Fast Five Quiz: Severe Asthma Management

Praveen Buddiga, MD


July 07, 2021

Figure 1. Asthma is a chronic disease of the respiratory system in which the airway occasionally constricts and becomes inflamed. A section of inflamed bronchi is shown.

According to the updated European Respiratory Society/American Thoracic Society (ERS/ATS) Guidelines on the management of severe asthma, when patients present with "difficult asthma," confirmation of their asthma diagnosis is recommended. Confirmation of reversible airflow limitation via spirometry with both inspiratory and expiratory loops, assessed before and after bronchodilator administration, should be obtained.

Chest radiography findings are normal in most patients with asthma, although in some cases they may indicate hyperinflation. However, chest radiography remains an important tool in the management of patients with severe asthma in the acute setting, such as during an admission for asthma exacerbation, particularly for detecting pneumothoraces.

Many experts believe that inflammatory endotype characterization should be considered a crucial component of the workup and management of severe asthma, as this can help guide treatment stratification and improve outcomes.

Allergen-inhalation challenges may be performed in certain patients, but in general they are not needed or recommended.

Learn more about the workup for severe asthma.


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