Guía ALERTA 2. América Latina y España: Recomendaciones para la prevención y el Tratamiento de la exacerbación Asmática

GEMA 5.3. Spanish Guideline on the Management of Asthma

“…Assessment of the severity of the exacerbation episode determines its treatment ( fig. 8 ), 467 and is carried out in two steps: Initial or static (pretreatment) evaluation : aimed at identifying signs and symptoms and objectively measuring the degree of airflow obstruction by determining FEV 1 or peak expiratory flow (PEF) and their impact on gas exchange, in order to establish the level of severity of the exacerbation ( table 31 ). Table 31 Assessment of severity of asthma exacerbation.…”

“… Criteria for hospital admission Criteria for ICU admission Remain symptomatic after treatment Respiratory arrest O2 requirement to maitain SaO2 > 92% Decrease in the level of consciousness – PEF or FEV1 < 50-60% after treatment. 529 – PEF or FEV 1 = 50-70% on arrival. A minimum observation period of 12 hours is advisable.…”

“…The recommended doses and dosing intervals depend on the severity of the exacerbation episode and the response to the initial doses. 594 The most commonly used drug is salbutamol , which is available as a solution for use with a nebulizer and a pressurized inhaler. The latter must be administered in sequences of 2-10 puffs of 100 μg until response is obtained.…”

Valoración y análisis de las crisis de broncoespasmo en pacientes adultos del servicio de urgencias

“…Para la medición del FEM y valoración del grado de obstrucción se utilizó el flujómetro TruZone de tipo manual. De acuerdo con la medición del FEM clasificamos la gravedad de la exacerbación en: leve (FEM mayor del 70% del teórico o 300 l/min), moderada (FEM entre el 50 y el 70% o entre 150 y 300 l/min) y grave (FEM inferior al 50% o menor de 150 l/min) 5 .…”

“…-Grave: FEM es inferior al 50% o menor de 150 l/min 5 . En Chile, Orena y Valdivia encontraron que el deterioro de la función pulmonar se asocia con un FEM menor al 80%.…”