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Sensitivity of Aerosol Bolus Behavior to Methacholine-Induced Bronchoconstriction FREE TO VIEW

Kyle G. Hardy; Larry P. Gann; Kevin B. Tennal; Robert Walls; F. Charles Hiller; Paula J. Anderson
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Affiliations: From the Division of Pulmonary and Critical Care Medicine, John L. McClellan Veterans Administration Medical Center and the University of Arkansas for Medical Sciences, University of Arkansas at Little Rock,  From the Department of Applied Science, University of Arkansas at Little Rock

Paula J. Anderson, MD, Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, 4301 W Markham, Slot 555, Little Rock, AR 72205

1998 by the American College of Chest Physicians

Chest. 1998;114(2):404-410. doi:10.1378/chest.114.2.404
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Study objectives: Airway narrowing causes alterations in the shape of an exhaled aerosol bolus that can serve as indexes of airway changes during bronchoprovocation. We compared the sensitivities of aerosol bolus behavior and specific airway conductance (SGaw) during bronchoprovocation in normal subjects.

Design and participants: Fifteen normal, nonsmoking subjects were studied. Doubling methacholine (MCh) concentrations were delivered during tidal breathing. After each dose, SGaw was determined followed by inhalation of narrow pulses of 1-µm particles introduced into 1-L breaths. Inhaled and exhaled particle concentrations were measured with light scattering photometry. Using plots of concentration vs volume, the exhaled bolus was compared with the inhaled bolus for measurements of volumetric change in mode location (modal shift), particle deposition, and dispersion. To determine baseline intrasubject variability, sham studies using buffer solution were performed on five subjects.

Results: MCh caused a proximal modal shift, and increased dispersion and deposition of the exhaled bolus. At most doses, a greater percentage of subjects showed significant change (p<0.05) from baseline for modal shift and deposition than for SGaw. Aerosol bolus behavior displayed less intrasubject variability than did SGaw during sham studies.

Conclusion: Aerosol bolus behavior is at least as sensitive as SGaw in detecting MCh-induced airway constriction in normal subjects and exhibits less intrasubject variability.




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