Wind, M. (Mariët) (2014) Het effect van lichaamshouding tijdens inhalatie van een éénmalige dosis corticosteroïd op inspanningsastma. thesis, Medicine.
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Abstract
Exercise induced bronchoconstriction (EIB) is a highly specific and frequent symptom of asthma in children. An exercise challenge test (ECT) can detect EIB. Maintenance therapy with inhaled corticosteroids (ICS) offers long term protection against EIB. A single high dose (1000-1600μgr) of ICS was also effective in the protection against EIB in previous studies. Pulmonary deposition of a single dose ICS of an autohaler in children of 5 till 14 years old is 37-54%. One can hypothesize that stretching the airway by a forward leaning body posture can improve the deposition of medication in the lungs. We evaluated the effect of body posture during inhalation of 200 microgram beclomethason-dipropionate four hours prior to an ECT in a cross-over intervention study. Twenty-eight patients with EIB, which was confirmed by an ECT in cold and dry air, without ICS maintenance therapy inhaled a single dose of ICS in standard position and once in forward leaning position. EIB was expressed as maximal % fall in FEV1 or FEV0.5 from baseline. There was no significant difference between the fall of FEV1 or FEV0.5 between the two different body positions (P = 0,593). The fall of FEV1 or FEV0.5 was significantly reduced after inhalation of ICS in both body postures compared to the fall of FEV1 or FEV0.5 without inhalation of medication (both P < 0.001). Possibly, our dose of ICS was on the plateau of the dose-response curve; in making it impossible to show a difference between the two different body positions. In conclusion, there was no significant difference of the severity of EIB between inhalation of medication in the standard body posture versus the forward leaning body posture.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Thio, Dr. B.J. |
| Supervisor name: | Visser, Drs. R. and Medisch Spectrum Twente te Enschede |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:49 |
| Last Modified: | 25 Jun 2020 10:49 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1053 |
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