Bronchoconstrictor effects of a deep inspiration in patients with asthma

A deep inspiration from functional residual capacity to total lung capacity, performed at a low flow rate by a group of 40 unselected adult patients with asthma, yielded an immediate and transient increase (71 per cent, P smaller than 0.001) in specific airway resistance. In 2 of the 40, deep inspiration provoked an attack of asthma. The effect of deep inspiration can be attributed to a vagal bronchoconstrictor reflex, because it was prevented or decreased in most of the cases by inhalation of an anticholinergic drug. Beta-adrenergic blockade by propranolol potentiated in a minority of subjects the bronchoconstrictor response to deep inspiration. Deep expiration also induced a bronchoconstrictor effect, which was weaker than that of deep inspiration. It follows that functional studies of asthmatics may be biased if the technique requires maximal respiratory maneuvers.