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Appendix:
1. LONG TERM MANAGEMENT OF ASTHMA:
Pharmacologic Approach
Action: Asthma classified based on severity
Levels of Control
Objective measures
Hospitalization
The decision to hospitalize is based on several factors. The following features can serve as guides on whether the patient
requires hospitalization:
• severity of attack - severe exacerbation or impending respiratory failure
• persistent severe airflow obstruction (PEFR < 60%)
• history of severe exacerbations
• current use or recent withdrawal from systemic corticosteroids
• inadequacy of support and home conditions
Admission to ICU
• progressive worsening of asthma symptoms despite initial management
• presence of sensorial changes (drowsiness, confusion) or loss of consciousness
• signs of respiratory fatigue (e.g. declining respiratory rate)
• impending respiratory arrest (paO2 < 60 mmHg on
• supplemental oxygen, pCO2 > 45 mmHg)