibiotics, while viral pneumonia is managed supportively. Some key points to consider in pediatric respiratory care include:
- Age-appropriate assessment techniques
- Recognition of respiratory distress signs, such as tachypnea, retractions, and nasal flaring
- Timely escalation of care when needed
- Regular reassessment of treatment effectiveness and adjustment of management plans based on clinical response
- Oxygen supplementation should be provided when saturation falls below 90-92% 1. It's also important to note that guidelines for managing pediatric bronchiectasis have been developed, which include recommendations for investigation and treatment strategies, such as antibiotic treatment of exacerbations and long-term antibiotic therapy 1. Key considerations in managing pediatric respiratory conditions include:
- Providing supportive care for bronchiolitis
- Using a stepwise approach for asthma management
- Recognizing and responding to respiratory distress signs
- Adjusting management plans based on clinical response
- Considering the latest guidelines and recommendations for specific conditions, such as bronchiectasis.
From the FDA Drug Label
Pediatric patients (4 years of age and older) should be started with 100 mcg (1 spray in each nostril once daily). Treatment with 200 mcg (2 sprays in each nostril once daily or 1 spray in each nostril twice daily) should be reserved for pediatric patients not adequately responding to 100 mcg daily Once adequate control is achieved, the dosage should be decreased to 100 mcg (1 spray in each nostril) daily. Maximum total daily doses should not exceed 2 sprays in each nostril (total dose, 200 mcg/day).
The recommended dosage for pediatric patients 4 years of age and older is 100 mcg once daily, with a maximum total daily dose of 200 mcg.
- The dosage may be increased to 200 mcg for patients not adequately responding to 100 mcg daily.
- Once adequate control is achieved, the dosage should be decreased to 100 mcg daily 2.
From the Research
Pediatric Respiratory Guidelines
There are no research papers to assist in answering this question as the provided studies focus on adult asthma treatment and respiratory system assessment.
Available Studies
- The studies provided focus on the treatment of adult asthma, including the comparison of inhaled fluticasone with intravenous hydrocortisone 3, the proposal of a new therapeutic dose terminology for inhaled corticosteroids 4, and the comparison of the clinical effectiveness of different inhaled corticosteroids and long-acting beta-agonists 5.
- Another study discusses the assessment and examination of the respiratory system, including patient history and physical examination 6.
- A systematic review and meta-analysis examines the efficacy of inhaled corticosteroids in the treatment of acute asthma in emergency departments 7.
Key Findings
- Inhaled fluticasone was found to be more effective than intravenous hydrocortisone in the treatment of adult acute asthma 3.
- The proposal of a new therapeutic dose terminology for inhaled corticosteroids suggests that the current classification of low, medium, and high doses is not evidence-based 4.
- The comparison of different inhaled corticosteroids and long-acting beta-agonists found that fluticasone and formoterol appear to provide improved therapeutic benefits 5.
- The systematic review and meta-analysis found that high doses of inhaled corticosteroids, in addition to systemic corticosteroids, reduce the risk of hospital admission in emergency department treatment of moderate-to-severe asthma exacerbations 7.