Dosimeter methacholine challenge: Comparison of maximal versus submaximal inhalations

Deep inhalation has bronchodilating and bronchoprotective effects, particularly in subjects who are normal or have mild airway hyperresponsiveness (AHR). We have anecdotally observed that the 5 breath to total lung capacity (TLC) dosimeter method reduced the response to methacholine in some subjects...

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Bibliographic Details
Published in:Journal of allergy and clinical immunology 2004-09, Vol.114 (3), p.517-519
Main Authors: Todd, David C., Davis, Beth E., Hurst, Thomas S., Cockcroft, Donald W.
Format: Article
Language:English
Subjects:
Administration, Inhalation
Adult
Asthma
Asthma - diagnosis
Biological and medical sciences
Bronchial Provocation Tests
Bronchoconstrictor Agents - administration & dosage
deep inhalation
dosimeter
False Negative Reactions
Female
Forced Expiratory Volume
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Humans
Immunopathology
Male
Medical sciences
Methacholine challenge
Methacholine Chloride - administration & dosage
Methods
Middle Aged
nebulizer
Nebulizers and Vaporizers
Spirometry
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Summary:Deep inhalation has bronchodilating and bronchoprotective effects, particularly in subjects who are normal or have mild airway hyperresponsiveness (AHR). We have anecdotally observed that the 5 breath to total lung capacity (TLC) dosimeter method reduced the response to methacholine in some subjects with mild AHR. To compare prospectively submaximal inhalations with TLC inhalations during the dosimeter methacholine challenge. Sixteen subjects with asthma and a methacholine PC 20 16 mg/mL) in these 5 subjects with current asthma, 4 of whom required inhaled corticosteroids. A submaximal inhalation dosimeter methacholine challenge results in a significantly lower PC 20 compared with the standard 5-breath dosimeter method. This effect is limited to the mildly responsive group, probably because of the bronchoprotective effect of the deep inhalation during the standard method, and results in false-negative tests in some subjects.
ISSN:0091-6749
1097-6825
DOI:10.1016/j.jaci.2004.06.016