Pathophysiology, Diagnosis, and Management of Asthma: A Review

This literature review comprehensively examines asthma, covering its pathophysiology, diagnosis, and management. It details the aetiology and trigger factors, including respiratory infections and allergic reactions, leading to airway inflammation and hypersecretion. Clinical features such as shortness of breath, wheezing, and chest tightness are discussed, along with risk factors and diagnostic methods like physical assessments, ECGs, and arterial blood gas analysis. The review also outlines pharmacological treatments, including nebulized salbutamol, ipratropium bromide, and IV hydrocortisone, as well as nursing strategies and patient education. Furthermore, it touches on disease prognosis and preventative measures, referencing various studies and guidelines for acute asthma management. Desklib offers more solved assignments and study resources for students.

Aetiology
Respiratory infection and allergic reaction
Severe stress
Smoking and air pollution [3]
Pathogenesis
Trigger factor Airway inflammation
Hyper secretion, Airway muscle contraction, Swelling Bronchial
membranes
Narrow breathing passage
Wheezing, cough, shortness of breath, tightness in chest
Acute severe asthma [4]
Clinical features
Shortness of breath
Unable to speak full
sentence in single
breath
Feel agitated
RR is equal to or more
than 25 BPM [5]
Diagnosis
 Complete history
 Physical and
neurological assessment
 ECG
 Arterial blood gas
analysis
 Peak expiratory flow [6]
Course of disease
With treatment: oxygen
exchange and lung function is
improved,
Without treatment:
mild/moderate: feeling tired,
easily upset
Moderate: cough, wheeze
Complications
Tachycardia or arrhythmias,
hypokalaemia, Trouble
sleeping, nausea, weight
gain, and Headache, [9]
 Disease prognosis
1 in 9 Australians have asthma (around
2.5 million)
Indigenous Australians is almost twice
as high as that of non-indigenous
Australians [10]
Primary prevention
Higher doses of inhaled
bronchodilators
Corticosteroids
An epinephrine shot
Temporary ventilation support [11]
Risk factor
Anyone with asthma
Living condition [2]
Acute severe Asthma
I t i s d e fi n e d a s t h e a s t h m a a tt a c k
t h a t d o e s n o t i m p r o v e b y
t r a d i ti o n a l o r p r i m a r y t r e a t m e n t s .
[ 1 ]
Treatment
Pharmacological
treatment
1. Nebulised Salbutamol
2. Ipratropium bromide
3. IV hydrocortisone
100 mg [8]
Nursing strategies
 ICU management
 Mechanical
ventilation
 Patient education
 Making favourable
environment [7]
Diagnosis
Results in
Causes
Diagnosed by
Leads to
immediate
need for

References
1. Lommatzsch, M., & Virchow, C. J. (2014). Severe asthma: definition, diagnosis and treatment. Deutsches Ärzteblatt
International, 111(50), 847.
2. Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G., Coats, A. J., & Jessup, M. (2016). 2016 ESC Guidelines for the
diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart
failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of
the ESC. European journal of heart failure, 18(8), 891-975.
3. A Cook, J., & Saglani, S. (2016). Pathogenesis and prevention strategies of severe asthma exacerbations in children. Current opinion in
pulmonary medicine, 22(1), 25-31.
4. Leatherman, J. (2015). Mechanical ventilation for severe asthma. Chest, 147(6), 1671-1680.
5. Wyatt, E. L., Borland, M. L., Doyle, S. K., & Geelhoed, G. C. (2015). Metered‐dose inhaler ipratropium bromide in moderate acute
asthma in children: A single‐blinded randomised controlled trial. Journal of paediatrics and child health, 51(2), 192-198
6. Feldman, A. S., He, Y., Moore, M. L., Hershenson, M. B., & Hartert, T. V. (2015). Toward primary prevention of asthma. Reviewing the
evidence for early-life respiratory viral infections as modifiable risk factors to prevent childhood asthma. American journal of respiratory
and critical care medicine, 191(1), 34-44.