title: Exercise-induced bronchoconstriction diagnosis in asthmatic children: comparison of treadmill running and eucapnic voluntary hyperventilation challenges.
abstract: BACKGROUND
  Exercise-induced bronchoconstriction (EIB) occurs in up to 90% of young people with asthma and can be diagnosed using serial measurements of forced expiratory volume in 1 second (FEV1) after standardized exercise, usually treadmill running (TR). Eucapnic voluntary hyperventilation (EVH) is a guideline-recommended alternative challenge for EIB diagnosis. The 2 methods have not been compared for EIB diagnosis in this population.
  
  
  OBJECTIVE
  To compare 2 methods of EIB diagnosis in children and adolescents with asthma.
  
  
  METHODS
  Thirty-four children 8 to 18 years of age attending the allergy clinic of the Hospital das Clínicas (Recife, Brazil) from September through December 2013 were examined. All underwent a basal FEV1 determination followed by TR for 8 minutes or EVH for 6 minutes on consecutive days. The first challenge was chosen at random. Serial FEV1 determinations were obtained at 3, 5, 7, 10, 15, and 30 minutes after the challenge and the test result was considered positive if at least 2 consecutive FEV1 measurements decreased at least 10% below the basal value.
  
  
  RESULTS
  Thirteen patients responded to the 2 challenges, 6 only after TR and 4 exclusively after EVH (agreement 71%, κ = 0.41). The 95% limits of agreement of FEV1 decreasing after the challenges were widely spread (mean 0.1%, limits 19.8% to -19.6%).
  
  
  CONCLUSIONS
  The 2 tests cannot be used interchangeably and the reproducibility of the FEV1 response to the EVH challenge has to be properly evaluated to better understand its role in EIB diagnosis.
authors.affiliation: Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Marcelo José
authors.initials: MJ
authors.lastname: Chateaubriand do Nascimento Silva Filho
authors.affiliation: Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Adriana Velozo
authors.initials: AV
authors.lastname: Gonçalves
authors.affiliation: Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Tavares Viana
authors.affiliation: Departments of Pediatrics and Allergy, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Décio Medeiros
authors.initials: DM
authors.lastname: Peixoto
authors.affiliation: Departments of Pediatrics and Allergy, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Emanuel Sávio
authors.initials: ES
authors.lastname: Cavalcanti Sarinho
authors.affiliation: Departments of Pneumology and Allergy, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil. Electronic address: josearizzo@gmail.com.
authors.forename: José Ângelo
authors.initials: JÂ
authors.lastname: Rizzo
mesh_terms: D000293:Adolescent; D001250:Asthma, Exercise-Induced / Q000175:diagnosis*; D016084:Bronchoconstriction / Q000502:physiology*; D002648:Child; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D006985:Hyperventilation; D008297:Male; D012420:Running / Q000502:physiology*; D013147:Spirometry