Asthma is a chronic disease accompanied by breathlessness. These bouts of breathlessness are called ‘attacks’. The severity and frequency of each attack of breathlessness varies from person to person. World Health Organization (WHO) estimates that globally 235 million people suffer from asthma. This chronic disease is very common among children. Though not very fatal, 80% of asthma related deaths occur in low income countries. Asthma is under diagnosed and under treated thus creating financial burden on families and restricting physical activity of the patient. This restriction sometimes is for lifetime. Asthma cannot be fully cured. But it can be controlled. The strongest risk factors that trigger asthma are a mix of hereditary reasons and environmental triggers. Tobacco smoke, air pollutants, chemical irritants and other similar environmental factors are known to trigger asthma attacks.
The best way to prevent asthma attacks is to be careful about environmental and other triggers and safely stay away from them. However, what to do when actually the attack happens? Steroids, anti-inflammatory drugs and bronchodilators relax the muscles that tighten the air flow. Inhalers are the most commonly used devices to deliver the asthma drugs directly to lungs. It is generally a handheld device. Inhalers can be Metered Dose Inhalers (MDI) or Dry Powder Inhalers (DPIs). MDIs deliver medications through a small handheld canister. DPIs require the patient to breathe deeply and quickly. Because of this DPIs are difficult to use during asthma attacks when it is difficult to breathe normally. Some patients specially children find it difficult to use MDIs and DPIs.
Then the doctor may prescribe a breathing machine. These machines convert the asthma medication from liquid to a mist. This makes it very easy to inhale. Generally a mouth piece is used in this process. But the medicine pushed in this way may take some more time to take effect. But their main advantage is ease of use as a patient can breathe absolute normally and effortlessly to utilize them. A breathing machine can be hand held or otherwise. They can also be portable for on road medication. They are most effective when the patient is breathing absolutely normally. Rapid deep breathing reduces the impact. So for children, this is best done when they are sleeping. Sometimes the choice of MDI or breathing machine is a difficult one. Inputs from the physician are important. However a few tries will tell which one is best for which patient.