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1、AARCGUIDELINE:METHACHOLINECHALLENGETESTING:2001REVISION&UPDATEAARCClinicalPracticeGuidelineMethacholineChallengeTesting:2001Revision&UpdateMCT1.0PROCEDURE:4.5theneedtoassessresponsetotherapeuticMethacholinechallengetest.Thisguidelinedoesinterventions;2notaddressotherbronchialc
2、hallenges(eg,his-tamine,exercise,occupationalexposures,specificMCT5.0CONTRAINDICATIONS:antigens,isocapnichyperventilation.)5.1Absolutecontraindicationsare:5.1.1ventilatoryimpairment:FEV1<50%MCT2.0DESCRIPTION/DEFINITION:ofpredictedor<1.0L;2[Thismaybea2.1Themethacholinechallenge
3、testisonerelativecontraindicationdependingonthemethodofassessingairwayresponsiveness.Inageorsizeofthepatientoronthepres-thistest,thepatientinhalesanaerosolofoneorenceofarestrictivelungdisorder(re-moreconcentrationsofmethacholine.Resultsducedforcedvitalcapacity,orFVC,withofpulm
4、onaryfunctiontests(eg,spirometry,arelativelynormalFEV1/FVC)];specificconductance)performedbeforeand5.1.2heartattackorstrokewithinthepre-aftertheinhalationsareusedtoquantitatere-vious3months;1,2sponse.Thisguidelineappliestoadultsand5.1.3knownaorticorcerebralaneurysm;1,2children
5、capableofadequatelyperforming5.1.4uncontrolledhypertension[Thespirometryorbodyplethysmographyandofco-AmericanThoracicSociety(ATS)sug-operatingduringthecourseofthechallenge.gestssystolicpressure>200and/ordias-2.2Apositivetestisdefinedasadecreasefromtolicpressure>110mmHg.].2theb
6、aselineforcedexpiratoryvolumeinthe5.2Relativecontraindicationsare:firstsecond(FEV1)orofthepostdiluentFEV15.2.1ventilatoryimpairment:FEV1>valueof20%,orofadecreaseinspecificcon-50%or>1.5Lbut<60%ofpredicted;2ductanceof35-45%fromthebaselineorpost-5.2.2inabilitytoperformspirometryo
7、fdiluentvalue.1-4acceptablequality;25.2.3significantresponsetothediluent,ifMCT3.0SETTINGS:administered(ie,>10%fallinFEV1fromPossiblesettingsinclude:baseline);103.1pulmonaryfunctionlaboratory;5.2.4upper-orlower-respiratory-tractin-3.2clinicorphysician’soffice;fectionwithinprevi
8、ous2to6weeks;1,11,123.3fieldsite(eg,occupationalsettingorwork
