Document Detail

Safety and tolerability of methacholine challenge in infants with recurrent wheeze.
MedLine Citation:
PMID:  14626336     Owner:  NLM     Status:  MEDLINE    
Bronchial hyperreactivity (BHR) is a key feature of asthma, but measurement can usually not be achieved in infants with standard lung function tests. We investigated the safety and tolerability of methacholine challenge in infants with recurrent wheezing episodes. 78 methacholine challenges in 51 sedated infants aged 12-36 months with recurrent wheezing episodes were performed. Methacholine challenge was stopped when clinical signs (coughing, wheezing, or cyanosis) or a drop of oxygen saturation (SPO2) of at least 5% or a drop of transcutaneous oxygen tension (PtcO2) of at least 0.8 kPa or an increase of resistance (RrsSO), of 50% by single occlusion technique were observed. Prior to methacholine challenge, all children were symptom-free with a mean SPO2 of 97.4% (SD 1.80%). In 48 cases (61.5%), no clinical sign was observed, 17 (21.8%) coughed, and 13 (16.7%) wheezed. A mean reduction of SPO2 of 5.0% (SD 3.89%) for the entire population was observed. In 15 of 78 cases, a decrease of SPO2 <90% occurred. This SPO2 drop was short-lasting and resolved spontaneously or after bronchodilator inhalation. Infants whose SPO2 dropped <90% showed a greater increase of RrsSO compared to infants who did not drop <90% (133% vs. 65% RrsSO increase, p<0.001). Methacholine challenge, using a combination of clinical observation, monitoring of SPO2 and PtcO2, and airway resistance using the single-occlusion technique, is a safe and tolerable tool to measure the BHR in infants with recurrent wheezing episodes.
C Bez; G Sach; A Jarisch; M Rosewich; J Reichenbach; S Zielen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of asthma : official journal of the Association for the Care of Asthma     Volume:  40     ISSN:  0277-0903     ISO Abbreviation:  J Asthma     Publication Date:  2003  
Date Detail:
Created Date:  2003-11-19     Completed Date:  2003-12-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8106454     Medline TA:  J Asthma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  795-802     Citation Subset:  IM    
Pediatric Pneumology, University Children's Hospital, Frankfurt/Main, Germany.
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MeSH Terms
Airway Resistance
Blood Gas Monitoring, Transcutaneous
Bronchial Hyperreactivity / diagnosis*
Bronchial Provocation Tests* / adverse effects
Bronchoconstrictor Agents / adverse effects,  diagnostic use*
Child, Preschool
Methacholine Chloride / adverse effects,  diagnostic use*
Oxygen / blood
Respiratory Sounds*
Reg. No./Substance:
0/Bronchoconstrictor Agents; 62-51-1/Methacholine Chloride; 7782-44-7/Oxygen

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

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