Asthma patients 'could be saved'

Severe asthma attacks can be highly dangerous

People who suffer life-threatening asthma attacks could be saved with better treatment, research suggests.

The key is to give them oxygen as quickly as possible.

However, many general practice surgeries do not contain oxygen cylinders.

Researchers say that as most asthma deaths occur in the community, oxygen cylinders should be available at all GP surgeries.

They want the British Thoracic Society to review the issue when it next updates its asthma guidelines.

Acute cases

Wider availability of oxygen may help

National Asthma Campaign

The research team reviewed 11 studies of acute severe asthma in both children and adults.

They found that an inadequate supply of oxygen was an important cause of death in those who died following a severe attack.

Some studies also suggest that treatment with air during severe attacks may actually be counter-productive.

The British Thoracic Society's guidelines advise oxygen as a first line treatment in hospital for all patients with acute severe asthma.

In general practice however, the guidelines imply that general practitioners should be prepared to treat acute asthma of all severities - but do not advise the use of oxygen for children or insist on its use in adults.

The researchers suggest that patients with severe asthma could also be provided with oxygen cylinders for emergency use at home.

"The important point is that asthmatic patients are still dying during acute attacks - and the use of oxygen ... in primary care is rational and could save lives."

Expert response

Professor Duncan Geddes, BTS president, said: "This is an important paper, highlighting a good treatment which we have known about for a long time - but which suggests that it is much more important in preventing asthma deaths than previously thought.

"Certainly, the BTS Asthma Guidelines Committee will need to take this research seriously - and re-consider their guidelines over the use of oxygen.

A spokesman for the National Asthma Campaign said there were approximately 1,500 deaths per year from asthma.

"The majority of these deaths occur outside hospital and it is correct that the mode of death is shortage of oxygen and exhaustion.

"Wider availability of oxygen may help in these circumstances.

"However, greater importance is better recognition of those with potentially fatal asthma and then working with such patients to teach them how to recognise deteriorating asthma or how to self-manage their own medication to prevent deterioration or a situation of risk.

"Prevention of severe asthma is ultimately preferable to life-saving first-aid late in the course of an attack."

Around 1,600 adults and 20 children in the UK die every year from acute asthma.

The research is published in the British Medical Journal.