Chest
Clinical InvestigationsComparison of Bronchial Responses to Ultrasonically Nebulized Distilled Water, Exercise, and Methacholine in Asthma
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MATERIALS AND METHODS
The group of asthmatic subjects studied comprised 19 male and six female subjects (age range, 9 to 19 years). The criteria for selection were a characteristic clinical history of asthma,20 an initial forced expiratory volume in one second (FEV1) of more than 70 percent of the predicted normal,21 and a range of bronchial responsiveness to inhaled methacholine from slightly to severely increased.3 No attempt was made to select subjects on the basis of a history of exercise-induced asthma. All
RESULTS
There was no significant difference in baseline FEV1 (as percent predicted) on the three days of study by analysis of variance (mean FEV1 before methacholine, 93.8±10.6 (±5D); mean FEV1 before exercise, 91.6 ±9.2; mean FEV1 before distilled water, 90.8 ± 9.7; p>0.5), and in each subject, baseline FEV1 varied by less than 10 percent (Table 1).
Seventeen out of 25 subjects showed a fall in FEV1 greater than 20 percent after exercise (Table 1). In eight subjects the stimulus-response curve with
DISCUSSION
The results of the present study show that both inhaled ultrasonically nebulized distilled water and exercise are effective bronchoconstrictor stimuli in subjects with more severe asthma. In fact, the level of nonspecific bronchial responsiveness, as measured by methacholine challenge, was significantly lower in the subjects who had a response to distilled water and exercise; these subjects also had a longer asthmatic history. In our patients the response to distilled water did not correlate
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Manuscript received March 10; revision accepted May 8.