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Asthma phenotyping and endotyping has emerged as a novel approach to asthma classification inspired by precision medicine which separates the clinical presentations of asthma, or asthma phenotypes, from their underlying causes, or asthma endotypes. The best-supported endotypic distinction is the type 2-high/type 2-low distinction.
While the acronyms are similar, reactive airway disease (RAD) and reactive airways dysfunction syndrome (RADS) are not the same. [1]Reactive airways dysfunction syndrome was first identified by Stuart M. Brooks and colleagues in 1985 as an asthma-like syndrome developing after a single exposure to high levels of an irritating vapor, fume, or smoke.
If the person with a severe asthma exacerbation is on a mechanical ventilator, certain sedating medications such as ketamine or propofol, have bronchodilating properties. According to a new randomized control trial ketamine and aminophylline are also effective in children with acute asthma who responds poorly to standard therapy. [9]
AERD affects an estimated 0.3–0.9% of the general population in the US, including around 7% of all asthmatics, about 14% of adults with severe asthma, and ~5-10% of patients with adult onset asthma. [2] [3] [8] AERD is uncommon among children, with around 6% of patients, predominantly female, reporting disease onset during childhood. [9]
For children younger than 15 years old, nasopharyngel catheters or nasal prongs are recommended over a face mask or head box. [26] A Cochrane review in 2014 presented a summary to identify children complaining of severe LRTI, however; further research is required to determine the effectiveness of supplemental oxygen and the best delivery method.
The Centers for Disease Control and Prevention estimate that 1 in 11 children and 1 in 12 adults have asthma in the United States of America. [1] According to the World Health Organization, asthma affects 235 million people worldwide. [2] There are two major categories of asthma: allergic and non-allergic.
The DSM-5 (2013), the current version, also features ICD-9-CM codes, listing them alongside the codes of Chapter V of the ICD-10-CM. On 1 October 2015, the United States health care system officially switched from the ICD-9-CM to the ICD-10-CM. [1] [2] The DSM is the authoritative reference work in diagnosing mental disorders in the world.
Brittle asthma is a type of asthma distinguishable from other forms by recurrent, severe attacks. [ 1 ] [ 2 ] [ 3 ] There are two subtypes divided by symptoms: Type 1 and Type 2, [ 4 ] depending on the stability of the patient's maximum speed of expiration, or peak expiratory flow rate (PEFR).