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Editorials: Point and Counterpoint |

COUNTERPOINT: Is Escalation of the Inhaled Corticosteroid Dose Appropriate for Acute Loss of Asthma Control in an Attempt to Reduce Need for Oral Corticosteroids in Children? No

Miles Weinberger, MD
Author and Funding Information

FINANCIAL/NONFINANCIAL DISCLOSURE: None declared.

Professor Emeritus of Pediatrics, University of Iowa, Iowa City, IA

CORRESPONDENCE TO: Miles Weinberger, MD, 450 Sandalwood Ct, Encinitas, CA 92024


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(3):490-492. doi:10.1016/j.chest.2016.06.026
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The proposal to treat loss of asthma control with increased inhaled corticosteroids raises a number of issues that need to be examined. First, just what is meant by loss of control? Is this the same as an exacerbation? If not, what’s the difference? For guidance, I looked at a previously published practice parameter. That document summarizes the goal of what they call the yellow zone as “Responding to the symptoms of acute loss of control in the yellow zone with effective interventions can help prevent deterioration to the red zone, necessitating use of systemic corticosteroids and/or urgent medical care.”(p145)

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