Comprehensive Guide to Managing Severe Asthma: Diagnosis and Treatment Strategies
This comprehensive guide covers the diagnosis and treatment options for severe asthma, highlighting key assessments, emergency management, and lifestyle measures to control this challenging condition effectively. Understanding proper steps can improve patient outcomes and quality of life with severe asthma.
Understanding and Managing Severe Asthma
Severe asthma affects approximately 24 million individuals nationwide, with no single standard definition. It is a complex respiratory condition requiring high-dose inhaled steroids along with systemic medications. The World Health Organization classifies severe asthma into three categories: WHO class I includes uncontrolled, untreated cases; class II involves uncontrolled asthma due to compliance issues or persistent triggers; and class III pertains to cases only manageable with maximum therapy.
Treating severe asthma can be challenging due to its resistance to standard medications, often termed therapy-resistant asthma. This form is notably less responsive to corticosteroids and other common treatments.
Diagnosing Severe Asthma
Diagnosis for adults and children over five involves lung function assessments. Poor results suggest inadequate control. Key tests include:
- Spirometry
Measures lung capacity by evaluating the volume of air expelled forcefully after deep inhalation. - Pulse oximetry
Finds oxygen levels in the blood, crucial during severe attacks. - Nitric oxide testing
Detects nitric oxide levels in breath, with elevated levels indicating bronchial inflammation. - Peak expiratory flow
Assesses how quickly one can exhale, useful during an emergency.
Managing a Severe Asthma Attack
Post diagnosis, treatment depends on symptoms and emergency action plans. Initial care often involves inhalers delivering rapid-relief medication like albuterol. Children may require nebulizers for assistance. If symptoms persist after 20 minutes, emergency interventions are necessary, such as:
- Oral corticosteroids
Reduce lung inflammation; administered orally or intravenously in severe cases. - Intubation
A breathing tube may be inserted to assist breathing in life-threatening situations while medication is administered. - Ipratropium (Atrovent)
A bronchodilator used when albuterol is insufficient. - Preventive inhalers
Contain corticosteroids to reduce inflammation and prevent attacks. - Add-on therapies
Additional medications combined with preventers and relievers to improve lung function and control symptoms.
