Severe Acute Asthma: Symptoms And Treatment

Severe acute asthma is a common reason for visiting the emergency room, with adolescents and young people in particular requiring special medical attention. 

Any asthma patient can have a severe, acute attack, which in some cases can be fatal. In this case, acting quickly is often life-saving. Sometimes hospitalization is required afterwards. Learn more about severe acute asthma in our post today .

It is a common motive for visiting the emergency room, with teenagers and young people in particular requiring special medical attention. The clinical picture is slightly different in women and men.

What is Acute Asthma?

Asthma is a chronic inflammation of the airways in which the airways are temporarily narrowed and therefore shortness of breath occurs. The respiratory system is divided into the upper and lower airways:

• Nose, sinuses and throat
• Larynx, trachea, bronchi and lungs

The effects of asthma are particularly noticeable in the bronchi and bronchioles, which are responsible for moving  air in and out of the lungs. This leads to a strong, permanent inflammation of the airways, whereby the mucous membrane swells and more mucus is formed. The blood circulation also increases.

This means that not enough air can be transported. This is because the airways narrow and problems such as shortness of breath arise, especially when breathing out.

The nose and sinuses are also affected. Another symptom of this disease is sinusitis.

There are a variety of factors that can trigger an asthma attack due to inflamed airways and smooth muscle contraction. For example, certain allergens, pollution, and respiratory infections can all lead to this. 

Severe acute asthma: symptoms

The symptoms are different for each patient and depend, among other things, on the extent of the disease. The most common complaints include:

• Severe breathlessness, pressure on the chest, whistling, and / or coughing when breathing
• Low peak peak expiratory flow time (PEFT)
• Symptoms that cannot be relieved by an inhaler

Severe acute asthma: treatment options

It is a medical emergency that needs to be assessed and addressed quickly. Two different aspects are taken into account:

• Static assessment  to diagnose the severity of the seizure
• Dynamic examination  to assess response to treatment

The intensity of treatment depends on the severity. But regardless of this, the following goals are aimed at:

• Treat hypoxemia by giving oxygen (too little oxygen in the arterial blood)
• Widen the narrowed airways from inhaling bronchodilators. 
• Treat the inflammation to prevent further seizures. Systemic corticosteroids are used for this.

Oxygen supply

As already mentioned, hypoxemia results in low oxygen levels, which are normally corrected by administering oxygen through a nasogastric tube.

Inhaled bronchodilators: beta agonists

Inhaled beta agonists of short duration are very common in an acute asthma attack. They work very quickly (in 5 minutes) and for up to 6 hours. Plus, they have few side effects.

Rapid treatment is possible through inhalation  , with fewer side effects than with the systemic route. This option is only possible if the response to the inhalation is insufficient.

Anticholinergics

In the event of an acute asthma attack, anticholinergics can be used to increase the vagal tone. When multiple high dose therapeutic protocols are used, this benefit becomes more apparent. This can reduce the number of hospital admissions  because lung function is improved. This treatment is therefore also cheaper.

Systemic corticosteroids

Systemic corticoids are also used very often in acute asthma attacks. These medicines widen the bronchi and are very effective against inflammation in the airways. Various studies indicate the following aspects:

• Systemic corticoids  take between 6 and 24 hours to develop anti-inflammatory effects.
• There are no fundamental differences between oral and intravenous administration.
• It could not be confirmed that there is a relationship between the dose and the effect. Therefore there is no benefit in giving very high doses.