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Clinical Investigations: AirwaysEucapnic Voluntary Hyperventilation as a Bronchoprovocation Technique: Development of a Standardized Dosing Schedule in Asthmatics
Section snippets
MATERIALS AND METHODS
The study was performed in the Pulmonary Clinic of Walter Reed Army Medical Center. Informed consent was obtained from all participants. The study protocol was approved by the hospital's institutional review board for human studies. Sixteen volunteers who met the definition of asthma as proposed by the American Thoracic Society17 in 1962 were recruited. Subjects must have had symptoms (or required treatment) for at least 6 months in an attempt to exclude people with transient reactive airways
RESULTS
The mean age (±SD) of our patients was 33±10 years and there were 12 men and 4 women. Their mean total eosinophil count was 347±607/mm3 (laboratory normal range, 40 to 350/mm3) and mean IgE, 106± 123 IU/mL (laboratory normal range, 3.7 to 269 IU/mL). Fifteen of the 16 subjects had a history of exercise-induced bronchospasm. Ten subjects were regularly using varying doses of both inhaled corticosteroids and β-agonist. One subject was receiving inhaled cromolyn, one subject was taking inhaled
DISCUSSION
When interpreting a bronchoprovocation challenge, one must compare the intensity of the stimulus applied to the intensity of the bronchoconstriction which results. In this study, we have shown that altering the method of EVH challenge technique affects the degree of bronchoconstriction that results, even when the absolute magnitude of the challenge is unchanged. We have also shown that the airway response to identical EVH challenge is reproducible within a 6-week period.
The mechanism of the
ACKNOWLEDGMENT
The authors thank Robin Howard for her assistance with statistical analysis.
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This work was supported by WRAMC protocol 1755.
The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Army, Uniformed Services University of the Health Sciences or the Department of Defense.