Comparison of histamine and methacholine for use in bronchial challenge tests in community studies.

Higgins, Bernard; Britton, John; Chinn, Susan; Jones, Trevor; Vathenen, A.S.; Burney, Peter; Tattersfield, AE

doi:10.1136/thx.43.8.605

Cited by 51 publications

(26 citation statements)

References 15 publications

(1 reference statement)

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“…Bu iki ajan genellikle birbirlerine yakın dozlarda bronkokonstrüksiyon oluştururlar. Ancak histaminle baş ağrısı, flushing ve ses kısıklığı gibi yan etkilerin daha çok olması ve histaminin tekrarlanabilirliğinin daha düşük olması nedeniyle günümüzde metakolin daha çok önerilmekte ve kullanılmaktadır (12,17).…”

Section: Bronş Provokasyon Testleriunclassified

Spirometry and Flow-Volume Curve

Demir¹

2017

Bulletin of Thoracic Surgery

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Spirometry is the essential part of a pulmonary function study and provides the most information. The two most important dynamic lung volumes measured are the forced vital capacity (FVC), and the forced expiratory volume in the 1st second (FEV 1 ). The third important parameter FEV 1 /FVC ratio is used to differantiate obstructive from restrictive lung disorder. The flow-volume curve is more informative and easier to interpret, as different disease produce distinct curve shapes. In this review spirometry and flow-volume curve will be discussed. SPİROMETRESpirometreler soluk alma ya da verme sırasında oluşan akım ya da volüm değişikliklerini zamanın türevi olarak ölçebilen aletlerdir. Solunum fonksiyonlarını değerlen-dirmede kullanılan en temel test yöntemidir. Spirometre solunum fonksiyon testleri içinde aslında sadece küçük bir bölümü oluştururken, pratik kullanım açısından en yaygın kullanılanıdır. Spirometre ilk kez 1846 yılında John Hutchinson adlı bir hekim tarafından kullanılmıştır (1). O günden bu yana da spirometreler özellikle teknolojideki gelişmelere koşut olarak gelişmiş ve yaygınlaşmıştır. Eskiden büyük hacim kaplayan sulu spirometreler kullanı-lırken günümüzde ceket cebine sığabilecek boyutlarda spirometreler mevcuttur.Spirometre; obstrüktif ve restriktif akciğer hastalıkları-nın tanısında, hastalığın şiddetini ve tedaviye yanıtını saptamada, meslek hastalıklarının tanı, tarama ve maluliyet değerlendirmesiyle preoperatif değerlendirmelerde rutin olarak kullanılır. Spirometrik değerlendirme klasik olarak zaman-volüm eğrisi ve akım-volüm halkası olarak iki farklı şekilde yapılır. Bilgisayar teknolojisindeki gelişmelerden önce klasik spirometreler ile akım-volüm halkası çizdirilmesi mümkün değildi. Akım-volüm halkası için geniş yer kaplayan ekstra aletlere gereksinim duyulurdu. Oysa yeni spirometrelerde eş zamanlı olarak hem zaman-volüm eğrisi hem de akım-volüm halkası çizdirilebilmektedir. Bu da hekimin sonuçları daha sağlıklı değerlendirmesini sağlamaktadır. Spirometre Endikasyonları

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Section: Bronş Provokasyon Testleriunclassified

Spirometry and Flow-Volume Curve

Demir¹

2017

Bulletin of Thoracic Surgery

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“…For that purpose the European Respiratory Society (ERS) (7) and the American Thoracic Society (ATS) (1 ) guidelines for BHR testing have made a serious attempt to integrate the variety of tools for measuring BHR. As well, methacholine and histamine challenges have been compared, but mainly among asthmatics (13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Bronchial hyperresponsiveness in a population of north Finland with no previous diagnosis of asthma or chronic bronchitis assessed with histamine and methacholine tests

Juusela

Poussa

Kotaniemi

et al. 2008

International Journal of Circumpolar Health

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Objectives. To assess the prevalence of bronchial hyperresponsiveness (BHR) in a population of north Finland among subjects with no previous diagnosis of asthma or chronic bronchitis by using histamine and methacholine challenges. The agreement between the methods was also evaluated. Study design. An epidemiological study assessing the prevalence of BHR measured with direct dosimetric challenge methods. Methods. Seventy-nine randomly selected subjects ( 1-73 years) were studied; 67% had respiratory or allergic symptoms. The baseline spirometry was normal or showed mild obstruction. Bronchial challenges to methacholine and histamine were performed on each subject in a randomized order. Provocative doses inducing the decrease of FEV 1 by 15% and 0% (PD 15 FEV 1 and PD 0 FEV 1 ) and dose response ratios (DDR) were calculated for both tests. Results. BHR with the methacholine test (PD 0 FEV 1 ≤2.6 mg) was found in 20% and with the histamine test (PD 15 FEV 1 ≤1.6 mg) in 28% of subjects; the agreement was 80% (kappa 0.45; 95% CI 0. 3-0.68). In staging the severity of BHR the methods had a good agreement (weighted kappa 0.64; CI 95% 0.46-0.82). Prevalence of BHR fulfilling the criteria of the both methods was 14%. Conclusions. The findings suggest that the prevalence of BHR in the population of north Finland with no previous diagnosis of asthma or chronic bronchitis is at least 14%, probably around 0%, assessed by histamine and methacholine challenge methods. The methods have a good agreement to be used for classifying the severity of BHR. (Int J Circumpolar Health 2008; 67(4):308-317)

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“…Furthermore, any comparison of results obtained from a pair of challenges needed in a prospective design, is prone to errors since between-test variability is in the order of magnitude of one doubling concentration [11]. In contrast, a retrospective analysis is a better approach for the question at hand since each subject serves as their own control within the same challenge.…”

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confidence: 99%

Methacholine inhalation challenge: a shorter, cheaper and safe approach

Izbicki

Bar‐Yishay²

2001

Eur Respir J

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Methacholine inhalation challenge: a shorter, cheaper and safe approach. G. Izbicki, E. Bar-Yishay. #ERS Journals Ltd 2001. ABSTRACT: Increased nonspeci®c 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 (bl) of forced expiratory volume in one second/ forced vital capacity (FEV1/FVC) ¢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 with minimal change in outcome. Only 15/449 patients (3.3%) would have experienced a severe response. Five subjects (of 169, 3.0%) with FEV1/FVCbl 0.7±0.8 reacted to inhalation up to 0.073 mmol. Four subjects (of 280, 1.4%) with FEV1/ FVCbl¢0.8 reacted to inhalation up to 0.219 mmol.The authors suggest that: 1) an initial dose of 0.219 mmol (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 ¢0.8 and 0.073 mmol (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.

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Comparison of histamine and methacholine for use in bronchial challenge tests in community studies.

Cited by 51 publications

References 15 publications

Spirometry and Flow-Volume Curve

Spirometry and Flow-Volume Curve

Bronchial hyperresponsiveness in a population of north Finland with no previous diagnosis of asthma or chronic bronchitis assessed with histamine and methacholine tests

Methacholine inhalation challenge: a shorter, cheaper and safe approach

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