Abstract
BackgroundPrevalence of exercise-induced bronchoconstriction (EIB) is high in elite athletes, especially after many years training in cold and dry air conditions. The primary treatment of EIB is inhaling a short-acting beta-2-agonist such as salbutamol. However, professional speed skaters also inhale nebulized isotonic saline or tap water before and after a race or intense training. The use of nebulized isotonic saline or tap water to prevent EIB has not been studied before, raising questions about safety and efficacy. The aim of this study is to analyze the acute effect of nebulized isotonic saline or salbutamol on EIB in elite speed skaters following a1,500-meter race.MethodsThis randomized controlled trial compares single dose treatment of 1 mg nebulized salbutamol in 4 mL of isotonic saline, or with 5 mL of isotonic saline. A minimum of 13 participants will be allocated in each treatment group. Participants should be between 18 and 35 years of age and able to skate 1,500 m in less than 2 min 10 s (women) or 2 min 05 s (men). Repeated measurements of spirometry, forced oscillation technique, and electromyography will be performed before and after an official 1,500-m race. Primary outcome of the study is the difference in fall in FEV1 after exercise in the different treatment groups. The trial is currently enrolling participants.DiscussionElite athletes run the risk of pulmonary inflammation and remodeling as a consequence of their frequent exercise, and thus increased ventilation in cold and dry environments. Although inhalation of nebulized isotonic saline is commonplace, no study has ever investigated the safety or efficacy of this treatment.Trial registrationThis trial protocol was registered with the Dutch trial registration for clinical trials under number NTR3550
Highlights
Prevalence of exercise-induced bronchoconstriction (EIB) is high in elite athletes, especially after many years training in cold and dry air conditions
The recommended dosage of nebulized salbutamol is 5 mg, which would require a therapeutic use exemption for participating athletes from the world anti-doping agency (WADA). Such a dosage is safe in highly trained athletes [8], we routinely recommend using 1 mg of salbutamol, which we believe leads to substantial reductions in EIB in this population
The aim of the study is to analyze the effect of nebulized isotonic saline or salbutamol on EIB in elite speed skaters following a 1,500-m race using spirometry, forced oscillation technique (FOT), and EMG
Summary
Prevalence of exercise-induced bronchoconstriction (EIB) is high in elite athletes, especially after many years training in cold and dry air conditions. Professional speed skaters inhale nebulized isotonic saline or tap water before and after a race or intense training. The aim of this study is to analyze the acute effect of nebulized isotonic saline or salbutamol on EIB in elite speed skaters following a1,500-meter race. In an effort to reduce EIB and thoracic pain, international professional speed skaters nowadays inhale nebulized isotonic saline or tap water before and after a race or intense training session. The recommended dosage of nebulized salbutamol is 5 mg, which would require a therapeutic use exemption for participating athletes from the world anti-doping agency (WADA) (www.wada-ama.org) Such a dosage is safe in highly trained athletes [8], we routinely recommend using 1 mg of salbutamol, which we believe leads to substantial reductions in EIB in this population. The use of nebulized isotonic saline treat EIB has not been studied before, raising questions about safety and efficacy
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