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Titolo:
Methacholine inhalation challenge: a shorter, cheaper and safe approach
Autore:
Izbicki, G; Bar-Yishay, E;
Indirizzi:
Hebrew Univ Jerusalem, Hadassah Univ Hosp, Hadassah Med Sch, Inst Pulmonol, IL-91120 Jerusalem, Israel Hebrew Univ Jerusalem Jerusalem Israel IL-91120 -91120 Jerusalem, Israel
Titolo Testata:
EUROPEAN RESPIRATORY JOURNAL
fascicolo: 1, volume: 17, anno: 2001,
pagine: 46 - 51
SICI:
0903-1936(200101)17:1<46:MICASC>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
BRONCHIAL RESPONSIVENESS; REACTIVITY; HISTAMINE; ASTHMA; PREVALENCE; CHILDREN;
Keywords:
abbreviated; bronchial challenge test; methacholine; protocol;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Bar-Yishay, E Hebrew Univ Jerusalem, Hadassah Univ Hosp, Hadassah Med Sch,Inst Pulmonol, POB 12000, IL-91120 Jerusalem, Israel Hebrew Univ JerusalemPOB 12000 Jerusalem Israel IL-91120 l
Citazione:
G. Izbicki e E. Bar-Yishay, "Methacholine inhalation challenge: a shorter, cheaper and safe approach", EUR RESP J, 17(1), 2001, pp. 46-51

Abstract

Increased nonspecific bronchial hyperresponsiveness to pharmacological agents such as histamine or methacholine (MCh) is a hallmark of asthma. The measurement of airway reactivity is quite sensitive but testing is tedious, and time and money consuming. The present aim was, therefore, to design the shortest possible, yet safe inhalation challenge protocol applicable for a lung function referral centre. All records of studies performed in our institution during 1996 were analyzed retrospectively with a baseline ratio (bI) of forced expiratory volume in one second/forced vital capacity (FEV1/FVC) greater than or equal to 0.7(n=449). It was questioned what the initial dose should be, and whether some inhalation steps could have been skipped without losing pertinent information and/or causing an adverse response (a fall in FEV1 >40%). When unavailable, provocative dose causing a 20% fall in FEV1 (PD20) values were obtained by linear inter- or extrapolation of the existing data. The present study showed that three-fold concentration steps could have been employed,vith minimal change in outcome. Only 15/449 patients (3.3%) would have experienced a severe response. Five subjects (of 169, 3.0%) with FEV1/FVCbI 0.7-0.8 reacted to inhalation up to 0.073 mu mol. Four subjects (of 280, 1.4%) with FEV1/ FVCbI greater than or equal to 0.8 reacted to inhalation up to 0.219 mu mol. The authors suggest that: 1) an initial dose of 0.219 mu mol (initial concentration= 0.21 mg mL(-1)) may be used when the baseline ratio of forced expiratory volume in one second to forced vital capacity greater than or equal to0.8 and 0.073 mu mol (initial concentration=0.07 mg . mL(-1)) when the baseline ratio is <0.8; 2) a tripling dose protocol is easier to perform, cheaper and 30.2% faster, yet just as safe; and 3) other abbreviated protocols used in epidemiologic settings may not be applicable in a referral centre setting.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/02/20 alle ore 22:43:31