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Treadmill superior in diagnosis of exercise-induced bronchoconstriction in asthmatic children

Eucapnic voluntary hyperventilation could not be used interchangeably with treadmill running to diagnose exercise-induced bronchoconstriction in children with asthma, according to study results.

The reproducibility of forced expiratory volume in 1 second response to the eucapnic voluntary hyperventilation challenge must be better evaluated to understand its role in the diagnosis of exercise-induced bronchoconstriction, according to the researchers.

José Â. Rizzo

“Although simple, safe and with a good positive predictive value, eucapnic voluntary hyperventilation (EVH) cannot be used interchangeably with exercise as a diagnostic bronchial provocation for exercise-induced bronchospasm,” study researcher José Â. Rizzo, MD, PhD, director of education, research and extension at the Clinical Hospital of Federal University of Pernambuco in Brazil, told Healio.com/Allergy.

Rizzo and colleagues conducted a cross-sectional study to assess the differences between EVH and treadmill running in diagnosing exercise-induced bronchoconstriction (EIB) in children with asthma. The cohort included 34 children aged 8 to 18 years who attended the allergy clinic at Federal University of Pernambuco from September to December 2013.

After patients were evaluated for forced expiratory volume in 1 second (FEV₁) at baseline, they ran on a treadmill or underwent EVH with an interval of 24 hours between challenges.

Researchers measured FEV₁ at 3, 5, 7, 10, 15 and 30 minutes after each challenge. Response was considered positive only if researchers observed an FEV₁ decrease of at least 10% compared with baseline during at least two consecutive measurements.

Nineteen patients responded positively after treadmill running, and 17 had a positive response after EVH. FEV₁ appeared to decrease in six patients after treadmill running and in four after EVH (P < .05).

Rizzo told Healio.com/Allergy more research is needed to validate using EVH to diagnosis EIB.

“Some aspects need to be better studied such as repeatability and the minimum ventilation rate in order for EVH to be considered valid,” he said. “Until such aspects are better elucidated, EVH should be used with caution and interpreted in the appropriate clinical context.” – by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.