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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)

From: Management of severe acute exacerbations of COPD: an updated narrative review

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
  1. Modified from report [1]. The cross mark identifies the correct setting
  2. Abbreviations: RR indicates respiratory rate, SatO2 oxygen saturation, PaO2 partial arterial oxygen pressure, IMV invasive mechanical ventilation