Table 3.
Potential indicators for do-not-hospitalize AECOPD patients or hospitalization in a general ward or in a respiratory or medical intensive care units (ICU)
| Variables | Do-not-hospitalize | General ward | Respiratory or medical ICU |
|---|---|---|---|
| Insufficient home support | X | ||
| Good response to initial medical management | X | ||
| Failed response to initial medical management | X | ||
| Fewer symptoms (dyspnea on effort, RR < 30 breaths/min, SatO2 > 90%, no confusion, no drowsiness) | X | ||
| Severe symptoms (resting dyspnea, RR ≥ 30 breaths/min, SatO2 ≤ 90%, confusion, drowsiness) | X | ||
| Very severe symptoms (dyspnea) that respond inadequately to initial emergency therapy | X | ||
| Presence of serious comorbidities (e.g. heart failure, newly occurring arrhythmias, etc.) | X | ||
| Onset of new physical signs (e.g. cyanosis, peripheral edema) | X | ||
| Acute respiratory failure (without use of accessory respiratory muscles and change in mental status) | X | ||
| Acute respiratory failure (with use of accessory respiratory muscles and change in mental status) | X | ||
| Persistent or worsening hypoxemia (PO2 < 40 mmHg) and/or severe respiratory acidosis (pH < 7.25) | X | ||
| Need for IMV | X | ||
| Hemodynamic instability (need for vasopressors) | X |
Modified from report [1]. The cross mark identifies the correct setting
Abbreviations: RR indicates respiratory rate, SatO2 oxygen saturation, PaO2 partial arterial oxygen pressure, IMV invasive mechanical ventilation