Real and Pseudo Late Asthmatic Reactions after Submaximai Exercise Challenge in Patients with Bronchial Asthma: Discussion (1)

In: Asthma

29 Jan 2013

A rather high coefficient of variation for repeated PEFR measurements within one control day within one asthmatic patient was found in the first 30 minutes. This may be attributable to the rather high intrainstrumental variability of the mini Wright peakflow meter, which sometimes differs about 15 percent from a standardized flow value, especially in the low flow ranges. As there was no statistically significant difference between the coefficients of variation of the PEFR on both control days, the coefficient of variation of the PEFR on control day in patient group of study 1 was comparable to that in the patient group of study 2.
By taking a limit of a fall in PEFR ^20 percent to define a LAR, we were sure that this fall could not be explained on the basis of spontaneous variability in PEFR, since a 15.3 percent variability is the upper limit of the 95 percent confidence interval. From the McNemar test it can be concluded that a real LAR after exercise did occur in the group of 81 asthmatic patients who performed an EC. This can also be concluded from the repeated measurements analysis of variance in the asthmatic patients who cycled and had completely recorded PEFR values. Also, the results were grossly the same when the PEFR value on the same time on the control day was taken instead of the baseline PEFR on the exercise day; this is an indication that there was a real LAR after EC on the exercise day without an accompanying LAR on the control day. ventolin inhalers
A real LAR occurred in eight patients, 10 percent of the asthmatic population studied. The prevalence may have even been greater since not all patients could be taken off steroid therapy long enough.


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