Document Detail

A comparison of a single-step cold-dry air challenge and a routine histamine provocation for the assessment of bronchial responsiveness in children and adolescents.
MedLine Citation:
PMID:  7656626     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It has remained unclear whether bronchial responsiveness as measured by a single-step cold-dry air challenge (CACh) correlates closely to the responsiveness that is assessed by a routine pharmacologic challenge. METHODS: On 2 consecutive days, we performed a CACh and a histamine challenge in 128 symptom- and medication-free pediatric and adolescent asthma patients. The CACh consisted of 4 min of isocapnic hyperventilation of -10 degrees C, absolutely dry air; responsiveness was expressed by the induced change in FEV1 (delta FEV1). The histamine challenge consisted of sequential inhalations of incremental increases in concentrations of histamine; responsiveness was expressed by the concentration which caused a 20% fall of FEV1 (PC20). RESULTS: Five children did not bronchoconstrict sufficiently in the histamine challenge for measuring a PC20 and were excluded from analysis. In the remaining 123, delta FEV1 (CACh) ranged from +5 to -73%, PC20 (histamine) from 0.05 to 7.2 mg/mL. There was a statistically significant correlation between delta FEV1 and PC20 (r = 0.54, p < 0.001), but also a considerable scatter of individual data points around the regression line. Fifty-two subjects were hyperresponsive by CACh and 114 by histamine criteria. CONCLUSIONS: There is a relatively weak correlation between the results of these two challenges; thus, one cannot be substituted one for the other. Histamine appears as more sensitive in detecting airway hyperresponsiveness than CACh. The poor correlation between the responses to these two challenges can be explained by differences between the challenge protocols, or, alternatively, by differences between applied stimuli and activated mechanisms.
B Steinbrugger; E Eber; M Modl; E Weinhandl; M S Zach
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Chest     Volume:  108     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1995 Sep 
Date Detail:
Created Date:  1995-10-05     Completed Date:  1995-10-05     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  741-5     Citation Subset:  AIM; IM    
Pediatric Department, University of Graz, Austria.
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MeSH Terms
Asthma / diagnosis*,  physiopathology
Bronchial Hyperreactivity / physiopathology*
Bronchial Provocation Tests / methods*
Cold Temperature
Forced Expiratory Volume / physiology
Histamine / diagnostic use*
Sensitivity and Specificity
Reg. No./Substance:

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

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