title: Severe and near-fatal asthma in children and adolescents.
abstract: Near-fatal asthma attacks occur rather frequently in asthmatic patients during childhood and adolescence. Major risk factors appear to be the severity and/or treatment difficulties, which may be related to the characteristics of the disease but also to mistaken or delayed diagnosis, poor compliance to treatment, and psychosocial problems. Indeed, difficult-to-control asthma symptoms can be caused by other disorders mimicking asthma, by unidentified exacerbating factors, by low compliance with the prescribed therapy, by inability to use the devices correctly (metered-dose inhalers, dry powder inhalers, nebulizers) and by low perceptiveness of airway obstruction. Children and adolescents with severe, difficult-to-treat asthma should receive specialist assessment and follow-up. Pharmacologic intervention should be combined with a detailed education and action plan, designed to get the disease under control but also to meet patient' and parents desires.
authors.affiliation: Dept of Pulmonology, G. Gaslini Institute, Genoa, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fregonese
authors.forename: M
authors.initials: M
authors.lastname: Silvestri
authors.forename: F
authors.initials: F
authors.lastname: Sabatini
authors.forename: A C
authors.initials: AC
authors.lastname: Defilippi
authors.forename: G A
authors.initials: GA
authors.lastname: Rossi
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D002648:Child; D006801:Humans; D012720:Severity of Illness Index