Managing and Treating Severe Asthma: A Comprehensive Guide
Severe asthma management involves accurate diagnosis through lung function tests and prompt treatment with inhalers, corticosteroids, and emergency interventions like intubation. Lifestyle adjustments and trigger avoidance are key to control and prevent attacks, ensuring better quality of life for sufferers. This guide offers comprehensive insights into managing severe asthma effectively.
Managing and Treating Severe Asthma: A Comprehensive Overview
Severe asthma affects millions, with about 24 million individuals diagnosed nationally, according to the Asthma and Allergy Foundation. There’s no single definition, but it typically involves a condition requiring high-dose inhaled steroids and additional controllers like systemic steroids. The World Health Organization categorizes severe asthma into three types: untreated uncontrolled asthma, uncontrolled asthma due to adherence issues or triggers, and uncontrolled asthma managed only with intensive therapy.
Treating severe asthma poses challenges due to its resistance to common medications, sometimes termed therapy-resistant asthma. This form often shows limited response to corticosteroids and other drugs.
Diagnosing Severe Asthma
For those over five years, lung function tests are essential to determine severity. Poor lung function suggests inadequate control. Key tests include:
Spirometry
Patients breathe deeply into a device measuring the volume of air exhaled quickly, known as FEV (Forced Expiratory Volume).
Pulse oximetry
This measures blood oxygen levels, especially during flare-ups or attacks.
Nitric oxide testing
A recent method that gauges nitric oxide expelled in breath. Elevated levels often point to bronchial inflammation and severe asthma.
Peak expiratory flow
During emergencies, this test assesses how swiftly one can expel air, indicating airway obstruction.
Emergency Treatment for Severe Asthma
Once diagnosed, tailored treatments commence based on symptoms. Adherence to emergency plans is crucial at attack onset.
Initial management often involves inhalers with fast-acting bronchodilators like albuterol, to be used in 2-6 puffs, repeated after 20 minutes if needed. Nebulizers aid young children unable to use inhalers. Persistent symptoms may require emergency care, including:
Oral corticosteroids
To control lung inflammation, administered orally or intravenously if severe.
Intubation
In life-threatening cases, a breathing tube ensures oxygen supply while medications are administered.
Ipratropium (Atrovent)
Used when albuterol is insufficient to relax bronchial muscles.
Preventive inhalers
Contain corticosteroids to reduce lung inflammation and prevent flare-ups.
Add-on therapies
Combining medications improve lung function and control attacks more effectively.
Post-treatment, patients are often monitored in the hospital to prevent recurring attacks and receive guidance for future management. Persistent symptoms may necessitate hospitalization for intensive medication and observation.
Lifestyle Modifications
Managing severe asthma also involves lifestyle changes: identifying and avoiding triggers, avoiding smoking, and maintaining healthy habits to reduce flare-ups and improve overall control.
