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Mannitol dry powder challenge in comparison with exercise testing in children
Pediatric Pulmonology, 04/15/2011
Barben J et al. - Mannitol dry powder (MDP) challenge test is feasible in children and is a suitable alternative for bronchial challenge testing in childhood.
Methods- Children aged 6–16 years, referred to two respiratory outpatient clinics for possible asthma diagnosis, underwent standardized exercise testing followed within a week by an MDP challenge.
- Agreement between the two challenge tests using Cohen's kappa and receiving operating characteristic (ROC) curves was compared.
- 111 children performed both challenge tests.
- 12 children were excluded due to exhaustion or insufficient cooperation (11 at the exercise test, 1 at the MDP challenge), leaving 99 children for analysis.
- MDP tests were well accepted, with minor side effects and a shorter duration than exercise tests.
- The MDP challenge was positive in 29 children (29%), the exercise test in 21 (21%). Both tests were concordant in 83 children (84%), with moderate agreement.
- Positive and negative predictive values of the MDP challenge for exercise-induced bronchoconstriction were 68% and 89%.
- The overall ability of MDP challenge to separate children with or without positive exercise tests was good.
