Emma S Campisi1, Myrtha E Reyna2, May Brydges2, Aimee Dubeau2, Theo J Moraes2, Paolo Campisi3, Padmaja Subbarao2,4. 1. Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. 2. Division of Respiratory Medicine, Department of Paediatrics, and Program in Translational Medicine, SickKids Research Institute, The Hospital for Sick Children, 555 University Avenue, Toronto, Canada. 3. Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. paolo.campisi@sickkids.ca. 4. Dalla Lana School of Public Health, Division of Epidemiology, University of Toronto, 27 King's College Circle, Toronto, Canada.
Abstract
PURPOSE: This is a pilot study that describes the feasibility and clinical course of a cohort of preschool children with severe asthma undergoing a combined adenotonillectomy (TA), bronchoscopy (B), and bronchoalveolar lavage (BAL) procedure. METHODS: A retrospective cohort study of preschool patients with severe asthma who underwent a combined TA-B-BAL procedure between 2012 and 2019. Subjects were treated at a tertiary care asthma clinic and had a diagnosis of preschool asthma according to the Canadian Thoracic Society Guidelines. Data on demographics, clinical characteristics, medication use, virology and microbiology from bronchoalveolar lavage, and asthma control questionnaires were collected. Variables were analyzed using paired t test. RESULTS: Eighteen preschool subjects (mean age 3.19 ± 1.13 years) with severe asthma were identified through the asthma clinic. Patients treated with standard asthma care and a combined TA-B-BAL procedure experienced a decrease in the number of oral steroid courses (p = 0.017), emergency department visits (p = 0.03) and wheezing exacerbations (p = 0.026) following the procedure. Ten patients experienced clinically meaningful improvements in TRACK scores after the procedure (p < 0.001). CONCLUSION: This pilot study provides early evidence that a combined TA-B-BAL procedure is feasible in preschool children with severe asthma and that the procedure may reduce asthma medication use and hospital visits.
PURPOSE: This is a pilot study that describes the feasibility and clinical course of a cohort of preschool children with severe asthma undergoing a combined adenotonillectomy (TA), bronchoscopy (B), and bronchoalveolar lavage (BAL) procedure. METHODS: A retrospective cohort study of preschool patients with severe asthma who underwent a combined TA-B-BAL procedure between 2012 and 2019. Subjects were treated at a tertiary care asthma clinic and had a diagnosis of preschool asthma according to the Canadian Thoracic Society Guidelines. Data on demographics, clinical characteristics, medication use, virology and microbiology from bronchoalveolar lavage, and asthma control questionnaires were collected. Variables were analyzed using paired t test. RESULTS: Eighteen preschool subjects (mean age 3.19 ± 1.13 years) with severe asthma were identified through the asthma clinic. Patients treated with standard asthma care and a combined TA-B-BAL procedure experienced a decrease in the number of oral steroid courses (p = 0.017), emergency department visits (p = 0.03) and wheezing exacerbations (p = 0.026) following the procedure. Ten patients experienced clinically meaningful improvements in TRACK scores after the procedure (p < 0.001). CONCLUSION: This pilot study provides early evidence that a combined TA-B-BAL procedure is feasible in preschool children with severe asthma and that the procedure may reduce asthma medication use and hospital visits.
Authors: Wenjia Chen; Padmaja Subbarao; Rachel E McGihon; Laura Y Feldman; Jingqin Zhu; Wendy Lou; Andrea S Gershon; Kawsari Abdullah; Theo J Moraes; Aimée Dubeau; Malcolm R Sears; Diana L Lefebvre; Stuart E Turvey; Piush J Mandhane; Meghan B Azad; Teresa To Journal: Pediatr Pulmonol Date: 2019-06-06
Authors: Megan N Januska; David L Goldman; Wilmore Webley; W Gerald Teague; Robyn T Cohen; Supinda Bunyavanich; Alfin G Vicencio Journal: Pediatr Pulmonol Date: 2019-11-15