Bronchial hyperreactivity in response to inhalation of ultrasonically nebulised solutions of distilled water and saline.

Abstract

To assess non-specific bronchial reactivity the effect of inhaling ultrasonically nebulised solutions of distilled water and hypotonic (0 3%), isotonic (0 9%), and hypertonic (27%, 3 6%) saline was investigated in 10 asthmatic patients and nine normal subjects. Expired ventilation and the maximum percentage fall in forced expiratory volume in one second (FEV,) were recorded. The sensitivity to the inhaled solutions was determined by measuring the ventilation required to induce a fall in FEV, of 20% from the prechallenge value. Hypotonic and hypertonic but not isotonic solutions caused a significant fall in FEV, in the asthmatic subjects. Normal subjects showed no response to either distilled water or 3 6% saline, the only solutions with which they were challenged.The method used for this challenge is rapid, simple, and inexpensive and provides a new means of diagnosing non-immunologically mediated bronchial hyperreactivity.

Bronchodilator premedication does not decrease respiratory adverse events in pediatric general anesthesia

“…23,24 Phase I results showed nebulized saline significantly increased emergence coughing compared to the non-intervention group (Table II). Since coughing could affect other endpoints, the nebulized saline was abandoned; the nonintervention group became the only comparison group.…”

Protective effect of bronchial challenge with hypertonic saline on nocturnal asthma

“…On the study day, the asthmatics were submitted to HS challenge at 16:00 and at 18:00 h. No medications were given after each challenge, and the spontaneous recovery of FEV 1 was measured. During the same night, at 4:00 h, the FEV 1 was assessed by spirometry to calculate the nocturnal reduction of FEV 1 . On the control day, FEV 1 was measured at 16:00 h and inhalation of isotonic saline was performed after this spirometry (sham challenge).…”

“…During the same night, FEV 1 was assessed at 4:00 h to calculate the nocturnal reduction of FEV 1 . The control day was used to determine the basal overnight reduction in FEV 1 . No medications were taken between 16:00 and 4:00 h. After each test, subjects were asked to record their respiratory symptoms.…”

“…1 The recovery time (spontaneous recovery of FEV 1 ) was obtained by measuring FEV 1 every 5 min after the challenge during the first hour and then at 15-min intervals until FEV 1 spontaneously returned to 90% of the basal value.…”

“…Inhalation of hypertonic saline (HS) causes bronchoconstriction in asthmatic subjects (1). Neurogenic reflexes, mediators of inflammatory cells and epithelial cells in the airway mucosa are thought to be involved in this event (2).…”