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Bronchodilator reversibility testing: laboratory practices in Australia and New Zealand
Author(s) -
Borg Brigitte M,
Reid David W,
Walters E Haydn,
Johns David P
Publication year - 2004
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2004.tb06121.x
Subject(s) - bronchodilator , medicine , spirometry , salbutamol , asthma , lung function , bronchodilator agents , metered dose inhaler , inhaler , pulmonary function testing , anesthesia , physical therapy , lung
Objectives: To determine the variation in the methods used to assess and interpret the reversibility of airflow limitation in lung‐function laboratories throughout Australia and New Zealand. Design: A postal survey performed in 2000, requesting details of methods used to assess and interpret bronchodilator reversibility. Setting and participants: 60 lung‐function laboratories identified from the Australian and New Zealand Society of Respiratory Science mailing list. Main outcome measures: Bronchodilator agent, dose, mode of administration, time to repeat spirometry and definition of a significant response. Results: 37 laboratories responded (response rate, 64%). Thirty‐three laboratories used salbutamol as their routine bronchodilator agent. Twenty‐four laboratories used a metered‐dose inhaler (MDI) with (21) or without (3) a spacer device as the preferred mode of bronchodilator administration. There was wide variation in the bronchodilator dose administered (median, 400 μg; range, 200–800 μg salbutamol for MDIs) and the time to repeat spirometry following bronchodilator administration (median, 10 min; range, 4–20 min). Ten laboratories used criteria consistent with either the National Asthma Council or Thoracic Society of Australia and New Zealand COPDX guidelines to define a significant bronchodilator response, and two used American Thoracic Society criteria. The remaining 25 respondents listed a variety of other criteria. Conclusion: The methods used to assess and interpret acute bronchodilator reversibility in lung‐function laboratories in Australia and New Zealand vary considerably. This may have a significant effect on the diagnosis and management of patients. Laboratories should report the method used to assess bronchodilator response.