Document Detail

Diagnostic value of negative expiratory pressure for airway hyperreactivity.
MedLine Citation:
PMID:  14605046     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVES: To examine the value of negative expiratory pressure (NEP) in the assessment of methacholine bronchoprovocation testing (BPT). DESIGN: Prospective, observational study. SETTING: Pulmonary function laboratory in a university hospital. PARTICIPANTS: Fifty-nine patients with chronic cough referred from outpatient clinics for methacholine BPT. METHODS: Each subject inhaled successive doubling concentrations of methacholine (from 0.049 to 25 mg/mL) until the FEV(1) decreased for > 20% or the maximum concentration of methacholine was inhaled. NEP was measured in the sitting position during tidal breathing before and after methacholine BPT. The FEV(1) and forced oscillation airway resistance (Rrs) and interrupter airway resistance (Rint) were also obtained simultaneously. A positive BPT result was defined as a fall in FEV(1) > or = 20%. RESULT: At baseline, only five patients had expiratory flow limitation as demonstrated by NEP (EFL-N). There were 39 patients with positive BPT results, and the other 20 patients had negative results. Among the BPT-positive patients, only 13 patients (33.3%) had EFL-N after methacholine challenge. The sensitivity indexes (absolute change/SD) of FEV(1), NEP, Rrs, and Rint were 16.0 +/- 9.6%, 1.1 +/- 1.6%, 3.8 +/- 4.5%, and 5.89 +/- 4.4% (mean +/- SD), respectively. The percentage changes in FEV(1) in BPT-positive patients correlated with the percentage changes in Rrs (r = 0.419, p = 0.008) and only marginally with the percentage changes in Rint (r = 0.307, p = 0.058), but not with the changes in EFL-N (r = 0.048, p = 0.77). CONCLUSION: These data suggest that NEP at sitting position is not sensitive in the assessment of methacholine bronchoprovocation as compared to FEV(1) and airway resistance measurements.
Ping-Huai Wang; Ping-Hung Kuo; Chia-Lin Hsu; Huey-Dong Wu; Yu-Shein Chang; Sow-Hsong Kuo; Pan-Chyr Yang
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  124     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-07     Completed Date:  2003-12-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1762-7     Citation Subset:  AIM; IM    
Departments of Internal Medicine, Far Eastern Memorial Hospital, Taipei County, Taiwan.
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MeSH Terms
Airway Resistance
Bronchial Hyperreactivity / diagnosis*
Bronchial Provocation Tests*
Forced Expiratory Flow Rates
Forced Expiratory Volume
Methacholine Chloride / diagnostic use
Prospective Studies
Respiratory Mechanics*
Sensitivity and Specificity
Vital Capacity
Reg. No./Substance:
62-51-1/Methacholine Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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