Increased bronchial responsiveness to histamine associated with shortened inhalation time

A study was undertaken to assess the variability of results of histamine inhalation tests with the tidal breathing method, keeping the total dose of histamine delivered to the mouth constant but using either different nebulizers or the same Wright nebulizer operated under changing conditions. Seventeen asthmatic children had double histamine bronchial provocation tests with a Bennett-Twin nebulizer (output 0.31 ml/min, nebulization time 1 min) and a Wright nebulizer (output 0.15 ml/min, nebulization time 2 min), with a driving flow rate, in both instances, of 7 L/min. Another group of 15 asthmatic children had double provocation tests with a Wright nebulizer driven by a flow rate of either 7 L/min (output 0.15 ml/min, nebulization time 2 min) or 12 L/min (output 0.30 ml/min, nebulization time 1 min). In each experiment the volume of histamine solution delivered was about 0.30 ml. PC20-FEV1 was significantly lower, indicating an increased bronchial response, when both methods using "faster" delivery of histamine were used. We conclude that comparison of results obtained with histamine inhalation tests by the tidal breathing method cannot be made unless the nebulizer and operating criteria are the same.