{"id":4309,"date":"2021-01-11T12:51:14","date_gmt":"2021-01-11T11:51:14","guid":{"rendered":"https:\/\/www.alpha1-deutschland.org\/?p=4309"},"modified":"2021-01-21T16:19:57","modified_gmt":"2021-01-21T15:19:57","slug":"atmung-atemnot-notfallmanagement-bei-alpha-1","status":"publish","type":"post","link":"https:\/\/alpha1-deutschland.org\/en\/atmung-atemnot-notfallmanagement-bei-alpha-1","title":{"rendered":"Respiration \u2013 Shortness of breath \u2013 Emergency management in Alpha-1"},"content":{"rendered":"
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Respiration \u2013 Shortness of breath \u2013 Emergency management in Alpha-1<\/span><\/h1>\n<\/div>\n\n\n\n
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Author<\/h4><\/span><\/span>\n<\/div>\n
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Heike Isensee and co-author Dr. Alexander Rupp<\/p>\n<\/div>\n\n\n\n

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Our lungs are a high-performance organ \u2013 in a healthy person, they process the equivalent of a hot air balloon full of air every day. Without breathing (and therefore without oxygen supply), irreversible damage occurs after just 3 minutes without oxygen.<\/p>\n

Shortness of breath can have many causes:<\/span><\/h2>\n
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  1. Infections (caused by viruses, bacteria, rarely fungi or mixed forms)<\/li>\n
  2. Allergic reactions<\/li>\n
  3. Environmental factors (e.g., particulate matter\/smoke\/soot) or lower oxygen concentrations, e.g., at an unusual altitude.<\/li>\n
  4. Physical exertion<\/li>\n
  5. Other additional illnesses (comorbidities), e.g. heart failure<\/li>\n
  6. Smoking (the inhaled carbon monoxide occupies oxygen transporters and causes inflammation\/emphysema)<\/li>\n
  7. Acute or chronic inflammation of the airways<\/li>\n
  8. Chronic destruction of the alveoli in the lungs (emphysema)<\/li>\n
  9. Psychological stress, especially anxiety. Anxiety causes shortness of breath, shortness of breath causes anxiety! (Vicious cycle)<\/li>\n<\/ol>\n

    Peak flow, cough and mucus<\/span><\/h2>\n

    How can I recognize a deterioration in my condition before acute shortness of breath occurs?<\/p>\n

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    1. Regular peak flow measurement: A decline in your usual peak flow reading could indicate an impending problem, even if you feel healthy. Use the peak flow meter while standing upright and holding the device horizontally. The reading indicates your maximum exhaled airflow in liters per minute. It is recommended to take measurements twice (up to three times) in the morning, at midday, and in the evening. More frequent measurements are advisable if you have a bronchial infection, are starting new medications, or if the readings fluctuate significantly. For patients with respiratory conditions, an escalation (increase) of inhaled therapy is usually already discussed with your doctor.<\/li>\n
    2. Increased mucus production<\/li>\n
    3. Thicker mucus than usual<\/li>\n
    4. Increased coughing<\/li>\n<\/ol>\n

      Notes on this: Coughing is a natural reflex to mobilize mucus, which is produced, for example, due to smoking, inflammation, dust, etc., and transport it out of the airways with the help of cilia. Yellow-green phlegm suggests a bacterial infection (only then is antibiotics advisable, and only after consulting a doctor). Whitish phlegm is more indicative of a viral infection. The color of the secretions can be used as a clue, but should not be overemphasized as a diagnostic tool. A better way to differentiate is, for example, by measuring C-reactive protein (CRP) in the blood. Proper coughing technique is important. Never try to forcefully cough up mucus. The mucus should be breathed slowly and effortlessly up to the larynx and then expelled by clearing the throat. If possible, always cough with pursed lips, inhaling after every two to three coughs. Prolonged coughing fits without phlegm should be suppressed as much as possible.<\/p>\n

      Alpha-1 bronchitis carries a high risk of chronic bronchitis. This involves increased mucus production, and at the same time, the cilia may be damaged or destroyed, for example, in smokers or ex-smokers. As a result, mucus clearance becomes increasingly difficult.<\/p>\n

      Important: Every patient should be able to recognize a deterioration in their condition and manage it themselves. This includes increasing inhaled therapy as agreed upon with the doctor, using appropriate breathing techniques (pursed-lip breathing), and adopting breathing-easing postures. Patients should also be able to independently use their emergency inhaler if their condition worsens, increase their maintenance medication as prescribed, or, in cases of severe deterioration, take a course of oral corticosteroids (see also the action plan below).<\/p>\n

      Emphysema and pursed-lip breathing<\/span><\/h2>\n

      In emphysema, the lung tissue is flaccid because the delicate walls of the alveoli are destroyed and the walls of the small airways (bronchioles) are hypermobile. The bronchi are also flaccid. A whistling sound during exhalation ("stridor") indicates obstruction of the lower airways (because the bronchi collapse, preventing proper airflow, similar to deflating a balloon while pinching the inlet). This leads to progressive overinflation of the lungs, as more and more air becomes trapped. By creating counter-pressure, for example, through pursed-lip breathing during exhalation, the alveoli can be emptied more effectively, as the bronchi remain open.<\/p>\n

      The correct exhalation pressure for pursed-lip breathing can be practiced as follows: Remove the (often green) plunger, i.e., the part used to push, from a 10ml disposable syringe. Then, close your lips around the wider, rear end of the syringe and exhale through it.<\/p>\n

      Correct, controlled exhalation using pursed-lip breathing leads to a nearly complete exhalation. This allows for better inhalation.<\/p>\n<\/div>\n\n\n\n

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      Tips for better mucus clearance: <\/span><\/h2>\n