Department of Occupational and Environmental Medicine, Regions Hospital, St Paul, Minnesota

Authors: Hurst, Thomas S1; Cockcroft, Donald W2; Hannah, Victor D3; Davis, Beth E2

Source: Respiratory Care, Volume 51, Number 1, January 2006 , pp. 46-48(3)

Publisher: The Journal Respiratory Care Company

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Abstract:

BACKGROUND: Exposure to the bronchoconstricting agent methacholine is a potential hazard to technical staff during methacholine challenge testing, which remains a useful and frequently performed test. There are several methods of performing the test. One of the 2 methods listed in the American Thoracic Society's guidelines is the 2-min tidal-breathing method. The methacholine can be inhaled using one of several methods. The loosely-fitting-mask method is likely to produce more contamination of the local environment than a filtered exhalation system. METHODS: We tested 2 variations of the tidal-breathing method of measuring the methacholine provocational concentration (PC20, the dose that produces a 20% decrease in forced expiratory volume in the first second). One involved use of the open-mask technique and the other a T-piece-and-filter system that precluded the release of methacholine-containing droplets into the environment. We performed duplicate methacholine challenge tests with 10 subjects who had a wide range of PC20. The tests were done in random order, and each subject performed one test using the mask and one using the T-piece/filter system. RESULTS: With the mask system the geometric mean PC20 was 4.7 mg/mL, versus 5.1 mg/mL with the T-piece-filter system (p = 0.36). These values are very close and would not be substantially different clinically. CONCLUSION: The 2 methods are equivalent, and the low cost of the products used in the T-piece/filter method makes it suitable for reducing technician exposure to methacholine, using potentially completely disposable components.

Keywords: FILTER; METHACHOLINE CHALLENGE TEST; T-PIECE; TECHNICIAN EXPOSURE

Document Type: Research Article

Affiliations: 1: Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan, S7N 0W8, Canada;, Email: thurst@duke.usask.ca 2: Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada 3: Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, Pulmonary Function Laboratory, Royal University Hospital, Saskatoon, Saskatchewan

Publication date: January 1, 2006

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