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Asma en niños

Última revisão: 18 Jun 2025
Última atualização: 20 May 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presencia de factores de riesgo
  • desencadenantes de episodios de sibilancias
  • mayor esfuerzo respiratorio
  • características de la enfermedad atópica
  • antecedentes de respuesta al tratamiento dentro del plazo adecuado
Detalhes completos

Outros fatores diagnósticos

  • edad >3 años
  • tos nocturna seca
  • disnea de esfuerzo
  • sibilancia espiratoria
  • deformidad de la pared torácica
Detalhes completos

Fatores de risco

  • sensibilización alérgica
  • enfermedad atópica
  • infecciones de las vías respiratorias en las etapas tempranas de la vida
  • eosinofilia sérica
  • antecedentes familiares de asma o atopia
  • Polimorfismos de genes y epigenética
  • Fumar cigarrillos de forma pasiva o activa
  • vapeo
  • Tabaquismo materno en el embarazo
  • función pulmonar anormal e hiperreactividad de las vías respiratorias
  • Contaminación del aire interior y exterior
  • estado socioeconómico bajo
  • exposición a pesticidas
  • sexo masculino
  • obesidad
  • enfermedad por reflujo gastroesofágico (ERGE)
  • apnea obstructiva del sueño (AOS)
  • tecnología de reproducción asistida
  • cesárea
  • Microbiota intestinal
  • uso de fármacos supresores de ácido en el embarazo y la infancia
  • uso de paracetamol en el embarazo
  • Uso de antibióticos en el embarazo
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • espirometría
  • flujo espiratorio máximo (FEM)
  • Respuesta al broncodilatador
Detalhes completos

Investigações a serem consideradas

  • fracción exhalada de óxido nítrico (FeNO)
  • pruebas de provocación de las vías respiratorias
  • prueba de provocación con ejercicio
  • hemograma completo (HC)
  • prueba del sudor
  • cultivo de esputo
  • prueba de punción cutánea
  • radiografía de tórax
  • estudios ciliares de microscopía electrónica
  • tomografía computarizada (TC) de tórax
  • tomografía computarizada (TC) sinusal
  • broncoscopia
Detalhes completos

Novos exames

  • lavado broncoalveolar

Algoritmo de tratamento

CONTÍNUA

edad 0 a 5 años

edad 6 a 11 años

Colaboradores

Autores

Paul D. Robinson, MBChB, MRCPCH, FRACP, PhD, ATSF

Respiratory and Sleep Physician

Queensland Children's Hospital

Conjoint Professor

Child Health Research Centre

University of Queensland

Brisbane

Queensland

Australia

Disclosures

PDR declares that he has no competing interests.

Anne Chang, MBBS, FRACP, MPHTM, PhD, FAPSR, FThorSoc, FAHMS

Professor

Respiratory and Sleep Physician

Queensland Children's Hospital

Queensland University of Technology

Brisbane

Menzies School of Health Research

Charles Darwin University

Darwin

Australia

Disclosures

AC is an author of a number of references cited in this topic.

Peer reviewers

Kenan Haver, MD

Associate Professor of Pediatrics, Harvard Medical School

Boston Children's Hospital

Division of Pulmonary Medicine

Boston

MA

Disclosures

KH receives royalties from UpToDate.

Peter Griffiths, MBChB

General Practitioner

Harborne Medical Practice

Birmingham

UK

Disclosures

PG declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Global Initiative for Asthma. 2024 Global strategy for asthma management and prevention. May 2024 [internet publication].Full text

National Institute for Health and Care Excellence. Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN). Nov 2024 [internet publication].Full text

National Institute for Health and Care Excellence. Asthma pathway (BTS, NICE, SIGN). Nov 2024 [internet publication].Full text

National Heart, Lung, and Blood Institute; National Asthma Education and Prevention Program. Guidelines for the diagnosis and management of asthma. Aug 2007 [internet publication].Full text

Expert Panel Working Group of the National Heart, Lung, and Blood Institute (NHLBI) administered and coordinated National Asthma Education and Prevention Program Coordinating Committee (NAEPPCC), Cloutier MM, Baptist AP, et al. 2020 focused updates to the asthma management guidelines: a report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020 Dec;146(6):1217-70.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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