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REPRODUCIBILITY OF EUCAPNIC VOLUNTARY HYPERVENTILATION FOR EXERCISE-INDUCED BRONCHOSPASM DIAGNOSIS IN ASTHMATIC CHILDREN AND ADOLESCENTS.
  • +6
  • José Rizzo,
  • Edil Rodrigues Filho,
  • Adriana Gonçalves,
  • Laienne Albuquerque,
  • Eduardo Albuquerque,
  • Cláudio Albuquerque,
  • Anderson Almeida,
  • Decio Medeiros,
  • Marco Correia Júnior
José Rizzo
Federal University of Pernambuco

Corresponding Author:jarizzo@hotlink.com.br

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Edil Rodrigues Filho
Federal University of Pernambuco
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Adriana Gonçalves
Federal University of Pernambuco
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Laienne Albuquerque
Federal University of Pernambuco
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Eduardo Albuquerque
Federal University of Pernambuco
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Cláudio Albuquerque
Federal University of Pernambuco
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Anderson Almeida
Federal University of Pernambuco
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Decio Medeiros
Federal University of Pernambuco
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Marco Correia Júnior
Federal University of Pernambuco
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Abstract

BACKGROUND: Exercise-induced respiratory symptoms are frequently reported by asthmatics and exercise-induced bronchospasm (EIB) is a frequent cause that requires objective testing for diagnosis. Eucapnic voluntary hyperventilation (EVH) is recommended as an exercise surrogate stimulus for this purpose, but its short-term reproducibility is not yet established in young asthmatics. OBJECTIVE: To evaluate the short-term test-retest agreement and reproducibility of FEV1 changes after EVH in young asthmatics. METHODS: Asthmatics aged between 10 and 20 years underwent EVH for EIB diagnosis on two occasions 2-4 days apart at a specialized university clinic. FEV1 was measured 5, 15 and 30 minutes after EVH with a target ventilation rate 21 times baseline FEV1. EIB was diagnosed as a decrease >10% in FEV1 from baseline. RESULTS: Twenty-six of 62 recruited individuals tested positive for EIB on both visits (positive group) and 17 on one visit only (divergent group); and 19 tested negative on both visits (negative group). The overall agreement was 72.5% (95%CI 61.6%, 83.6%) and positive and negative agreement was 41.9% and 30.6% respectively. Despite overall low bias in FEV1 response between test days (0.87%), the limits of agreement were wide (+20.72%). There were no differences in pre-challenge FEV1 or achieved ventilation rate, between visits either between groups (p=0.097 and p=0.461) or within groups, (p=0.828 and p=0.780). No test was interrupted by symptoms and there were no safety issues. CONCLUSIONS: More than one EVH test should be performed in young asthmatics with a negative test to exclude EIB and minimize misdiagnosis and mistreatment.
14 Feb 2021Submitted to Pediatric Allergy and Immunology
22 Feb 2021Reviewer(s) Assigned
15 Mar 2021Review(s) Completed, Editorial Evaluation Pending
25 Mar 2021Editorial Decision: Revise Major
28 May 20211st Revision Received
28 May 2021Review(s) Completed, Editorial Evaluation Pending
28 May 2021Reviewer(s) Assigned
11 Jun 2021Editorial Decision: Revise Minor
22 Jun 20212nd Revision Received
22 Jun 2021Review(s) Completed, Editorial Evaluation Pending
24 Jun 2021Editorial Decision: Accept