背景:2019年,来自八个意大利科学儿科学会的多学科专家小组制定了一项共识文件,以使用吸入型皮质类固醇治疗和预防最常见的儿科气道疾病。目的是为医疗保健提供者提供多学科文件,包括在临床实践中有用的适应症。共识文件旨在发给在儿科部门工作的儿科医生,初级保健服务和急诊科,以及居民或博士生,儿科护士和儿科肺科专家或顾问,过敏,传染病,耳朵,鼻子,咽喉药物。
方法:识别人群的临床问题,干预措施,方法学家讨论了比较和结果,并根据Delphi方法获得了关于主题和建议强度的普遍共识(根据GRADE系统)。文献选择包括次要来源,如循证指南和系统评价,并与随后发表的主要研究相结合。
结果:专家小组提供了一些关于在学龄前哮喘中使用吸入性皮质类固醇的建议,支气管哮喘,过敏性和非过敏性鼻炎,急性和慢性鼻-鼻窦炎,腺样体肥大,喉炎和喉痉挛。
结论:我们提供了多学科的最新建议,以管理和预防需要吸入性糖皮质激素的最常见儿科气道疾病,为了分享有用的适应症,找出知识差距,推动未来的研究。
BACKGROUND: In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a
consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The
consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine.
METHODS: Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based
guidelines and systematic reviews and was integrated with primary studies subsequently published.
RESULTS: The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic
rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm.
CONCLUSIONS: We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research.