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Inspiratory airflow limitation after exercise challenge in cold air in asthmatic children.
MedLine Citation:
PMID:  22789953     Owner:  NLM     Status:  Publisher    
Methacholine and histamine can lead to inspiratory flow limitation in asthmatic children and adults. This has not been analyzed after indirect airway stimuli, such as exercise. The aim of the study was to analyze airflow limitation after exercise in cold, dry air. 72 asthmatic children with mild to moderate asthma (mean age 13.2 ± 2.2 yrs) performed a treadmill exercise challenge. A fall of >10% in FEV(1) was the threshold for expiratory flow limitation and a fall of >25% of MIF(50) was the threshold for inspiratory flow limitation. The occurrence of wheeze, stridor and cough were quantified before and after exercise. After exercise, the mean fall in FEV(1) was 17.7 ± 14.6%, while the mean fall in MIF(50) was 25.4 ± 15.8%; no correlation was found between fall in FEV(1) and MIF(50) (R(2): 0.04; p = 0.717). 53 of the 72 children showed an inspiratory and/or expiratory airflow limitation. 38% (20/53) of these children showed an isolated expiratory flow limitation, 45% (24/53) showed both expiratory and inspiratory flow limitation and 17% (9/53) showed an isolated inspiratory flow limitation. The fall in FEV(1) peaked 9 min after exercise and correlated to expiratory wheeze. The fall in MIF(50) peaked 15 min after exercise and correlated to inspiratory stridor. The time difference in peak fall between FEV(1) and MIF(50) was statistically significant (5.9 min; p < 0.001, 99% CI: 2.3-9.5 min). In conclusion, this study shows that an exercise challenge in asthmatic children can give rise to inspiratory airflow limitation, which may give rise to asthma like symptoms.
Jean M Driessen; Job van der Palen; Wim M van Aalderen; Frans H de Jongh; Boony J Thio
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-10
Journal Detail:
Title:  Respiratory medicine     Volume:  -     ISSN:  1532-3064     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Department of Pediatrics Medisch Spectrum Twente, P.O. Box 50 000, 7500 KA Enschede, The Netherlands.
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