@article {Bhatiarespcare.06283, author = {Rajeev Bhatia and Emma Schwendeman}, title = {Efficient Use of Simple Exercise-Induced Bronchoconstriction Challenge Testing in Pediatric Exercise-Induced Dyspnea}, elocation-id = {respcare.06283}, year = {2018}, doi = {10.4187/respcare.06283}, publisher = {Respiratory Care}, abstract = {BACKGROUND: A simple exercise test to evaluate for exercise-induced bronchoconstriction (EIB) is routinely ordered in pediatric patients with exercise-induced dyspnea. However, the utility of this test in establishing the cause of exercise-induced dyspnea is not thoroughly examined in the pediatric population. We sought to assess the efficiency of a simple EIB challenge test in finding the cause of exercise-induced dyspnea in pediatric patients referred to our tertiary center in the last 5 y.METHODS: We performed a retrospective chart review for all of these exercise tests done at Akron Children{\textquoteright}s Hospital from March 2011 to March 2016. Patients with chronic conditions (eg, cystic fibrosis, cardiac abnormality) were excluded. Demographics, clinical diagnosis of asthma, a presumptive diagnosis of exercise-induced asthma or EIB by the referring provider, symptoms with and without exercise, albuterol use, spirometry, and simple EIB challenge test results were collected. The chi-square test of independence was utilized in the examination of potential dependent relationships between categorical variables. A P value \<.05 was considered to be statistically significant.RESULTS: Out of 164 enrolled subjects (57 males; age 6{\textendash}20 y), only 19\% showed evidence of EIB. There were no significant associations between EIB status (ie, EIB-positive or EIB-negative) based on exercise testing and gender, typical symptoms of EIB, diagnosis of exercise-induced asthma or EIB, and albuterol use (P \> .05). However, a subject without asthma was 2.8 times more likely to have negative exercise test for EIB (odds ratio 2.8, 95\% CI 1.3{\textendash}6.5); in addition, approximately 85\% of tests in subjects without asthma were negative.CONCLUSION: In a majority of subjects without asthma, a simple EIB challenge testing failed to uncover the cause of exercise-induced dyspnea and thus was inefficient. In these subjects, cardiopulmonary exercise testing may be more useful and cost-effective to explore other causes of dyspnea including EIB.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/early/2018/09/25/respcare.06283}, eprint = {https://rc.rcjournal.com/content/early/2018/09/25/respcare.06283.full.pdf}, journal = {Respiratory Care} }