Ventica Clinical Advisor, Prof. Andrew Liu from Children’s Hospital Colorado, answered our questions about treating young children with asthma-like symptoms. Prof. Liu specializes in pediatric asthma, allergy & immunology. He has a wealth of pediatric asthma management experience through clinical work and plenty of research projects in this field.
In the USA, how is asthma diagnosed in the youngest children?
For preschoolers, toddlers up to the age of five, it is difficult to support an asthma diagnosis with a test. A complication is that 30-35% of all preschoolers may experience recurrent wheeze, but not all will develop persistent asthma or respond to asthma treatments. So, today, if the early presentation suggests asthma, we have little idea of whether the lungs are responding to treatments we prescribe, aside from changes in the overall clinical picture.
What is your impression of the Ventica solution?
We will be starting an NIH-sponsored research project, which includes Ventica monitoring, very soon. So, this is only my first impression, but to me the concept looks very promising. I see Ventica as another wearable and one specifically designed for very young children to wear. With our response to the current pandemic, we now have sophisticated platforms, nation-wide, for gathering data by remote monitoring and the Ventica concept fits nicely there along with other methods. Also, parents in the community are much more receptive to remote monitoring today than earlier.
After a child is referred to our pulmonary clinic, we would typically see the child again in one to two months to assess and achieve treatment control and subsequently every 3-12 months to maintain good control. Asthma episodes are, however, seasonal due to respiratory viruses and allergies. Children, especially, are vulnerable to this seasonality, with asthma episodes peaking in the fall and the spring. So, a remote solution at the home, like Ventica, would allow us to be virtually present far more often than just present at scheduled visits and, crucially, extend our resources during these seasonal peaks.
Ventica is fundamentally based on sensing how well air is flowing through the lungs. Decades ago, researchers discovered that changes in breathing flow in early childhood predicted persistent asthma later in life, as well as breathing flow features that predicted which children who would grow out of their asthma condition on their own. For the measurements, those original studies required sedation, which would no longer be acceptable, but the Ventica method holds out the possibility of gathering similar data non-invasively, while the child is sleeping naturally. These are the kind of questions we hope our research project can answer today. The added-value Ventica promises to provide in this research has created a lot of excitement.
Have you any future expectations for the development of asthma monitoring in children?
Asthma episodes which are fatal are rare but nevertheless happen, with up to 200 child deaths a year in the USA. The number life-threatening episodes are far more common and account for a significant number of child visits to the ER. The reality is that many of these asthma episodes happen at night, when the only help available is the ER, which maybe far away. There is a belief that the physiology of the lungs has the clues to a growing risk of a severe asthma episode and those clues could be picked up from the breathing loops which, incidentally, Ventica is measuring. The ability to pick up early on severe, imminent pulmonary episodes amongst children at highest risk would be the holy grail in this field. Something for future development!