Cargando…

Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests

INTRODUCTION: Bronchial challenge tests by inhalation of aerosolized methacholine (MCH) are commonly used in the clinical diagnosis of airway hyperresponsiveness (AHR). While the detection of airway narrowing relies on the patient's cooperation performing forced spirometry, body plethysmographi...

Descripción completa

Detalles Bibliográficos
Autores principales: Nensa, F, Marek, W, Marek, E, Smith, HJ, Kohlhäufl, M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521367/
https://www.ncbi.nlm.nih.gov/pubmed/20156751
http://dx.doi.org/10.1186/2047-783X-14-S4-170
_version_ 1782252941103595520
author Nensa, F
Marek, W
Marek, E
Smith, HJ
Kohlhäufl, M
author_facet Nensa, F
Marek, W
Marek, E
Smith, HJ
Kohlhäufl, M
author_sort Nensa, F
collection PubMed
description INTRODUCTION: Bronchial challenge tests by inhalation of aerosolized methacholine (MCH) are commonly used in the clinical diagnosis of airway hyperresponsiveness (AHR). While the detection of airway narrowing relies on the patient's cooperation performing forced spirometry, body plethysmographic measurements of airway resistance are less depending on the patient's cooperation and do not alter the respiratory tract by maximal maneuvers. Hence we compared both methods concerning their clinical value and correlation during MCH challenges in patients with asthma. MATERIALS AND METHODS: Cumulative MCH challenges test, consisting of up to 5 steps, evaluated with body plethysmography on each step were performed in 155 patients with bronchial asthma. Airway responses were recorded at each step of MCH application (Master-Screen Body, Cardinal Health, Höchberg). At the baseline test and after crossing the provocation dose (PD) threshold in body plethysmography (PD+100 sReff), forced expirations were performed and FEV(1), FVC, and FEV(1 )%FVC were measured. Using regression analysis of the airway parameters and taking the MCH dose as the covariate, we could extrapolate to missing spirometric values and interpolate the estimated MCH dose when crossing the PD threshold (PD-20 FEV(1)) between two consecutive measurements. The administered PD+100 MCH doses for specific airway resistance, sRtot, and sReff were compared with resistance parameters Rtot and Reff, and to PD-20 of FEV(1 )and FEV(1 )%FVC. RESULTS: Regarding sReff we found a mild, moderate, or severe AHR in 114 patients (75%), but only 50 (32%) according to FEV(1). A statistical analysis showed strongly linear correlated parameters of airway resistance, but no significant correlation between the results of body plethysmography and forced spirometry CONCLUSIONS: Using MCH challenges, we found specific airway resistance to be the most sensitive parameter to detect AHR. Raw is largely independent of height and gender facilitating the interpretation of measurements carried out longitudinally.
format Online
Article
Text
id pubmed-3521367
institution National Center for Biotechnology Information
language English
publishDate 2009
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-35213672012-12-14 Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests Nensa, F Marek, W Marek, E Smith, HJ Kohlhäufl, M Eur J Med Res Research INTRODUCTION: Bronchial challenge tests by inhalation of aerosolized methacholine (MCH) are commonly used in the clinical diagnosis of airway hyperresponsiveness (AHR). While the detection of airway narrowing relies on the patient's cooperation performing forced spirometry, body plethysmographic measurements of airway resistance are less depending on the patient's cooperation and do not alter the respiratory tract by maximal maneuvers. Hence we compared both methods concerning their clinical value and correlation during MCH challenges in patients with asthma. MATERIALS AND METHODS: Cumulative MCH challenges test, consisting of up to 5 steps, evaluated with body plethysmography on each step were performed in 155 patients with bronchial asthma. Airway responses were recorded at each step of MCH application (Master-Screen Body, Cardinal Health, Höchberg). At the baseline test and after crossing the provocation dose (PD) threshold in body plethysmography (PD+100 sReff), forced expirations were performed and FEV(1), FVC, and FEV(1 )%FVC were measured. Using regression analysis of the airway parameters and taking the MCH dose as the covariate, we could extrapolate to missing spirometric values and interpolate the estimated MCH dose when crossing the PD threshold (PD-20 FEV(1)) between two consecutive measurements. The administered PD+100 MCH doses for specific airway resistance, sRtot, and sReff were compared with resistance parameters Rtot and Reff, and to PD-20 of FEV(1 )and FEV(1 )%FVC. RESULTS: Regarding sReff we found a mild, moderate, or severe AHR in 114 patients (75%), but only 50 (32%) according to FEV(1). A statistical analysis showed strongly linear correlated parameters of airway resistance, but no significant correlation between the results of body plethysmography and forced spirometry CONCLUSIONS: Using MCH challenges, we found specific airway resistance to be the most sensitive parameter to detect AHR. Raw is largely independent of height and gender facilitating the interpretation of measurements carried out longitudinally. BioMed Central 2009-12-07 /pmc/articles/PMC3521367/ /pubmed/20156751 http://dx.doi.org/10.1186/2047-783X-14-S4-170 Text en Copyright ©2009 I. Holzapfel Publishers
spellingShingle Research
Nensa, F
Marek, W
Marek, E
Smith, HJ
Kohlhäufl, M
Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests
title Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests
title_full Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests
title_fullStr Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests
title_full_unstemmed Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests
title_short Assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests
title_sort assessment of airway hyperreactivity: comparison of forced spirometry and body plethysmography for methacholine challenge tests
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521367/
https://www.ncbi.nlm.nih.gov/pubmed/20156751
http://dx.doi.org/10.1186/2047-783X-14-S4-170
work_keys_str_mv AT nensaf assessmentofairwayhyperreactivitycomparisonofforcedspirometryandbodyplethysmographyformethacholinechallengetests
AT marekw assessmentofairwayhyperreactivitycomparisonofforcedspirometryandbodyplethysmographyformethacholinechallengetests
AT mareke assessmentofairwayhyperreactivitycomparisonofforcedspirometryandbodyplethysmographyformethacholinechallengetests
AT smithhj assessmentofairwayhyperreactivitycomparisonofforcedspirometryandbodyplethysmographyformethacholinechallengetests
AT kohlhauflm assessmentofairwayhyperreactivitycomparisonofforcedspirometryandbodyplethysmographyformethacholinechallengetests