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Exercise-induced asthma.

Abstract

EIB is a common manifestation in diagnosed asthmatics and is a sensitive warning sign of worsening asthma. EIB may occur as an isolated entity in the absence of signs and symptoms of chronic asthma. Careful diagnosis is crucial in determining if this condition represents a preasthmatic state or simply a transient condition resulting from individual sensitivity to hyperventilation. The pathophysiology of EIB is hypothesized to result from rapid airway rewarming after hyperventilation. Effective treatment modalities include behavioral techniques and pharmacologic agents. Appropriate treatment regimens consisting of pharmacologic or behavioral modalities should prevent serious sequelae and should enable the patient to participate at all levels of athletics. The nurse is an essential member of the team identifying, preventing, and treating exercise-induced bronchospasm or asthma.

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BibTeXRIS

Edward G Brooks, Mary Lou Hayden. 2003. Exercise-induced asthma.. https://doi.org/10.1016/s0029-6465(03)00097-5

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Screening of athletes for exercise-induced bronchoconstriction.

Exercise-induced bronchoconstriction (EIB) has a high prevalence in elite athletes, particularly endurance athletes, winter athletes and swimmers. Recent studies have shown that a clinical diagnosis of EIB has only a moderate sensitivity and specificity for EIB. This finding in conjunction with a recent ruling by the IOC-medical commission that all athletes competing in initially the 2003 Winter Olympic Games in Salt Lake City, and now the 2004 Summer Olympic Games in Athens require objective evidence of EIB, support the need for bronchial provocation challenge tests in the diagnosis of EIB. The recommended bronchial provocation challenge test is the eucapnic voluntary hyperpnea (EVH) challenge; this challenge test has been shown to have both a high sensitivity and specificity for EIB. Pharmacological challenge tests, such as the methacholine challenge test, have been shown to have only a low sensitivity but high specificity for EIB in elite athletes, and are thus not recommended in the athlete with pure EIB. Exercise challenge tests performed both in the laboratory and field have a high specificity for EIB; however those in the laboratory have only a moderate sensitivity for EIB in elite athletes, whilst those in the field are limited by problems with standardization. The osmotic challenge tests, such as the hypertonic saline and newer inhaled dry powder mannitol challenge have both a high sensitivity and specificity for EIB, and may be used as an alternative to the EVH challenge.

Asthma, Exercise-Induced↗