Thank you very much for listening to this talk about "Severe Asthma in Children".
I'm Professor Andrew Bush.
I'm a Professor of Pediatrics at Imperial College and
a consultant pediatric chest physician at the Royal Brompton Hospital,
and I'm presenting on behalf of our multidisciplinary team.
I have no conflict of interest with regard to this presentation.
The aims of my presentation are as follows.
I'm going to present three cases of children
representative of the sort of airway diseases referred to us.
The details have been slightly altered to preserve anonymity.
I aim to update our thinking about severe asthma from where
we were in 2008 in light of the National Review of Asthma Deaths.
I'm going to review some novel mechanistic data that we've
discovered in those with true severe therapy-resistant asthma.
And I'm going to propose three very different phenotypes of
'steroid resistant asthma' and discuss their management.
So first of all,
I'm going to talk about three children who have not read the guidelines.
This is the first case.
This is a 12 year old atopic girl.
She had asthma for the last four years, worse in the last year.
She'd been taken to Accident and Emergency by ambulance six times in the preceding month.
She had continued acute bronchodilator responsiveness
to Salbutamol demonstrated in clinic.
And we use a smart inhaler electronically monitoring her treatments,
and she activated the inhaler about 80 percent of the time that we wanted.
She was admitted for an assessment.