The Indian Journal of Pediatrics

, Volume 85, Issue 8, pp 658–666 | Cite as

Management of Recurrent Preschool, Doctor-Diagnosed Wheeze

  • Ka-ka Siu
  • Shuk-yu Leung
  • Sum-yi Kong
  • Daniel Kwok-keung NgEmail author
Review Article


Preschool wheeze occurs in half of the children before they reach 6 y of age and recurrence is also common. Recurrent preschool wheeze is classified as either typical or atypical. For typical recurrent preschool wheeze, the diagnoses are either asthma or bronchiolitis/bronchitis. Responsiveness to a properly administered bronchodilator confirms asthma, atopic or otherwise. All atypical preschool wheeze should be referred to pediatric respirologist for assessment. Lung function test by impulse oscillometry (IOS) before and after bronchodilator is helpful to confirm airway hyperresponsiveness, an essential feature of asthma. Assessment of atopy is important by either skin prick test or serum IgE level. Treatment of acute wheeze includes standard supportive care, bronchodilator for those diagnosed with asthma and hypertonic saline for those diagnosed as having acute bronchiolitis. Other treatments included nebulized adrenaline for acute bronchiolitis and systemic steroids for asthma. For those with significant respiratory distress, continuous positive airway pressure (CPAP) or heated humidified high flow should be considered. Daily or intermittent inhaled corticosteroid or intermittent montelukast would reduce asthma exacerbation rate. A significant proportion of preschool wheeze persists till school age. An early diagnosis of asthma would be important to allow early optimal management.


Asthma Bronchiolitis Bronchitis Diagnosis Management Preschool Wheeze 



All authors have participated in the concept and design; analysis and interpretation of data; drafting or revising of the manuscript, and that they have approved the manuscript as submitted.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding



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Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  • Ka-ka Siu
    • 1
  • Shuk-yu Leung
    • 1
  • Sum-yi Kong
    • 1
  • Daniel Kwok-keung Ng
    • 1
    Email author
  1. 1.Department of PediatricsKwong Wah HospitalHong KongChina

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