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Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
Chapter 120. Wheezing in Infants and Children
Sections: Wheezing, Bronchiolitis, Asthma, Acknowledgments, References.
Topics Discussed: wheezing.
Excerpt:"The respiratory system is comprised of lung parenchyma and compliant airways.
Flow limitation and elevated airway resistance induce flutter of the
airway wall that generates the high-pitched sounds known as wheezing.
Wheezing implies obstructive airway disease when diffuse, and focal obstruction
when localized. However, severe flow limitation may exist without
wheezing. Because intrathoracic airway lumen size normally increases
during inspiration and decreases during expiration, wheezing is generally
more prominent during expiration. Bronchiolitis is the most frequent
cause of wheezing in infants, and asthma is the most frequent cause
in children and adolescents.Approximately 30% of children will have an illness associated
with wheezing by 3 years of age and 50% by 6 years of age.1 Most
children have benign, transient wheezing episodes that do not persist
beyond 6 years of age. These "early wheezers" may
have congenitally smaller airways that predispose them to wheezing
with viral illnesses during infancy and early childhood. Maternal
smoking is a risk factor for both transient and persistent wheezing.
However, the approximately 14% of children whose wheezing
appears before 3 years of age and..."
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