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Vol. 72, No. 1, 2005
Issue release date: January–February
Section title: Clinical Investigations
Respiration 2005;72:52–60
(DOI:10.1159/000083401)

Questionnaire Responses That Predict Airway Response to Hypertonic Saline

Leuppi J.D.a,c · Anderson S.D.b · Brannan J.D.b · Belousova E.a · Reddel H.K.a · Rodwell L.T.b
aWoolcock Institute of Medical Research, University of Sydney, Sydney, and bDepartment of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, Australia; cPneumology and Basel Institute for Clinical Epidemiology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland

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Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Received: 11/20/2003
Accepted: 5/26/2004
Published online: 2/28/2005
Issue release date: January–February

Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 3

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: http://www.karger.com/RES

Abstract

Background: Airway hyperresponsiveness to hypertonic saline (HS) is associated with airway inflammation. We investigated if responsiveness to HS was predicted by asthma symptoms in the last 3 months. Objectives: To investigate if responsiveness to HS can be estimated by questionnaire items investigating asthma symptoms of the last 3 months. Methods: Six hundred and four patients with physician-diagnosed asthma being assessed for asthma severity were studied. Bronchial provocation with 4.5% saline was performed, and a questionnaire was administered. The response to 4.5% saline was reported as the provoking dose to cause a 15% fall in the forced expiratory volume in 1 s FEV1 (PD15) and the response-dose ratio (RDR). Results: Based on the GINA guidelines, asthma severity was intermittent in 497 patients, mild in 107 patients, moderate in 3 patients and severe in 1 patient. A PD15 to 4.5% saline was recorded in 234 of the 604. Questions on self-recognition of asthma, dust as a trigger, food as a trigger, and frequency of bronchodilator use were significant predictors for a PD15, and currently taking steroids decreased the likelihood of a positive response to 4.5% saline. Using a multiple-linear regression model, a difference in the RDR could be calculated between those who answered positively compared with the reference group, who answered negatively. This difference could be used as a guide for predicting abnormal reactivity. An increase in RDR in response to 4.5% saline, compared with the reference group, was demonstrated in the presence of self-recognition of asthma severity, dust and cats as a trigger or use of bronchodilator during sleep hours. Conclusions: Because of the high positive predictive value of HS for identifying patients with asthma it might be that the need for bronchodilator use at night not only predicts airway hyperresponsiveness to HS, it also could reflect the severity of asthma.

© 2005 S. Karger AG, Basel


  

Author Contacts

Dr. Sandra D. Anderson
Department of Respiratory Medicine, E 11 S Main Building
Royal Prince Alfred Hospital, Missenden Road
Camperdown, NSW 2050 (Australia)
Tel. +61 2 9515 6120, Fax +61 2 9515 8196, E-Mail sandya@mail.med.usyd.edu.au

  

Article Information

Received: November 20, 2003
Accepted after revision: May 26, 2004
Number of Print Pages : 9
Number of Figures : 0, Number of Tables : 3, Number of References : 31

  

Publication Details

Respiration (International Journal of Thoracic Medicine)

Vol. 72, No. 1, Year 2005 (Cover Date: January-February 2005)

Journal Editor: C.T. Bolliger, Cape Town
ISSN: 0025–7931 (print), 1423–0356 (Online)

For additional information: http://www.karger.com/res


Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Received: 11/20/2003
Accepted: 5/26/2004
Published online: 2/28/2005
Issue release date: January–February

Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 3

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: http://www.karger.com/RES


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