Pediatric Asthma Emergency: Managing Acute Exacerbations Amid Rising Pollution

Bangalore: Dr Shiv Tej N and Dr Venugopal Reddy I, members of the Pediatric Team at Ovum Woman and Child Hospital, Bangalore, explain everything you need to know about Asthma in children.

Why is Asthma Important?

Asthma is one of the most common chronic illnesses in children, affecting about 14% of children globally according to the World Health Organization (WHO). It is a serious condition that can lead to life-threatening emergencies if not managed properly. With increasing pollution levels, more children are experiencing severe asthma symptoms, making awareness and management of this condition crucial.
Understanding Asthma
Asthma is a condition that causes the airways in the lungs to narrow and swell, producing extra mucus. It can be triggered by a variety of factors, such as:
    • Air pollution (like particulate matter and nitrogen dioxide)
    • Viruses (such as RSV, rhinovirus, or influenza)
    • Allergens (dust mites, pet dander, pollen)
    • Emotional or physical stress
These triggers cause the muscles around the airways to tighten (bronchospasm), and the lining of the airways becomes inflamed, which leads to symptoms.

Symptoms of Asthma

Early recognition of asthma symptoms can help manage the condition and prevent emergencies. Look out for the following:
    • Common symptoms.
    • Wheezing or coughing (especially at night)
    • Shortness of breath
    • Fatigue or tiredness
    • Recurring cough
    • Severe symptoms:
    • Extreme difficulty in breathing
    • Trouble speaking or doing physical activities
    • Anxiety or confusion
    • Low oxygen levels
Managing an Asthma Attack
Asthma attacks, or acute exacerbations, can escalate quickly, so prompt treatment is essential. The goal is to relieve symptoms rapidly, prevent the attack from worsening, and reduce the need for hospitalization.
    • Mild attacks can be treated with inhaled short-acting beta agonists (like albuterol) and oral corticosteroids.
    • Moderate attacks may require the addition of ipratropium bromide or intravenous medications like magnesium sulfate.
    • Severe attacks might need oxygen therapy, intravenous corticosteroids, and possibly mechanical ventilation.
How Pollution Impacts Asthma
Pollution is a major trigger for asthma attacks in children. The developing lungs of children are more vulnerable to damage, and their higher breathing rate increases their exposure to harmful pollutants like:
    • Particulate matter (PM2.5): These tiny particles penetrate deep into the lungs.
    • Nitrogen dioxide (NO2): This gas increases inflammation in the lungs.
    • Ozone (O3): Ground-level ozone can damage lung tissue.
Impact of Frequent Asthma Attacks on Children
Repeated asthma attacks can seriously affect a child’s health, both physically and emotionally:
    • Physical Effects:
    • Decreased lung function and increased risk of respiratory failure.
    • Permanent changes in the airway structure, leading to worsened symptoms.
    • Weakened immune system, making children more susceptible to infections.
    • Emotional and Psychological Effects:
    • Anxiety and stress due to fear of attacks and hospital visits.
    • Social isolation and depression as children may miss school and playtime.
    • Sleep disturbances and concentration difficulties.
    • Social Impact:
    • Missed school days, affecting education and social development.
    • Limited physical activity and social interactions.
Preventing Asthma Attacks
While asthma cannot be cured, attacks can be prevented with proper management:
    • For Families:
    • Educate children and caregivers about asthma and its triggers.
    • Ensure regular use of prescribed medications and adherence to treatment plans.
    • Avoid known triggers and regularly monitor symptoms.
    • For Healthcare Providers:
    • Regularly monitor asthma control and adjust treatment when necessary.
    • Develop personalized management plans for each child.
    • Collaborate with caregivers, schools, and community resources to support children with asthma.
Effective asthma management empowers children and families to take control of their symptoms. By understanding the condition, using medications properly, and making lifestyle changes, children with asthma can lead healthier lives.
Resources:
    • Global Initiative for Asthma (GINA)
    • Asthma and Allergy Foundation of America
    • American Lung Association
    • World Health Organization (WHO)