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The fundamental problem in asthma appears to be immunological: young children in the early stages of asthma show signs of excessive inflammation in their airways. Epidemiological findings give clues as to the pathogenesis: the incidence of asthma seems to be increasing worldwide, and asthma is now very much more common in affluent countries.
[96] [97] It is the single best test for asthma. If the FEV 1 measured by this technique improves more than 12% and increases by at least 200 millilitres following administration of a bronchodilator such as salbutamol, this is supportive of the diagnosis. It however may be normal in those with a history of mild asthma, not currently acting up. [20]
There is, of course, no reason why asthma and exercise-induced bronchoconstriction should not co-exist but the distinction is important because without successful treatment of underlying asthma, treatment of an exercise component will likely be unsuccessful.
Asthma is an extremely common chronic disease affecting over 26 million people and 7 million children in the US. [3] Recognizing the trigger for asthma and avoiding it can be a simple yet effective way to deal with the disease and avoid an asthma attack. [ 6 ]
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.
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