Asthma is a chronic respiratory condition of the lungs. It is caused by inflammation surrounding the airways, decreasing their ability to exchange air. An acute asthma exacerbation occurs when the symptoms of asthma worsen suddenly or over a few days.
Significance
An acute exacerbation indicates that your asthma is not well controlled. Controller medications include inhaled steroids, which work by decreasing the inflammatory response, and allergy medicines, which decrease the body's responsiveness to allergens.
Types
There are different triggers for asthma, and these triggers can lead to an exacerbation. Allergies can trigger acute exacerbations in patients with allergic asthma. According to the Asthma and Allergy Foundation of America, allergic asthma affects over half of all asthma sufferers. Allergies cause an asthma exacerbation by increasing the production of a protein called IgE in the body. This protein stimulates mast cells in the blood stream to release other substances that lead to inflammation of the airways and an asthma attack. Other triggers of an acute exacerbation include colds, changes in the weather, and exercise.
Symptoms
Symptoms of an acute exacerbation include an increase in the frequency of coughing, difficulty breathing and shortness of breath, with wheezing and retractions. Wheezing is the high-pitched noise that the lungs make as they attempt to move air through the narrowed airways, like the noise you make when you blow on the end of a straw. Retractions are the pulling in of abdominal and chest muscles in an attempt to bring in more oxygen-rich air into the lungs.
Treatment
Treatment of an asthma exacerbation includes sitting the person up in a comfortable position that facilitates breathing; use of oxygen; bronchodilators, like albuterol, which work by opening up the airways; and steroids to reduce the inflammation surrounding the airway. Intravenous fluids are indicated if the person is dehydrated and is unable to take fluids by mouth.
Warning
There are signs that indicate whether an acute exacerbation has become a life-threatening asthma attack. According to the National Guidelines Clearinghouse, these include: absent breath sounds in the lungs; cyanosis, or a bluish tinge around the lips and the fingertips that indicates low oxygen content in the blood; decreased blood pressure or heart rate; and changes in mental status, such as confusion or loss of consciousness.
