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First published online on October 20, 2007
Chest, doi:10.1378/chest.07-1328
A more recent version of this article appeared on January 1, 2008
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Feasibility of Repetitive Lung Function Measurements by Raised Volume Rapid Thoracoabdominal Compression (RVRTC) during Methacholine Challenge in Young Infants.

Lotte Loland, MD, PhD and Hans Bisgaard, MD, DMSci.

Danish Pediatric Asthma Center, Department Pediatrics, Copenhagen University Hospital, Gentofte, Niels Andersens Vej 65, DK-2900 Hellerup,Denmark. www.copsac.com

Bisgaard{at}copsac.dk

Abstract

Background: The aim of the study was to evaluate feasibility of lung function measurements by the raised volume rapid thoracoabdominal compression (RVRTC) technique during bronchial methacholine challenge in young infants.

Method: Four hundred and two healthy infants were tested at 1 month of age with RVRTC during repeated methacholine challenges with quadrupling doses, from 0.037 µmol to 16.674 µmol.

Results: Measurement of baseline lung function was successful in 99% and the provocative dose (PD) was achieved in 79% of infants by forced expiratory volume in 0.5 seconds (FEV0.5). Additionally, PD was successfully measured in 87% by trans-cutaneous oxygen (Ptc,O2). No serious adverse events were observed during testing or after discharge from the clinic. The methacholine dose range was appropriate as PD could be determined in the majority of infants. 21% dropped > 40% in FEV0.5 during the test. Short lasting, self-limiting episodes of hypoxemia below 80% occurred in 1% and bradycardia below 90 bpm in 19% of infants respectively. The most common observations by parents were changes in the sleeping (95%), eating (57%) and behavior (58%) pattern of the infant after discharge. The mean acceptability rating among parents was 8 on a scale from 1-10 with 13% rating 5 or less.

It took one operator 3 hours to complete the test, the actual lung function accounting for half the time.

Conclusion: This very comprehensive experience with standardized measurements of lung function by RVRTC during methacholine challenge in young infants in a single centre leads us to conclude that the test is feasible and safe in asymptomatic young infants.

Key Words: feasibility studies • safety • method acceptability • respiratory function tests • infant • bronchial provocation tests






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