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Asma em crianças

Last reviewed: 23 Sep 2025
Last updated: 31 Jul 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • fatores desencadeantes de episódios de sibilância
  • aumento do esforço respiratório
  • características de doença atópica
  • história de resposta ao tratamento dentro do prazo adequado
Full details

Other diagnostic factors

  • idade >3 anos
  • tosse seca noturna
  • dispneia ao esforço
  • sibilância expiratória
  • deformidade da parede torácica
Full details

Risk factors

  • sensibilização alérgica
  • doença atópica
  • infecções do trato respiratório no início da vida
  • eosinofilia sérica
  • história familiar de asma ou atopia
  • polimorfismos no gene e epigenética
  • tabagismo passivo ou ativo
  • vaping
  • tabagismo materno durante a gestação
  • função pulmonar anormal e hiper-responsividade das vias aéreas
  • Poluição do ar em ambientes abertos e fechados
  • condição socioeconômica baixa
  • exposição a pesticidas
  • sexo masculino
  • obesidade
  • doença do refluxo gastroesofágico (DRGE)
  • apneia obstrutiva do sono (AOS)
  • tecnologias de reprodução assistida
  • parto cesáreo
  • Microbiota intestinal
  • uso de medicamento de supressão ácida na gestação e na infância
  • uso de paracetamol na gestação
  • uso de antibiótico na gestação
Full details

Diagnostic investigations

1st investigations to order

  • espirometria
  • Pico do fluxo expiratório (PFE)
  • resposta ao broncodilatador
Full details

Investigations to consider

  • fração de óxido nítrico exalado (FeNO)
  • testes de provocação das vias aéreas
  • teste de desafio de exercício
  • Hemograma completo
  • teste do suor
  • cultura de escarro
  • teste alérgico cutâneo por puntura ("prick test")
  • radiografia torácica
  • estudos ciliares de eletromicrografia
  • tomografia computadorizada (TC) do tórax
  • tomografia computadorizada (TC) dos seios da face
  • broncoscopia
Full details

Emerging tests

  • lavagem broncoalveolar

Treatment algorithm

ONGOING

0 a 5 anos de idade

idade entre 6 e 11 anos

Contributors

Authors

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

利益声明

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

同行评议者

Kenan Haver, MD

Associate Professor of Pediatrics, Harvard Medical School

Boston Children's Hospital

Division of Pulmonary Medicine

Boston

MA

利益声明

KH receives royalties from UpToDate.

Peter Griffiths, MBChB

General Practitioner

Harborne Medical Practice

Birmingham

UK

利益声明

PG declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

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.

关键文献

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

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

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

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

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.全文  摘要

参考文献

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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