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Refractoriness after hyperventilation-induced asthma.

F Rakotosihanaka, F Melaman, P d'Athis

    Bulletin Europeen De Physiopathologie Respiratoire
    |November 1, 1986
    PubMed
    Summary
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    Asthmatic subjects may experience a refractory period after hyperventilation-induced bronchospasm. Repeated challenges showed a reduced response in some asthmatics, suggesting a protective effect against exercise-induced asthma.

    Area of Science:

    • Respiratory Medicine
    • Pulmonary Physiology
    • Clinical Immunology

    Background:

    • The phenomenon of bronchospasm following hyperpnoea in asthma patients is well-documented.
    • However, a debated aspect is whether a subsequent challenge elicits a refractory period.

    Purpose of the Study:

    • To investigate the effect of repeated eucapnic hyperpnoea challenges on asthmatic subjects.
    • To compare the responses of asthmatic subjects to normal subjects following repeated challenges.
    • To determine if a refractory period exists after hyperpnoea-induced bronchospasm in asthma.

    Main Methods:

    • Ten healthy and 34 asthmatic subjects underwent two isocapnic hyperventilation challenges (25 L/min/m² BSA for 6 min) with dry air at room temperature.
    • Intervals between challenges were 30 min for normal subjects and 30-60 min for asthmatics to ensure FEV1 recovery.

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  • A subset of 13 asthmatics received stepwise ventilation challenges until symptoms or a limit was reached.

    • Main Results:

    • Normal subjects showed no significant change in FEV1 after either challenge.
    • Asthmatic subjects exhibited a significantly less pronounced fall in FEV1 after the second challenge compared to the first (p < 0.05).
    • Individual analysis revealed partial to full refractoriness in 14 out of 34 asthmatic subjects.

    Conclusions:

    • Repeated eucapnic hyperpnoea challenges can lead to a reduced bronchospastic response in a subset of asthmatic individuals.
    • This suggests the potential for a refractory period following hyperpnoea-induced bronchospasm in asthma.
    • Findings indicate a possible protective mechanism against exercise-induced asthma in some patients.