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Therapeutic methods repeatability of response to hypertonic saline aerosol in children with mild to severe asthma
Author(s) -
Riedler Josef,
Reade Tom,
Robertson Colin F.
Publication year - 1994
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950180511
Subject(s) - medicine , repeatability , hypertonic saline , asthma , nebulizer , methacholine , inhalation , provocation test , tonicity , anesthesia , reproducibility , isotonic saline , saline , respiratory disease , pathology , chemistry , statistics , alternative medicine , mathematics , chromatography , lung
Non‐isotonic aerosols are being used more commonly to perform bronchial provocation tests. In contrast to histamine and methacholine challenge tests they appear to have higher specificity and a higher predictive value. The aim of the present study was to assess the reproducibility of the response to challenge with 4.5% hypertonic saline administered via an ultrasonic nebulizer in children with mild to severe asthma. Seventeen children with asthma aged 10 to 14 years completed two or three challenge tests at the same time of day within a 10 day period. Of these 17 children 9 had mild, 4 moderate, and 4 severe asthma. Children inhaled 4.5% hypertonic NaCl from an ultrasonic nebulizer with an output of 1.9 to 2.5 mL/min (Timeter) using the protocol developed by Anderson with modifications. A fall in forced expiratory volume in 1 second (FEV 1 ) from baseline of 15% or more was considered a positive response and PD 15 , was calculated. In 16/17 subjects a greater than 15% fall in FEV 1 occurred consistently on all study days. One subject with moderate asthma had a less than 15% fall in FEV 1 on both study days. The coefficient of repeatability for PD 15 was 1.8. This equals 0.85 of a doubling dose difference between the two or three measurements of PD 15 . The cumulative time of aerosol inhalation causing a fall in FEV 1 2 15%) (PT 15 ) showed a coefficient of repeatability of 1.59, similar to 0.67 doubling dose difference. The PD 15 and PT 15 were highly significantly correlated. The 4.5% NaCl challenge test yields good reproducibility in children with mild to severe asthma under laboratory conditions. Pediatr Pulmonol. 1994;18:330–336 © Wiley‐Liss, Inc.