Abstract
The Global Initiative for Asthma (GINA) guidelines do not specify a bronchodilator range for bronchodilator response (BDR) testing and simply recommend a salbutamol dose of 200 to 400 μg. We determined the oscillometric BDR results of children given low-dose (2 puffs, 200 μg) and standard-dose (4 puffs, 400 μg) salbutamol to compare the small airway responses of healthy controls (defined using criteria based on the guidelines developed at the American Thoracic Society) and exclusion subjects (defined as any child that did not meet the inclusion criteria for healthy controls). The oscillometric reactance of small airways is significantly associated with the dose of salbutamol used for BDR testing in exclusion children. We suggest use of the standard-dose of salbutamol for oscillometric BDR testing.
Highlights
The dose of a short-acting beta 2-agonist, such as salbutamol, is associated with the bronchodilator response (BDR) [1]
Our results show that the oscillometric BDR data of healthy controls were similar for children given standard and low doses of salbutamol
Our results show that the measured reactance of small airways in exclusion children depended on the dose of salbutamol used for BDR testing
Summary
The dose of a short-acting beta 2-agonist, such as salbutamol, is associated with the bronchodilator response (BDR) [1]. The Global Initiative for Asthma (GINA) guidelines do not specify a bronchodilator range for BDR testing, and recommend a salbutamol dose of 200 to 400 μg [3]. Most previous studies comparing healthy volunteers with asthmatic subjects [4,5,6,7,8] and epidemiologic studies of children [9, 10] used 2 puffs (200 μg) of salbutamol for oscillometric BDR testing. These previous studies used different criteria to define healthy children [9,10,11,12,13,14]. A dose of 200 to 400 μg salbutamol for conventional BDR testing has been acceptable in clinical practice; on the other hand, oscillometric BDR test results in previous epidemiologic studies [10,11,12,13,14] and patient-control studies [4,5,6,7,8], which used a range of 200 to 300 μg dose salbutamol, are questionable, because
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