In Fatal Asthma, pulmonary medicine expert witness Dr. James F. Lineback, Newport Longevity Medical Group, writes:
Fortunately, the overwhelming majority of asthmatics experience mild symptoms that are easily treated with medications which open up the airway and reduce inflammation in those structures. A certain subset however, have more severe narrowing of the airways and must be treated more aggressively and monitored more carefully with serial pulmonary function testing.
Patients with severe asthma require more medication, have more frequent visits to the emergency room, and may actually require mechanical ventilation for acute respiratory failure. These patients constitute a high risk group for a fatal outcome and generally have certain risk factors, such as steroid dependence, prior need for mechanical ventilation, a high number of medications, and frequent episodes of acute respiratory failure. Aggressive treatment in this group prevents accumulation of dried secretions in the airways as well as severe life threatening airway obstruction. Once this process occurs, these patients are faced with a significant increase “work of breathing” which eventually leads to respiratory muscle fatigue.