Chest
Histamine Challenge Test in Children Using Forced Oscillation to Measure Total Respiratory Resistance
Section snippets
MATERIALS AND METHODS
The subjects for this study consisted of 31 Caucasian children between seven and 17 years of age who were referred for a histamine challenge test. Twelve were boys and 19 girls. No one was receiving medication at the time of the study. All had baseline values for total respiratory resistance (Rrs), measured by forced oscillation, that were within normal limits, 16 as were their baseline spirometry values. 17 Two-thirds had been referred because of symptoms suggestive of exercise-induced asthma,
RESULTS
There were 17 patients with a positive response to histamine as indicated by a PC20 of 8 mg/ml or less. These constituted group A, and the 14 subjects with negative test results made up group B. Allergic rhinitis was present in five members of group A and one of group B. Anthropometric data and mean baseline values for R6, R26, Rm, X26 and (R6 – R26)/R26 for both groups are given in Table 1. There was no significant difference in any of these parameters between the two groups. Range of baseline
DISCUSSION
Using the definition of a positive histamine challenge test as a PC20, not greater than 8 mg/ml, the method of forced oscillation to measure Rrs using a threshold of an increase in R6 of 50 percent or greater or an increase in (R6 – R26)/R26 of 0.45 or greater will include all positive tests; in other words, sensitivity of 100 percent. Those two patients whose PC20 was greater than 8 mg/ml but who were positive by the criteria of forced oscillation had changes in FEV1 of 16 and 18 percent. If,
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2011, Respiratory Physiology and NeurobiologyCitation Excerpt :A broad range of data acquisition durations has been reported in the literature. Durations as short as 8 s appear to be practical for preschool children (Hall et al., 2007), but have also been used in older children (Harrison et al., 2010; Lebecque et al., 1987) and adults (Tossa et al., 2009) because of the constraints of some commercial FOT devices. However, current FOT guidelines recommend that “several breathing cycles”, free from respiratory artefact should be obtained in data acquisition periods (Beydon et al., 2007; Oostveen et al., 2003), which may be difficult to achieve with shorter durations, especially in older subjects who generally have slower respiratory rates.
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Supported by the Canadian Cystic Fibrosis Foundation and the McGill University Montreal Children’s Hospital Research Institute, Montreal, Canada.
This is publication no. 87003 of the McGill University Montreal Children’s Hospital Research Institute.
Manuscript received October 1; revision accepted January 27.