Absolute contraindications are severe obstruction (FEV 1

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Bronchial hyperresponsiveness or sensitization fundamental pathophysiological feature of asthma. It develops due to inflammation of bronchial asthma wall and is highly expressed in both allergic and in non-allergic form of the disease. We can prove the non-specific bronchial provocation tests which are of great help in the diagnosis of asthma.
Definition of bronchial hyperreactivity Indications for bronhoprovokaciju Direct nonspecific bronchial provocation tests Indirect non-specific bronchial provocation tests Contraindications for conducting tests Factors influencing the interpretation of the test Conclusion
Bronchial hyperresponsiveness is a characteristic of the airways that react to the increased cctv camera minimum amount of non-specific stimuli, which in healthy subjects can cause constriction cctv camera of the airways. Clinical tests for testing bronchial hiperrekativnosti based on the notion that the difference in the behavior cctv camera of airway people with bronchial hyper-reactivity to healthy subjects only quantitative in nature. The degree of airway reactivity is generally coincides with the level of inflammation (called. Surrogate marker of inflammation) and clinical levels of disease severity.
There are several important indications for implementing bronhoprovokacijskih tests. It is primarily a diagnosis of asthma. Therefore, tests are used in patients with symptoms suggestive cctv camera of asthma and normal lung function, then patients with atypical symptoms and bronchospasm in patients with chronic cough. They are also used in suspected occupational asthma, and can be applied as a "screening" of some professions (primarily in the military cctv camera and diver). The indications for bronhoprovokaciju include the assessment of response to prescribed therapy, and it serves us and to identify the specific trigger for the occurrence of asthma (occupational and environmental exposure, food additives).
Direct non-specific bronchial provocation tests operate by direct stimulation of receptors of smooth muscles. For this purpose the methacholine and histamine that cause bronchoconstriction in equivalent concentrations. Methacholine is used more often because it has fewer side effects, and is a synthetic derivative of acetylcholine. It comes in the form of a dry crystalline powder whose solutions are stable at lower temperatures (4 C) to three months.
The test result is shown as a provocation concentration causing a decrease in FEV 1 (forced expiratory volume in the first second of expiration) to 20% - 20 PC FEV1 or provocation cctv camera dose which causes a fall in FEV 1 of 20% - PD 20 FEV first Obtained automatically from the logarithmic curve in the diagram dose-response linear interpolation between the last two points. The table below provides the steps bronchial reactivity, ie. hyperreactivity depending cctv camera on the result of tests performed. cctv camera Degree of bronchial reactivity PC20FEV1 PD20FEV1 Result> 16.0 mg / mL> 960 normal bronchial reactivity from 4.0 to 16 mg / ml 240-960 Limit bronchial reactivity 1.0-4.0 mg / mL 60-240 cctv camera Bronchial cctv camera hyperresponsiveness mild degree < 1.0 mg / mL and <60 Bronchial hyperreactivity medium to large degree cctv camera
Indirect non-specific bronchial provocation tests provoke the release of inflammatory mediators. For this purpose can be used adenosine monophosphate, mannitol, physical exertion or eukapnička hyperventilation. Physical activity we so used to diagnose bronchoconstriction induced by excessive physical activity, when spirometry at rest in order. cctv camera Is performed on a treadmill or bike for about 10 minutes.
Spirometry was performed before the loading as well as 5, 10, 15, 20 and 30 minutes after the load (bronchoconstriction usually occurs 10 to 15 minutes after the end of the test). The test is considered positive when FEV 1 fell by 10-15%.
Absolute contraindications are severe obstruction (FEV 1 <50% of expected or <1.0 L), myocardial infarction or stroke in the past month, aortic or cerebral cctv camera aneurysm and uncontrolled hypertension (systolic blood pressure greater than 200 mmHg, diastolic blood pressure higher 100 mm Hg).
Relative contraindications are moderate obstruction (FEV1> 50% but <60% of the expected or <1.5 L), inability to adequately spirometry, a significant response cctv camera to saline (> 10% decrease in FEV 1), infection of the upper or lower respiratory system in the last 2 to 6 weeks, the treatment cholinesterase inhibitors (for myasthenia gravis), pregnancy and lactation.
The results bronchoprovocative testing may affect the following factors: acute airway inflammation (colds, flu), which require a break of 4-6 weeks vaccine live attenuated vaccine (measles, mumps, rubella, polio, pertussis, influenza), which is need a break of 3-6 weeks inhalation respiratory cctv camera irritants in high