《2010CTS年共识：总结六岁及以上的儿童和成人哮喘的管理指南》内容预览

BACKGROUND/OBJeCTive: To integrate new evidence into theCanadian Asthma Management Continuum diagram, encompassing bothpediatric and ** asthma.

MeTHODS: The Canadian Thoracic Society Asthma Committee mem-bers, comprised of experts in pediatric and ** respirology, allergy andimmunology, emergency medicine, general pediatrics, family medicine,pharmacoepidemiology and evidence-based medicine, updated the con-tinuum diagram, based primarily on the 2008 Global Initiative for Asthmaguidelines, and performed a focused review of literature pertaining to keyaspects of asthma diagnosis and management in children six years of ageand over, and **s.

ReSULTS: In patients six years of age and over, management of asthmabegins with establishing an accurate diagnosis, typically by supplementingmedical history with objective measures of lung function. All patients andcaregivers should receive self-management education, including a writtenaction plan. Inhaled corticosteroids (ICS) remain the first-line controllertherapy for all ages. When asthma is not controlled with a low dose ofICS, the literature supports the addition of long-acting beta2-agonists in**s, while the preferred approach in children is to increase the dose ofICS. Leukotriene receptor antagonists are acceptable as second-line mono-therapy and as an alternative add-on therapy in both age groups. Anti-immunoglobulin E therapy may be of benefit in **s, and in children12 years of age and over with difficult to control allergic asthma, despitehigh-dose ICS and at least one other controller.

CONCLUSiONS: The foundation of asthma management is establishingan accurate diagnosis based on objective measures (eg, spirometry) in indi-viduals six years of age and over. Emphasis is placed on the similarities anddifferences between pediatric and ** asthma management approaches toachieve asthma control.

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