Posted: June 11th, 2023

Asthma Pathophysiology

Asthma Pathophysiology

Complications from severe asthma can lead to the sudden and preventable death of seemingly healthy individuals. It is crucial for nurses and patients to understand the triggers that initiate pathophysiological mechanisms and manage these changes effectively (Fuseini & Newcomb, 2017). Adhering to treatment and avoiding triggers are important ways to mitigate severe complications. Acute and chronic asthma can result in various physiological changes in the body, with varying degrees of intensity among individuals (Lefebvre et al., 2015). Factors such as genetics, behavior, and age can influence these pathophysiological changes. Therefore, proper diagnosis and treatment are necessary to prevent sudden and severe complications.

Pathophysiological Mechanisms

Chronic asthma involves the inflammation of airways due to excessive mucus secretion, leading to intermittent obstruction (Grabiec & Hussell, 2016). Individuals with chronic asthma may experience breathing difficulties as a result of airway obstruction. Bronchial hyper-responsiveness is another functional change associated with asthma, which can cause complications when exposed to dust or pollen (Fuseini & Newcomb, 2017).

Acute asthma presents sudden and severe complications, including shortness of breath, wheezing, tightness in the chest, and persistent coughing (Matera et al., 2019). The pathophysiological changes vary depending on the severity of the condition, and in some cases, can even result in collapsed lungs, leading to respiratory failure (Grabiec & Hussell, 2016). Poor pulmonary function is also observed in acute asthma.

Arterial Blood Gas Patterns

Arterial Blood Gas (ABG) analysis measures oxygen uptake and carbon dioxide removal in the blood within the lungs. Pathophysiological changes that affect breathing or airway constriction can disrupt this function (Matera et al., 2019). As the severity of asthma worsens, the oxygen level decreases due to poor absorption in the lungs. For instance, an asthmatic patient experiencing shortness of breath or breathing difficulty may have oxygen levels below the normal range of 75-100 mmHg. Similarly, the patient may exhibit higher levels of carbon dioxide above the normal range of 35-45 mmHg. Asthmatics may also have lower pH levels compared to the normal value of 7, potentially recording a pH around 5 (Grabiec & Hussell, 2016). Monitoring arterial blood gas patterns is essential to prevent severe complications that can lead to death.

Gender

Gender is a patient factor that influences the pathophysiology of acute and chronic asthma. While boys are at a higher risk of asthma attacks compared to girls, women are more susceptible to asthmatic attacks in adulthood compared to men (Matera et al., 2019). This increased risk in women is attributed to changes in their bodies during childbirth, the menstrual cycle, and menopause, which affect their immune system. Consequently, women are more likely to experience severe complications. Female sex hormones play a role in triggering airway inflammation in women, unlike men (Lefebvre et al., 2015). Other pathophysiological mechanisms in women include smooth muscle contraction, increased mucus production, and airway changes that heighten the risk of asthma. Women need to take extra care and undergo appropriate testing to avoid preventable conditions.

Diagnosis and Treatment

The diagnosis and treatment of acute and chronic asthma in women require tailored approaches to address the specific issues related to female pathophysiological mechanisms. Diagnosis typically involves reviewing the medical history and conducting a physical examination (Fuseini & Newcomb, 2017). The treatment plan may involve the prescription of short-acting bronchodilators such as Ventolin or Proventil to relax the muscles surrounding Binns, E., Tuckerman, J., Licciardi, P. V., & Wurzel, D. (2022). Respiratory syncytial virus, recurrent wheeze and asthma: A narrative review of pathophysiology, prevention and future directions. Journal of Paediatrics and Child Health, 58(10), 1741-1746.

References
Binns, E., Tuckerman, J., Licciardi, P. V., & Wurzel, D. (2022). Respiratory syncytial virus, recurrent wheeze and asthma: A narrative review of pathophysiology, prevention and future directions. Journal of Paediatrics and Child Health, 58(10), 1741-1746.
Fuseini, H., & Newcomb, D. C. (2017). Mechanisms driving gender differences in asthma. Current Allergy and Asthma Reports, 17(3), 19.
Grabiec, A. M., & Hussell, T. (2016). The role of airway macrophages in apoptotic cell clearance following acute and chronic lung inflammation. Seminars in Immunopathology (Vol. 38, No. 4, pp. 409-423). Springer Berlin Heidelberg.
Lefebvre, P., Duh, M. S., Lafeuille, M. H., Gozalo, L., Desai, U., Robitaille, M. N., … & Lin, X. (2015). Acute and chronic systemic corticosteroid–related complications in patients with severe asthma. Journal of Allergy and Clinical Immunology, 136(6), 1488-1495.
Matera, M. G., Rinaldi, B., Calzetta, L., Rogliani, P., & Cazzola, M. (2019). Pharmacokinetics and pharmacodynamics of inhaled corticosteroids for asthma treatment. Pulmonary Pharmacology & Therapeutics, 101828.
Rosenkranz, M. A., Esnault, S., Christian, B. T., Crisafi, G., Gresham, L. K., Higgins, A. T., … & Busse, W. W. (2016). Mind-body interactions in the regulation of airway inflammation in asthma: a PET study of acute and chronic stress. Brain, Behavior, and Immunity, 58, 18-30.
Striz, I., Golebski, K., Strizova, Z., Loukides, S., Bakakos, P., Hanania, N. A., … & Diamant, Z. (2023). New insights into the pathophysiology and therapeutic targets of asthma and comorbid chronic rhinosinusitis with or without nasal polyposis. Clinical Science, 137(9), 727-753.
Stikker, B. S., Hendriks, R. W., & Stadhouders, R. (2023). Decoding the genetic and epigenetic basis of asthma. Allergy, 78(4), 940-956.

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