Wheezing in Paediatric Patients

The prevalence of wheezing disorders in children younger than 6 years varies worldwide and appears to have increased during the last decade. It is estimated that about one in three children experiences wheezing during the first 3 years of life. One-third of preschoolers develop recurrent wheezing, defined as four or more episodes in the previous year. Many children with recurrent wheezing develop eosinophilic asthma, although only 40% of them will show recurrent wheezing later in childhood. Phenotyping preschool children with wheezing is essential to understanding the pathophysiology of the disease in order to provide effective management and treatment strategies. A symptom-based approach has been revealed to be inadequate and there is yet no consensus as to the appropriate way to manage preschool wheeze. Basic management requires the paediatrician to identify any underlying diagnosis and to establish empathetic communication with parents in order to decide whether to continue or not ineffective therapies.