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Eur Respir J. 2017 May 1;49(5). pii: 1601526. doi: 10.1183/13993003.01526-2016. Print 2017 May.

ERS technical standard on bronchial challenge testing: general considerations and performance of methacholine challenge tests.

Author information

1
Division of Respiratory Medicine, Dept of Pediatrics, Physiology and Experimental Medicine, Research Institute, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada allan.coates@sickkids.ca.
2
Pulmonary Function Testing and Clinical Trials Consultant, Rochester, MN, USA.
3
Division of Respirology, Critical Care and Sleep Medicine, Royal University Hospital, Saskatoon, SK, Canada.
4
Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA.
5
Dept of Clinical Pharmacy and Pharmacology and QPS-Netherlands, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
6
Dept of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
7
Division of Respirology, Dept of Medicine, McMaster University, Hamilton, ON, Canada.
8
Children's Lung Health, Telethon Kids Institute, School of Physiotherapy and Exercise Science, Curtin University and Centre for Child Health Research, University of Western Australia, Perth, Australia.
9
Dept of Pulmonology, Semmelweis University, Budapest, Hungary.
10
Dept of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.
11
Dept of Respiratory Medicine, University of Ghent, Ghent, Belgium.
12
Pulmonary and Critical Care, University of Vermont College of Medicine, Burlington, VT, USA.
13
Division of Pediatric Pulmonology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
14
University Clinic of Medicine, Kantonsspital Baselland, Liestal, Medical Faculty University of Basel, Basel, Switzerland.
15
AMC Hospital, University of Amsterdam, Amsterdam, The Netherlands.

Abstract

This international task force report updates general considerations for bronchial challenge testing and the performance of the methacholine challenge test. There are notable changes from prior recommendations in order to accommodate newer delivery devices. Rather than basing the test result upon a methacholine concentration (provocative concentration (PC20) causing a 20% fall in forced expiratory volume in 1 s (FEV1)), the new recommendations base the result upon the delivered dose of methacholine causing a 20% fall in FEV1 (provocative dose (PD20)). This end-point allows comparable results from different devices or protocols, thus any suitable nebuliser or dosimeter may be used, so long as the delivery characteristics are known. Inhalation may be by tidal breathing using a breath-actuated or continuous nebuliser for 1 min (or more), or by a dosimeter with a suitable breath count. Tests requiring maximal inhalations to total lung capacity are not recommended because the bronchoprotective effect of a deep breath reduces the sensitivity of the test.

PMID:
28461290
DOI:
10.1183/13993003.01526-2016
[Indexed for MEDLINE]
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