Medical and physiotherapy management of asthma.
BTS ASTHMA GUIDELINES (2010)
www.brit-thoracic.org.uk/clinical-information/asthma/asthma-guidelines.aspx
RCP Report on ALLERGY SERVICES in the UK (2010)
bookshop.rcplondon.ac.uk/contents/pub317-44f79458-267d-4006-af05-3f0e468e22c5.pdf
Cochrane report on IMMUNOTHERAPY (2010):
www.library.nhs.uk/RESPIRATORY/ViewResource.aspx?resID=236885&tabID=289
UK Department of Health (2011) - An outcomes strategy for people with COPD and asthma
www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/COPD/Outcome%20Strategy%20for%20COPD_Asthma.pdf
Abramson NJ (2001) Are asthma medications and management related to deaths from asthma? Am J Respir Crit Care Med, 163, 1, 12-18
ajrccm.atsjournals.org/cgi/content/full/163/1/12
less reliance on beta-agonists, and closer medical supervision, should reduce asthma mortality
Barbaro MPF, Lacedonia D (2011) Dyspnea perception in asthma: Role of airways inflammation, age and emotional status. Respir Med, 105, 2, 195-203
SOB perception relates to depression and advanced age.
Berg S (2005) Corticosteroids and your child's growth. Asthma, 10, 11-13
www.sciencedirect.com/science?_ob=ArticleURL&_udi=B75DH-4FFG97H-8&_user=10&_handle=V-WA-A-W-AD-MsSAYZW-UUA-U-AAAWBVAVDW-AAUEEWWWDW-ECVDYDBUY-AD-U&_fmt=full&_coverDate=02%2F28%2F2005&_rdoc=7&_orig=browse&_srch=%23toc%2313039%232005%23999899998%23567897!&_cdi=13039&_artOutline=Y&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=1e56aa84303518f4c220330bb00d3c04#toc1
in children, high-dose inhaled steroids retard growth rate but not ultimate stature
Beuther DA (2010) Recent insight into obesity and asthma. Curr Opin Pulm Med, 16, 1, 64-70
asthma can lead to obesity, and obesity is a risk factor for asthma, possibly due to inflammatory, immunologic, genetic or mechanical mechanisms
Blackwell R (2004) Asthma evidence and tradition. AACP Journal, July, p.33
literature research, western and eastern approach
Burgess JA (2011) Factors influencing asthma remission: a longitudinal study from childhood to middle age. Thorax, 66, 508-513
thorax.bmj.com/content/66/6/508.abstract#cited-by
effect of allergic rhinitis or eczema on asthma remission might be altered by early, aggressive treatment,
Importance of avoiding exposure to tobacco smoke.
Burggraaf J et al (2001) Cardiovascular side effects of inhaled salbutamol in hypoxic asthmatic patients. Thorax, 56, 567-9
nebulised ί2-agonists must be given with oxygen in hypoxic patients to counteract the shunt of vasodilation
Butland BK (2000) Diet, lung function, and lung function decline. Thorax, 55, 102-8
hard fruit such as apples are better for asthma than soft or citrus fruit
Chida Y (2008) A bidirectional relationship between psychosocial factors and atopic disorders: a systematic review and meta-analysis. Psychosom Med, 70, 102-116
www.psychosomaticmedicine.org/cgi/content/abstract/70/1/102
strong relationship between psychosocial factors and atopic disorders
Da Silva PL (2012) Interdisciplinary therapy improves biomarkers profile and lung function in asthmatic obese adolescents. Pediatr Pulmonol, 47, 1, 817
Davidson R, Roberts SE, Wotton CJ (2010) Influence of maternal and perinatal factors on subsequent hospitalisation for asthma in children. BMC Pulm Med, 10, 14, doi:10.1186/1471-2466-10-14
www.biomedcentral.com/1471-2466/10/14
perinatal risk factors include maternal asthma, maternal smoking, low birth weight, short gestational age, lack of breast-feeding, older siblings and possibly caesarean delivery
Deshpande DA (2010) Bitter taste receptors on airway smooth muscle bronchodilate by localized calcium signaling and reverse obstruction. Nature Med, 16, 12991304
inhalation of bitter substances dilates airways x3 more than beta-agonists
Didour M (1997) Effects of lung cycle ergometer training in elderly patients with bronchial asthma. Eur Resp J, 10, 458S
for elderly patients with asthma, rehab leads to improved quality of life
Donno MD, Bittersnich D, Chetta A (2000) The effect of inflammation on mucociliary clearance in asthma. Chest, 118, 1142-9
secretions are thicker and more difficult to clear than with other obstructive diseases
sodium cromoglycate helps mucociliary transport in asthma
Durward A et al (2000) Resolution of mucus plugging and atelectasis after intratracheal rhDNase therapy in a mechanically ventilated child with refractory status asthmaticus. Crit Care Med, 28, 2, 560-2
case study of patient with impacted mucus unresponsive to conventional treatment but responsive to rhDNase.
Emtner M, Hedin A, Stalenheim G (1998) Asthmatic patients' views of a comprehensive asthma rehabilitation programme. Physiother Res Int, 3, 175-13
rehab including education, exercise training, breathing techniques, relaxation
Emtner M, Hedin A (2005) Adherence to and effects of physical activity on health in adults with asthma. Advances Physiother, 7, 3, 123-34
www.informaworld.com/smpp/content~content=a723942364~db=alhe~order=page
exercise programmes increase patients ability to control their asthma
Fernandez MM (2001) Non-invasive mechanical ventilation in status asthmaticus. Int Care Med, 27, 486-92
NIV can reduce the need for IPPV in asthma patients
Garcia G (2003) Difficult asthma. Allergy, 58, 114-21
aetiology, classification, treatment
Gore RB (2010) The utility of antifungal agents for asthma. Curr Opin Pulm Med, 16, 1, 36-41
refractory asthma may indicate sensitivity to environmental fungi
Gradwell G (1994) Emergency room asthma treatment with PEP. Respir Care, 39, 1072
PEP with nebuliser reduces hospital admissions
Gruenberg D, Busse W (2010) Biologic therapies for asthma. Curr Opin Pulm Med, 16, 1, 19-24
people with difficult asthma may benefit from adjunctive treatments such as anti-immunoglobulin E and anti-interleukin-5.
Hashimoto S (2011) Internet-based tapering of oral corticosteroids in severe asthma: a pragmatic randomised controlled trial. Thorax, 66, 514-520
thorax.bmj.com/content/66/6/514.abstract
internet-based management tool with home monitoring in severe asthma reduces corticosteroid consumption without compromising asthma control or quality of life.
Hijazi N (2000) Diet and childhood asthma in a society in transition. Thorax, 55, 775-9
poor diet predisposes to asthma, particularly lack of antioxidants such as vitamin C
Holloway EA, West RJ (2007) Integrated breathing and relaxation training for adults with asthma in primary care: a randomised controlled trial. Thorax, 62, 1039-1042
thorax.bmj.com/cgi/content/abstract/62/12/1039?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Holloway+&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
breathing retraining and relaxation improve QoL, and reduce anxiety, Nijmegen score and RR.
Inwald D, Roland M (2001) Oxygen treatment for acute severe asthma. Br Med J, 323, 98-100
important info on the need for oxygen as the first treatment for acute severe asthma
Joos S (2000) Immunomodulatory effects of acupuncture in the treatment of allergic asthma. J Alt Compl Med, 6, 519-25
acupuncture can modulate immune system in people with asthma
Kallstrom TJ (2004) Evidence-based asthma management. Resp Care, 49, 783-92
www.rcjournal.com/contents/07.04/07.04.0783.pdf
education and drug therapy
Kellet C, Mullan J (2002) Breathing control techniques in the management of asthma. Physiotherapy, 88, 751-8
Bukeyko and other breathing techniques
King MJ, Hanania NA (2010) Asthma in the elderly: current knowledge and future directions. Curr Opin Pulm Med, 16, 1, 55-59,
asthma is common in elderly people but is frequently undiagnosed and undertreated
Kolbe J, Fergusson W, Vamos M (2002) Case-control study of severe life threatening asthma. Thorax, 57, 317-22
factors associated with preventable asthma deaths are behavioural rather than pharmacological
Kuyper LM (2003) Characterization of airway plugging in fatal asthma. Am J Med, 115, 611
mucus plugging is usually found in fatal asthma
Lanes SF, Rodriguez LAG, Huerta C (2002) Respiratory medications and risk of asthma death. Thorax, 57, 683-6
excessive use of short-acting 2-agonists are associated with increased risk of death
Ma J, Strub P, Camargo CA (2010) The breathe easier through weight loss lifestyle intervention. BMC Pulm Med, 10, 16. doi:10.1186/1471-2466-10-16
www.biomedcentral.com/1471-2466/10/16
causal link between obesity and asthma
obesity tips asthma into being more difficult to manage
Manocha R, Marks GB, Kenchington P, Peters D, Salome CM (2002) Sahaja yoga in the management of moderate to severe asthma. Thorax, 57,110-15
yoga shows some beneficial subjective and objective effects
McFadden ER (1995) Asthma. Lancet, 345, 1215-60.
if oximetry shows SaO2 < 90%, respiratory failure is likely and ABGs are required
McHugh P et al (2003) Buteyko breathing technique for asthma. New Zealand Med J, 116, 1187.
www.nzma.org.nz/journal/116-1187/710/
Buteyko group showed reduced inhaled steroid use by 50% and β2-agonist use by 85% at six months; in the control group, inhaled steroid use was unchanged and β2-agonist use was reduced by 37%.
Mellis CM et al (2002) Is asthma prevention possible with dietary manipulation? Med J Aust, 177, S78-80
modifiable dietary risk factors
Mutlu GM et al (2002) Severe status asthmaticus: management with permissive hypercapnia and inhalation anesthesia. Crit Care Med, 30, 477-80
permissive hypercapnia is relatively safe
inhalation anesthesia should be used carefully
Nagarathna R, Nagendra H. (1985) Yoga for bronchial asthma: a controlled study. Br Med J, 291:10779
www.bmj.com/cgi/content/abstract/291/6502/1077
benefits of yoga in asthma
Noverr MC (2005) Development of allergic airway disease in mice following antibiotic therapy and fungal microbiota increase. Inf Immunity, 73, 1, 30-38
iai.asm.org/cgi/content/full/73/1/30?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Huffnagle%2C+G&searchid=1&FIRSTINDEX=0&fdate=1/1/2004&tdate=1/31/2005&resourcetype=HWCIT
increase in the incidence of asthma correlates with widespread use of antibiotics which alter the gut microflora and can lead to overgrowth of Candida
Oddo M (2006) Management of mechanical ventilation in acute severe asthma: practical aspects. Int Care Med, 32, 4, 501-10
springerlink.metapress.com/(4nt0hn55kegoqri5o1po2rub)/app/home/contribution.asp?referrer=parent&backto=issue,4,37;journal,4,297;browsepublicationsresults,615,1574
ventilator settings, monitoring hyperinflation, extrinsic PEEP, patient-ventilator synchrony, avoiding muscle paralysis and risk of myopathy
Ohrui T, Arai H, Ichinose M (2002) Relationship between asthma severity and progression of Alzheimers disease. Thorax, 57, 565
a silver lining - asthmatics who get Alzheimers disease might find their asthma ameliorated
Opat AJ (2000) A clinical trial of the Buteyko breathing technique in asthma as taught by a video. J Asthma, 37, 557-64
Osborne CA, OConnor BJ, Lewis A (2000) Hyperventilation and asymptomatic chronic asthma. Thorax, 55:101622
thorax.bmj.com/cgi/content/abstract/55/12/1016
mild asthma is associated with reduced arterial and ETCO2 which relates to airway hyperresponsiveness rather than to airway obstruction or mucosal inflammation
Parsons JP, Mastronarde JG (2010) Gastroesophageal reflux disease and asthma. Curr Opin Pulm Med, 16, 1, 60-63
asthmatic patients have more reflux than the general population.
Patel A (2001) Intratracheal recombinant human deoxyribonuclease in acute life-threatening asthma refractory to conventional treatment. Survey Anesthesiol, 45, 17-18
Pearson MG (2007) Breathing exercises for asthma: panacea or placebo?
Thorax, 62, 1033-4.
thorax.bmj.com/cgi/content/extract/62/12/1033?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Pearson&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=62&firstpage=1033&resourcetype=HWCIT
Phanareth K (2002) A proposal for a practical treatment guideline designed for the initial two-hours of the management of patients with acute severe asthma and COPD. Respir Med, 96, 659-71
www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WWS-46G484J-2&_user=10&_handle=V-WA-A-W-AD-MsSAYZW-UUA-U-AAABUVWUED-AAAUZWWYED-EDBZYVUYA-AD-U&_fmt=summary&_coverDate=09%2F30%2F2002&_rdoc=2&_orig=browse&_srch=%23toc%237138%232002%23999039990%23331306!&_cdi=7138&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=fb61bc81e747bdd78806a6c7aff99ed6
oxygen and drug treatment
Phipps P, Garrard CS (2003) The pulmonary physician in critical care: acute severe asthma in the ICU. Thorax, 58, 81-88
dont treat a ventilated asthma patient without reading this article
Raviv S, Smith JL (2010) Diet and asthma. Curr Opin Pulm Med, 16, 1, 71-76
n-3 fatty acids, soy isoflavones, vitamin D, and antioxidants may modify asthma severity
Remes S, Pekkanen J, Remes K (2002) In search of childhood asthma. Thorax, 57, 120-6
includes a running test to identify asthma in children
Romain AP (2004) Similarities and differences in asthma and COPD exacerbations. Proc Am Thorac Soc, 1, 73-6
Slats AM et al (2008) Enhanced airway dilation by positive-pressure inflation of the lungs compared with active deep inspiration in patients with asthma. J Appl Physiol, 105, 1725-32
jap.physiology.org/cgi/content/full/105/6/1725
positive-pressure inflation can enhance bronchodilation in patients with asthma.
Thomas M, Griffiths C (2005) Asthma and Panic. Am J Respir Crit Care Med, 171, 1197-8 (editorial)
ajrccm.atsjournals.org/cgi/content/full/171/11/1197
evidence for the relationship between panic and respiratory symptoms
ABGs = arterial blood gases
BTS = British Thoracic Society
ETCO2 = end-tidal CO2 monitor
PEP = positive expiratory pressure
QoL = quality of life
RR = respiratory rate
RCP = Royal College of Physicians (UK)