1.What is asthma?
Asthma is an inflammatory reactive disease in which the airways of the lungs react metaphorically and overreact to irritants. A metabolic reaction means that your lungs are more sensitive than most people’s lungs and become inflamed (swollen) when exposed to cold air, dust mites, house dust mites, pollen or grass, animal dander, smoke, whistling viral infections and chemical irritants. Overreaction is when your lungs’ bronchi overreact to irritants that cause them to constrict and cover them with mucus, causing the smooth muscles of the tiny bronchi to contract spasmodically making the airways narrow and interfering with the movement of airflow in and out of the lungs, making whistling difficult, resulting in coughing, wheezing, chest tightness and shortness of breath, and difficulty in whistling. Asthma differs from other lung diseases in that the symptoms of asthma rarely come on consistently. Asthma tends to come on suddenly or only last for a short time. Asthma is not as difficult to cure as other lung diseases, and its symptoms can be reversed with the right medication.
2.What kind of people are susceptible to bronchial asthma?
Asthma is the result of a combination of genetic and environmental factors. Most children have a history of infantile eczema and allergic rhinitis, and many have a family history of the disease. The formation and recurrent attacks of asthma are often the result of a combination of environmental factors (e.g., allergen inhalation, whistling infections, and cold stimulation). Asthma is also strongly age-related. Although asthma can occur at any age, it mostly begins in children, commonly in infants younger than 3 years of age and in children older than 3 years of age, with slight differences in presenting symptoms and diagnostic criteria.
Asthma can occur within the first few months of life, but it can be difficult to make a definitive diagnosis of asthma within 1 year of age.
A definitive diagnosis is more likely to be made in childhood, if at all. It is generally accepted that the most common cause of wheezing in infancy is a viral infection of the whistle tract, and that early wheezing is related to the small lung development, somewhat reduced lung function, and immune status that existed before the onset of symptoms. As we age, after lung development, some of the wheezing can be relieved in adolescence due to factors such as perfect immune function and endocrine changes, while some can continue into adulthood. If wheezing recurs it may be related to allergen exposure, especially in infants with atopic constitution whose airways are susceptible to pre-sensitization to environmental allergens and irritants, especially early exposure to large numbers of dust mites, fungi and animal allergens. These infants have increased airway reactivity after initial viral infection and wheezing can occur frequently.
3. What factors predispose to asthma?
Asthma symptoms can occur when a number of substances interfere with the lungs. These irritants are called asthma triggers. There are many different types of asthma triggers, some acting alone and some acting in combination with other types. The severity of your asthma depends on how many triggers are present in your surroundings and how sensitive your lungs are to these irritants. Common asthma triggers include the following.
1. Reaction sources.
Food and product additives: eggs, milk, peanuts, fish, soy, wine, beer, cheese, dried fruit, orange juice, soft drinks, coloring, etc.
Drugs: aspirin and aspirin preparations (including cold medicine compound), insulin, etc.
Molds, cockroaches, pollen, dust mites, rubber, plants.
2.Irritants
Smoke: cigarettes, cigars, pipes.
Perfume, natural gas, liquid propane, carbon monoxide, carbon dioxide, air fresheners, hair dyes, insecticides, mosquito coils.
Home building materials: plywood, back of carpet, formaldehyde in glue, paint, coating
3, other factors: whistle virus infection, cold air stimulation, air pressure changes, exercise and hyperventilation, emotional changes, etc.
4.When should your baby be highly suspected of asthma?
There are no specific tests or indicators available. They can be used to make a definitive diagnosis of asthma in preschool children. A diagnosis of asthma is highly suggested in children who wheeze if they have the following clinical features.
(1) frequent episodes of wheezing more than once a month
(2) Activity-induced cough or wheeze.
(3) Intermittent cough not due to a viral infection.
(4) wheezing symptoms lasting beyond 3 years of age.
5. Do you know how to predict whether your baby will develop persistent asthma?
The Asthma Predictor Index is an effective predictor of the risk of developing persistent asthma in wheezing children up to 3 years of age. Asthma Predictor Index: ≥4 wheezing episodes in the past 1 year, with 1 major risk factor or 2 minor risk factors.
Major risk factors included.
(1) Parental history of asthma.
(2) diagnosis of atopic dermatitis by a physician.
(3) evidence of sensitization to inhaled allergens.
Secondary risk factors include.
(1) evidence of food allergen sensitization.
(2) Peripheral blood eosinophils ≥ 4%.
(3) Wheezing unrelated to cold. If the asthma prediction index is positive, it is recommended to treat asthma as standard.
6.Why should pediatric asthma be diagnosed, prevented, treated and standardized at an early stage?
Because asthma is a chronic inflammatory disease of the airways mediated by multicellularity, the persistent result of chronic inflammatory changes in the airways can lead to airway mucosal damage, basement membrane thickening, fibroblast proliferation and other reshaping of the airway structure, that is, the tissue anatomy of the airways is altered. In fact, these changes in the airways begin in the early stages of asthma and, from a pathological point of view, have irreversible components. Early medication and standardized treatment can effectively control asthma and slow down the development of chronic inflammation in the airways to reduce the impairment of lung function, while avoiding exposure to all known allergens and triggers as much as possible. If asthma is allowed to occur and develop during childhood, it will cause irreversible parenchymal lung damage and reduced lung function, which will further affect the child’s normal life, work and study in the future and will cause lifelong problems for the child.
7.Why is inhaled medication the best way to treat asthma?
Inhaled medication is a milestone in the long struggle against asthma. Inhalation therapy is now recommended by medical experts at home and abroad and has become the preferred treatment for asthma. This is because the lesion of asthma is the bronchus, inhalation therapy can prevent and control asthma drugs through the whistle directly to the lesion, can quickly work. The amount of medication that is absorbed into the bloodstream and reaches the whole body is minimal when administered by inhalation. In addition, the dose of medication required for inhalation is much smaller than the dose required for systemic medication such as oral and injectable medication, with the daily dose unit for inhaled medication being micrograms and the daily dose unit for oral and injectable systemic medication being milligrams. One day’s oral and injectable doses are equivalent to six months or a year’s worth of inhaled medications. Inhaled drug delivery is faster and more effective than systemic drugs, while toxic side effects are significantly reduced and mitigated. Therefore, inhalation is the preferred method of administration for asthma control.
8.Does pediatric asthma need to be treated during remission?
This is a question that parents are not very clear about. Some parents do not insist on treating their children during the remission period because they are not clear about this issue, or they do not want to accept the fact that their children have asthma, or they are worried about the side effects of the medication, or their children do not comply well, and so on, resulting in recurrent asthma attacks. Treatment is needed during the remission period, when the child is not having an asthma attack, and treatment during the remission period is very important. It has been found that during the remission phase of asthma, although the asthma symptoms are relieved, the chronic inflammation of the airways still exists and the airway hyperresponsiveness is still present, only to a different degree. In this case, an asthma attack can be triggered by encountering allergens, triggering factors and whistling tract infections. Therefore, the remission period of asthma is the best period for the child to regain strength, strengthen the body and improve the chronic inflammation of the airways, and it is also the key period for the treatment of asthma. Effective treatment during the remission period can not only control asthma attacks but also reduce the symptoms of asthma attacks, and it is beneficial to enhance the physical strength of the children and improve their resistance to disease, which is significant in the treatment of asthma and is an important part of the standardized treatment of asthma. In other words, that is, the acute phase of an asthma attack is to relieve the symptoms as soon as possible, while the remission phase is to cure its root.
9.What is the standardized and systematic treatment of asthma?
The treatment of asthma is a process of systematic and long-term treatment. Once the diagnosis of asthma is established, standardized treatment is required. So what is standardized treatment? Each child’s asthma attack is different in severity, so treatment of asthma needs to be both standardized and individualized. You need to fix your child with an experienced pediatrician or whistleblower to establish good trust, cooperation and communication. Your doctor will develop an initial treatment plan for your child based on the severity of his or her asthma attacks and pulmonary function tests, choosing the specific medications, and inhalation methods that are right for you. During the course of treatment, you will communicate frequently with your doctor about your child’s response to treatment, and your doctor will use a stepwise approach to adjust the plan for your child based on how well your child’s asthma is controlled. This means that the doctor will decide when to reduce or taper the medication and when to stop it, depending on your child’s condition. So your child should have regular follow-ups (usually 1-3 months) and your child should also have good compliance with the doctor’s instructions and treatment recommendations.
10.What is a stepwise treatment plan for asthma?
Asthma is a dynamic chronic inflammatory disease and its treatment is a systemic project. The treatment plan should also vary from child to child at different times. Therefore, each child with asthma needs a stepwise treatment plan that is appropriate to the asthma staging and grading, which is also known as standardized and individualized treatment. The stepped treatment plan is given to different children according to their different stages and grades. Those with mild symptoms during acute attacks can start with inhalation of bronchodilators and hormonal drugs at home and decide whether to visit the hospital based on the efficacy. In the hospital, the doctor takes measures according to the degree of the attack and continuously evaluates the condition to decide whether to admit to the hospital for treatment. In remission, measures to prevent or reduce exacerbations should be taken based on long-term graded management of asthma. The stepwise treatment plan for long-term management recommends starting treatment with adequate therapeutic medication and achieving asthma control as soon as possible before tapering. The treatment plan will be evaluated every 3 months and will be adjusted up or down according to the graded level. This is also known as a “step-up or step-down” regimen. The goal of step therapy is to achieve optimal asthma control with as few medications as possible.