PEF: peak expiratory flow; ICU: intensive care unit; SABA: short-acting beta agonist (eg, albuterol); SpO2: pulse oxygen saturation; COPD: chronic obstructive pulmonary disease; MDI: metered dose inhaler; GC: glucocorticoid; PaCO2: carbon dioxide tension.
* Titrate oxygen to SpO2 93 to 95% for patients with severe exacerbations, particularly if at risk for hypercapnia. Aim for SpO2 >95% in pregnant patients. Titrate to SpO2 88 to 92%, if asthma-COPD overlap.
¶ Magnesium sulfate is 4.06 mmol/g (2 g = 8.1 mmol).
Δ Please refer to the UpToDate topic on treatment of asthma exacerbations in adults.
◊ Adding ipratropium to albuterol nebulizer treatments is preferred for patients with severe exacerbations; alternatively, SABA/ipratropium can be given via MDI 4 to 8 inhalations every 20 minutes, as needed for up to 3 hours.
§ The dose and duration of therapy can be modified based on the patient's past history of response, severity of exacerbation, and response to current treatment.Do you want to add Medilib to your home screen?