Tuberc Respir Dis.  2001 Sep;51(3):232-239. 10.4046/trd.2001.51.3.232.

The Diagnostic Value of Isocapnic Hyperventilation of Cold Air in Adults with Suspected Asthma

Abstract

BACKGROUND
Asthmatic patients frequently suffer cold-weather-associated respiratory symptoms. The sensitivity, specificity, accuracy and diagnostic value of isocapnic hyperventilation of cold air(IHCA) using a multistep method was investigated in patients suspected to have asthma. METHOD: One hundred and 29 adult patients who had an IHCA performed between july 1999 and December 2000, had an methacholine bronchoprovocation test because of a clinical suspicion of asthma.
RESULTS
According to strict criteria, 50 were defined as asthmatics and 79 as symptomatic nonashmatics. There were no differences in age, sex and smoking state between the asthmatic and symptomatic nonasthmatic groups. There was a significant decrease in the percentage reduction in the forced expiratory volume in 1 second(FEV1) after the IHCA between the asthmatics(-10.0±6.8%) and the symptomatic nonasthmatics(-2.3±2.5%). The factors associated with a reactivity to IHCA were FEV1/FVC, FEF25-75/FVC and FEV1(% of predicted). The accuracy was highest using a 7% fall in FEV1; the sensitivity was 76% and the specificity 96%.
CONCLUSION
IHCA is a specific, although not a sensitive, test for diagnosing asthma in adult patients. Furthermore, the diagnostic cut-off value of the different methods of IHCA need to be determined.

Keyword

Bronchial asthma; Cold air challenge

MeSH Terms

Adult*
Asthma*
Forced Expiratory Volume
Humans
Hyperventilation*
Methacholine Chloride
Sensitivity and Specificity
Smoke
Smoking
Methacholine Chloride
Smoke
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