Global Initiative for Asthma - Guidelines

The Global Initiative for Asthma (GINA) works with health care professionals and public health officials around the world to reduce asthma prevalence, morbidity, and mortality.

According to GINA an asthma diagnosis can be made when a documented airflow reduction (reduced FEV1/FVC) with excessive variability in lung function is found (reversibility) in a patient with typical asthma symptoms.

  • Documented expiratory airflow reduction
    An airflow reduction is defined as a reduced FEV1 with a reduced FEV1/FVC
  • Documented excessive variability in lung function can be found by any of the following means:
    • Positive bronchodilator reversibility test
      Adults: FEV1 of >12% and >200mL, 10-15 minutes after administration of 200-400mcg of salbutamol.
      Children FEV1 increase >12% predicted.
    • PEF measurements over 2 weeks
      Adults: average daily diurnal PEF variability >10%
      Children: average daily diurnal PEF variability >13%
    • FEV1 improvement of >12% and >200 mL after 4 weeks of anti-inflammatory treatment (adults)
    • Positive exercise challenge test
      Adullts: FEV1 decrease of >10% and >200mL
      Children: FEV1 decrease >12% predicted
    • Positive bronchial challenge test (adults)
    • Excessive variation in FEV1 between visits
      Adults: >12% and >200 mL
      Children: >12%

    The official and full GINA guidelines can be downloaded from the GINA Website .

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