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The role of hyperventilation in exercise-induced bronchoconstriction

R J Zeballos, R Shturman-Ellstein, J F McNally

    The American Review of Respiratory Disease
    |November 1, 1978
    PubMed
    Summary

    Voluntary isocapnic hyperventilation causes bronchoconstriction in asthmatic children, similar to exercise. Nasal breathing reduces this response, while mouth breathing worsens it, suggesting upper airway receptor stimulation is key.

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    Area of Science:

    • Pediatric Pulmonology
    • Respiratory Physiology
    • Exercise-Induced Bronchoconstriction

    Background:

    • Exercise-induced bronchoconstriction (EIB) is common in asthmatic children.
    • The mechanisms triggering EIB, particularly the role of hyperventilation and breathing patterns, require further elucidation.

    Purpose of the Study:

    • To compare the bronchoconstrictive effects of voluntary isocapnic hyperventilation with treadmill exercise in asthmatic children.
    • To investigate the influence of nasal versus mouth breathing on hyperventilation- and exercise-induced bronchoconstriction.
    • To determine if hyperventilation itself, or upper airway stimulation, is the primary driver of EIB.

    Main Methods:

    • Asthmatic and normal children underwent voluntary isocapnic hyperventilation (3- and 10-min durations) and moderate treadmill exercise.

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  • Bronchoconstriction was measured during both nasal and mouth breathing conditions.
  • Airway responses were compared between hyperventilation and exercise protocols.

    • Main Results:

    • Significant bronchoconstriction was induced by hyperventilation in asthmatic children, comparable to exercise.
    • Nasal breathing attenuated, while mouth breathing potentiated, bronchoconstriction during both hyperventilation and exercise.
    • No significant airway response was observed in normal children following hyperventilation or exercise.
    • 10-minute hyperventilation was not a greater stimulus than 10-minute exercise or 3-minute hyperventilation.

    Conclusions:

    • Voluntary isocapnic hyperventilation is a potent bronchoconstrictive stimulus in asthmatic children.
    • Breathing pattern (nasal vs. mouth) significantly modulates airway responses to hyperventilation and exercise.
    • Upper airway receptor stimulation by cold, dry air appears to be the primary cause of exercise-induced bronchoconstriction, not hyperventilation itself.