Abstract:
OBJECTIVE:The bronchial challenge test is commonly used to diagnose asthma but it is a tedious, time-consuming procedure. Although in recent years, several shortened methods have been proposed, it has been shown that they can give rise to exaggerated bronchoconstriction. The aims of the present study were a) to determine the frequency of exaggerated bronchoconstriction in patients with asthma following the application of a shortened bronchial challenge test, and b) to determine if the fraction of exhaled nitric oxide (FENO) can be used to predict the onset of exaggerated bronchoconstriction. PATIENTS AND METHODS:We performed a prospective study of 210 patients with asthma in whom FENO levels were measured in accordance with the abbreviated protocol recommended by the European Respiratory Society (ERS). Exaggerated bronchoconstriction was defined as a decrease of more than 20% in forced expiratory volume in 1 second after the first challenge, after a skipped dose, or after administration of saline. A receiver operating characteristic (ROC) curve was generated to determine the best FENO cutoff value for predicting exaggerated bronchoconstriction. The pretest probability of developing exaggerated bronchoconstriction was also calculated using Bayes' theorem. RESULTS:The frequency of exaggerated bronchoconstriction in our series was 30%. Patients who developed exaggerated bronchoconstriction had significantly higher FENO levels than those who did not (32.6 vs 16.2 parts per billion [ppb]). The chosen FENO cutoff of 19.5 ppb had a sensitivity of 80%, a specificity of 77%, and a negative predictive value of 88%. The area under the ROC curve was 0.83 (95% confidence interval, 0.77-0.89). CONCLUSIONS:The abbreviated bronchial challenge test recommended by the ERS led to exaggerated bronchoconstriction in 30% of the patients studied. FENO measurements could possibly be used to identify patients at increased risk of exaggerated bronchoconstriction. The shortened challenge test can be performed safely in individuals with a FENO of <19.5 ppb.
journal_name
Arch Bronconeumoljournal_title
Archivos de bronconeumologiaauthors
Lloris Bayo A,Perpiñá Tordera M,Martínez Pérez E,Macián Gisbert Vsubject
Has Abstractpub_date
2008-08-01 00:00:00pages
402-7issue
8eissn
0300-2896issn
1579-2129pii
S0300-2896(08)72102-1journal_volume
44pub_type
杂志文章abstract::The evaluation of the disabilities of patients with respiratory disease is regulated by the Spanish Ministry of Labor and Social Security, as are disabilities of any other type. We believe, however, that in respiratory pathologies this evaluation is especially complicated because, as they are chronic processes, they i...
journal_title:Archivos de bronconeumologia
pub_type: 杂志文章,评审
doi:10.1016/j.arbres.2011.12.005
更新日期:2012-08-01 00:00:00
abstract::Despite the administration of appropriate treatment, a high number of patients with asthma remain uncontrolled. This suggests the need for alternative treatments that are effective, safe and selective for the established asthma phenotypes, especially in patients with uncontrolled severe asthma. The most promising opti...
journal_title:Archivos de bronconeumologia
pub_type: 杂志文章,评审
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journal_title:Archivos de bronconeumologia
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journal_title:Archivos de bronconeumologia
pub_type: 杂志文章,评审
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journal_title:Archivos de bronconeumologia
pub_type: 杂志文章
doi:10.1016/s0300-2896(15)30911-x
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journal_title:Archivos de bronconeumologia
pub_type: 杂志文章,评审
doi:
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journal_title:Archivos de bronconeumologia
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pub_type: 杂志文章
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doi:10.1016/s1579-2129(06)60400-x
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pub_type: 杂志文章,评审
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更新日期:2010-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2015-11-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:1994-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2004-11-01 00:00:00
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doi:10.1016/j.arbres.2009.09.016
更新日期:2010-08-01 00:00:00
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journal_title:Archivos de bronconeumologia
pub_type: 杂志文章
doi:
更新日期:2006-10-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.1016/s1579-2129(06)60190-0
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:To analyze whether nasal continuous positive airway pressure (CPAP) reduces oxidative stress in patients with sleep apnea-hypopnea syndrome (SAHS). PATIENTS AND METHODS:Thirty-six patients with SAHS requiring nasal CPAP treatment and 10 controls in whom SAHS was ruled out were enrolled. Oxidative stress was ...
journal_title:Archivos de bronconeumologia
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更新日期:2006-03-01 00:00:00
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journal_title:Archivos de bronconeumologia
pub_type: 杂志文章,评审
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更新日期:2000-02-01 00:00:00
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journal_title:Archivos de bronconeumologia
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doi:
更新日期:1995-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.arbres.2012.11.009
更新日期:2013-04-01 00:00:00