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Cold air challenge in children with asthma
J Reisman1, L Mappa, F de Benedictis
1Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatric Pulmonology
|July 1, 1987
Summary
The cold air bronchial provocation test effectively identifies asthma in children. This test shows high sensitivity (95%) and specificity (89%) in distinguishing asthmatic children from healthy controls.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Diagnostic Testing
Background:
- Asthma diagnosis in children can be challenging.
- Bronchial provocation tests are used to assess airway hyperresponsiveness.
- Cold air challenges offer a potential method for asthma evaluation.
Purpose of the Study:
- To evaluate the sensitivity and specificity of a cold air bronchial provocation test.
- To determine the optimal time point for assessing the response to cold air challenge.
- To establish the diagnostic accuracy of this test in pediatric asthma.
Main Methods:
- 18 children with asthma and 18 healthy children underwent a 4-minute cold air hyperventilation challenge (mean temperature -15°C).
- Forced expiratory volume in 1 second (FEV1) was measured at 4, 6, and 8 minutes post-challenge.
- A decrease in FEV1 greater than 10% was considered a positive test.
Main Results:
- Asthmatic children showed a significant average FEV1 decrease of 27%, while healthy children had no significant drop.
- The maximal decrease in FEV1 occurred by 4 minutes post-challenge in both groups.
- Using the 4-minute mark as a cutoff, the test achieved 95% sensitivity and 89% specificity.
Conclusions:
- The cold air bronchial provocation test is a sensitive and specific method for diagnosing asthma in children.
- The 4-minute post-challenge measurement is a reliable time point for distinguishing asthmatic from non-asthmatic children.
- This non-invasive test can aid in the accurate diagnosis of pediatric asthma.