Eduardo Praca1, Hasnaa Jalou1, Nadia Krupp1, Angela Delecaris1, Joseph Hatch1, James Slaven2, Susan J Gunst3, Robert S Tepper1. 1. Department of Pediatrics, Division of Pulmonology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA. 2. Department of Biostatistics, Indiana University Schools of Medicine and Public Health, Indianapolis, IN, USA. 3. Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN, USA.
Abstract
BACKGROUND AND OBJECTIVE: Asthma is characterized by airway hyperreactivity and airway inflammation. We previously demonstrated that adults with mild well-controlled asthma exhibited a marked decrease in airway reactivity (PC20 increased >2-fold) after using nocturnal continuous positive airway pressure (CPAP) for 1 week. If CPAP produces a similar suppression of airway reactivity in children with moderate-severe asthma, who require chronic use of corticosteroids, then this non-pharmacological therapy might provide a beneficial alternative or supplemental therapy in these subjects. METHODS: Children aged 8-17 years with moderate-severe asthma were treated with 4 weeks of nocturnal CPAP (8-10 cm H2 O) or sham CPAP (<2 cm H2 O). Adherence was monitored with a modem installed in the equipment or by memory cards. Airway reactivity, assessed by methacholine bronchial challenge, was measured prior to and following treatment. RESULTS: The percentage of subjects adherent to treatment was similar in both groups (19/27 CPAP vs 19/28 sham, ~70%). There was a tendency for PC20 to increase with treatment in both groups (3.0-5.3 mg/mL CPAP vs 3.2 to 4.3 mg/mL sham, P = 0.083); however, the change did not differ significantly between groups (P = 0.569). CONCLUSION: We found that the 4-week treatment with nocturnal CPAP did not produce a twofold suppression of airway reactivity in children with moderate-severe asthma.
BACKGROUND AND OBJECTIVE:Asthma is characterized by airway hyperreactivity and airway inflammation. We previously demonstrated that adults with mild well-controlled asthma exhibited a marked decrease in airway reactivity (PC20 increased >2-fold) after using nocturnal continuous positive airway pressure (CPAP) for 1 week. If CPAP produces a similar suppression of airway reactivity in children with moderate-severe asthma, who require chronic use of corticosteroids, then this non-pharmacological therapy might provide a beneficial alternative or supplemental therapy in these subjects. METHODS:Children aged 8-17 years with moderate-severe asthma were treated with 4 weeks of nocturnal CPAP (8-10 cm H2 O) or sham CPAP (<2 cm H2 O). Adherence was monitored with a modem installed in the equipment or by memory cards. Airway reactivity, assessed by methacholine bronchial challenge, was measured prior to and following treatment. RESULTS: The percentage of subjects adherent to treatment was similar in both groups (19/27 CPAP vs 19/28 sham, ~70%). There was a tendency for PC20 to increase with treatment in both groups (3.0-5.3 mg/mL CPAP vs 3.2 to 4.3 mg/mL sham, P = 0.083); however, the change did not differ significantly between groups (P = 0.569). CONCLUSION: We found that the 4-week treatment with nocturnal CPAP did not produce a twofold suppression of airway reactivity in children with moderate-severe asthma.
Authors: R O Crapo; R Casaburi; A L Coates; P L Enright; J L Hankinson; C G Irvin; N R MacIntyre; R T McKay; J S Wanger; S D Anderson; D W Cockcroft; J E Fish; P J Sterk Journal: Am J Respir Crit Care Med Date: 2000-01 Impact factor: 21.405
Authors: A Spanevello; M Confalonieri; F Sulotto; F Romano; G Balzano; G B Migliori; A Bianchi; G Michetti Journal: Am J Respir Crit Care Med Date: 2000-09 Impact factor: 21.405
Authors: E Pizzichini; M M Pizzichini; A Efthimiadis; S Evans; M M Morris; D Squillace; G J Gleich; J Dolovich; F E Hargreave Journal: Am J Respir Crit Care Med Date: 1996-08 Impact factor: 21.405