Asthma is a heterogeneous disease or an inflammatory disorder of the airway related to the airflow impediment and bronchial hyper-responsiveness which ranges in severity across the continuum of the diseases. Here, adequate control cannot be achieved in a considerable ratio thought the application of possible treatments. It involves constriction and inflammation of the airways, making difficult to breathe.
Most of the patients with Asthma are diagnosed easily responding to the standard and effective treatment for control of symptoms with long term therapy for the control of airway inflammation.
The rate of Refractory Asthma increases when the communities adopt the western style and get urbanized.
Patients are considered refractory when they feel or experience certain importunate signs and symptoms like often asthma attacks, chest tightness, sputum production, cough mainly at night, or in the morning hours and feeling breathlessness and low lung function in spite of the regular asthma medications. A few of the refractory asthma patients need to take the oral steroids like prednisone in order to manage the attack of asthma.
Refractory asthma definition
Refractory asthma applies to the patients who are difficult to control in spite of the extensive re-evaluation of the diagnosis and the management over an observation period of nearly 6 months. Patients with this sort of asthma require a systematic and rigorous approach to the treatment.
In clinical practice and trails, refractory asthma is classified as a mild, moderate and a severe disease based upon its symptoms after which the therapy is advised to feel relax and breathe without any barrier.
Basically, refractory asthma is not meant for the patients suffering with fatal or severe fatal asthma, but it is to those who encompass the asthma subgroups like difficult to control, brittle asthma, irreversible asthma or poorly controlled asthma. In order to control it, treatment with oral corticosteroids and high dose inhaled corticosteroids are required to control the condition.
Fortunately, comprehensive individualized education is provided with encourage management skills for early identification and the treatment to reduce the emergency attacks and visits to the hospitals regularly.
What is the refractory period in asthma?
The refractory period is the period that follows certain exercise and isocapnic hyperventilation. In this period, two pairs of challenge test on 10 children of 9 to 14 years age of asthmatic symptoms are performed for a period of six hours where in pair A, hyperventilation challenge is followed by an exercise challenge where as in pair B, the test is reversed.
These tests are performed when the children are breathing cold and dry air. The test is coordinated in the condition of the work load, end tidal carbon-dioxide tension and ventilation. When the paired test was observed at a constant metabolic load, the severity of EIA was found relatively constant on each pair of the first test. It later reduced in the second test as the period of interval decreased between the tests.
The skill to broncho constrict was found fully within 4 hours of the test. In general, when the test at unreliable metabolic loads were pursued after a period of 30 minutes, the severity of EIA (exercise-induced asthma) increased in quantity to the load observed in the first test of each pair.
In contrast, the second test was inversely related to that which took place in the first test. Finally, the results were compatible with the proposal that the growth of EIA requires the discharge of a stored mediator or an enzyme precursor.
Refractory asthma treatment
While normal anti-inflammatory treatment with inhaled corticosteroids supports and helps numerous asthma patients, there are certain numbers of patients who require more modified diagnosis with treatment. Well, most of the test for Refractory asthma involves the assessment of a person’s capacity to inhale and exhale the air under changing conditions.
A bronchoscopy presents more direct examination of the lungs during which a physician or a specialist inserts a stretchy and a small tube into the nasal passage and threads it into the airways safely. The bronchoscope has a small camera to present visual inspection of the airways. In such condition, fluid can be gathered from the airways and a biopsy can regain small samples of the lung tissue. Well, the method is performed with a patient under light sedation.