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Dyspnea Perception During Induced Bronchoconstriction Is Complicated by the Inhaled Methacholine in Children With Clinical Asthma

Authors
 Yun Jung Choi  ;  Dong In Suh  ;  Myung Hyun Sohn  ;  Young Yull Koh 
Citation
 Allergy Asthma & Immunology Research, Vol.10(2) : 131-136, 2018 
Journal Title
 Allergy Asthma & Immunology Research 
ISSN
 2092-7355 
Issue Date
2018
Keywords
Asthma ; bronchial provocation test ; child ; dyspnea ; methacholine
Abstract
PURPOSE: Dyspnea is not widely utilized as an indicator of asthma provocation despite its universal presentation. We hypothesized that dyspnea severity was proportionate with the lung function decline, methacholine dose-step, and the degree of bronchial hyperresponsiveness (BHR). METHODS: We retrospectively analyzed 73 children's bronchial provocation test data with an assessment of dyspnea at every dose-step. Dyspnea severity was scored using a modified Borg (mBorg) scale. A linear mixed effect analysis was performed to evaluate the relationship between the mBorg scale, the percentage fall in the forced expiratory volume in 1 second (FEV1) (DeltaFEV1%), the methacholine dose-step, and the degree of BHR (BHR grade). RESULTS: Subjects were divided into 5 BHR groups based on their last methacholine dose-steps. The mBorg scores did not differ significantly among BHR groups (P=0.596, Kruskal-Wallis test). The linear mixed effect analysis showed that DeltaFEV1% was affected by the methacholine dose-step (P<0.001) and BHR grade (P<0.001). The mBorg score was affected by the dose-step (P<0.001) and BHR grade (P=0.019). We developed a model to predict the mBorg score and found that it was affected by the methacholine dose-step and DeltaFEV1%, elevating it by a score of 0.039 (chi(2) [1]=21.06, P<0.001) and 0.327 (chi(2) [1]=47.45, P<0.001), respectively. A significant interaction was observed between the methacholine dose-step and DeltaFEV1% (chi(2) [1]=16.20, P<0.001). CONCLUSIONS: In asthmatic children, inhaled methacholine, as well as the degree of BHR and lung function decline, may affect dyspnea perception during the bronchial provocation test. If we wish to draw meaningful information from dyspnea perception, we have to consider various complicating factors underlying it.
Files in This Item:
T201800520.pdf Download
DOI
10.4168/aair.2018.10.2.131
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162036
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