Bronchodilator reversibility testing: laboratory practices in Australia and New Zealand.
OBJECTIVE
To determine the variation in the methods used to assess and interpret the reversibility of airflow limitation in lung-function laboratories throughout Australia and New Zealand.


METHODS
A postal survey performed in 2000, requesting details of methods used to assess and interpret bronchodilator reversibility.


METHODS
60 lung-function laboratories identified from the Australian and New Zealand Society of Respiratory Science mailing list.


METHODS
Bronchodilator agent, dose, mode of administration, time to repeat spirometry and definition of a significant response.


RESULTS
37 laboratories responded (response rate, 64%). Thirty-three laboratories used salbutamol as their routine bronchodilator agent. Twenty-four laboratories used a metered-dose inhaler (MDI) with (21) or without (3) a spacer device as the preferred mode of bronchodilator administration. There was wide variation in the bronchodilator dose administered (median, 400 micro g; range, 200-800 micro g salbutamol for MDIs) and the time to repeat spirometry following bronchodilator administration (median, 10 min; range, 4-20 min). Ten laboratories used criteria consistent with either the National Asthma Council or Thoracic Society of Australia and New Zealand COPDX guidelines to define a significant bronchodilator response, and two used American Thoracic Society criteria. The remaining 25 respondents listed a variety of other criteria.


CONCLUSIONS
The methods used to assess and interpret acute bronchodilator reversibility in lung-function laboratories in Australia and New Zealand vary considerably. This may have a significant effect on the diagnosis and management of patients. Laboratories should report the method used to assess bronchodilator response.
Borg
Brigitte M
BM
Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital and Monash University Medical School, Melbourne, VIC.
Reid
David W
DW
Walters
E Haydn
EH
Johns
David P
DP
D001249:Asthma / Q000175:diagnosis; D001315:Australia; D001993:Bronchodilator Agents; D003937:Diagnosis, Differential; D006801:Humans; D007753:Laboratories / Q000592:standards*; D009520:New Zealand; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis; D012015:Reference Standards; D013147:Spirometry / Q000379:methods / Q000592:standards*
D001993:Bronchodilator Agents