Is an abbreviated bronchial challenge with histamine valid?
Schmidt LE; Thorne PS; Watt JL; Schwartz DA
Chest 1992 Jan; 101(1):141-145
The clinical utility of using an abbreviated histamine challenge protocol for assessing nonspecific airway reactivity was examined. The study group consisted of 12 male and 12 female nonsmoking asthmatic volunteers, 20 to 52 years old. Twenty were never smokers. The remaining four subjects had quit smoking within the last 6 months. Sixteen were receiving longterm bronchodilator medication. The subjects underwent the standard histamine challenge test which involved five inhalations of nine graded histamine doses ranging from 0.3 to 10.0mg/ml. They then underwent an abbreviated and modified abbreviated protocol in which 0.16, 2.12, and 10.6mg/ml histamine was inhaled. Measurements of 1 second forced expiratory volume (FEV1) were made every 30 seconds in the abbreviated protocol and every 3 minutes (min) in the modified abbreviated protocol. The abbreviated and modified abbreviated protocols required significantly less time to administer than the standard protocol, 17.5 and 30.4 versus 43.8min, respectively. The provocative dose, defined as the histamine dose required to cause a 20% decrease in FEV1, and the slope of the dose response curves of the standard protocol and the abbreviated and modified abbreviated protocols were statistically identical. The authors conclude that an abbreviated airway challenge with histamine can produce similar estimates of airway reactivity when compared with the standard method. This means that an abbreviated protocol based on histamine can be used to investigate nonspecific airway reactivity.
NIOSH-Grant; Pulmonary-system-disorders; Pulmonary-function-tests; Clinical-diagnosis; Bronchial-asthma; Respiratory-hypersensitivity; Humans
Internal Medicine University of Iowa Pulmonary Disease Division Iowa City, IA 52242
Pulmonary System Disorders
University of Iowa, Iowa City, Iowa