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Two puffs of 90 g albuterol prior to 3% saline sputum induction results in less FEV-1 decline than single concentration 25 mg/ml methacholine challenge

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Abstract:

Background: Assessment of sputum eosinophilia has shown benefit in the diagnosis and monitoring of asthma. However, the possibility of bronchospasm related to the hypertonic saline used in sputum induction appears to have limited this procedure's acceptance in clinical practice.

Objective: Because the methacholine (MCH) challenge has been widely accepted as safe in the diagnosis of mild asthma, we sought to compare the safety of SI with 3% hypertonic saline following pretreatment with 2 puffs of 90 g albuterol to that of a single concentration 25 mg/mL MCH challenge.

Methods: We performed a retrospective review of 152 consecutive subjects, 57 with mild asthma and the remaining with other respiratory problems who had undergone both a SI and a MCH challenge at our single site tertiary care referral center.

Results: Median reduction of FEV-1 in subjects with and without asthma (n = 152) was 9.95% in the MCH group compared to 35% in the SI group (p value < 0.0001). FEV-1 was reduced in excess of 20% in 33 of 152 (21.7%) MCH challenge tests compared to 1 of 152 (0.66%) SI. Median reduction of FEV-1 in asthmatic subjects (n = 57) was 17.86% in the MCH group compared to 32% in the SI group (p value < 0.0001).

Conclusions: With regard to potential bronchoconstriction, we conclude that 2 puffs of 90 g albuterol administered prior to 3% saline sputum induction results in less FEV-1 decline than single concentration 25 mg/mL MCH.

Document Type: Research Article

DOI: https://doi.org/10.2500/aap.2006.27.2900

Publication date: 2006-09-01

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  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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