Chapter-09 Bronchoprovocation Challenge Test

BOOK TITLE: Diagnostic Evaluation of the Respiratory System

1. Sorino Claudio
2. Bagnasco Diego
3. Braido Fulvio
Publishing Year
Author Affiliations
1. S. Anna Hospital, Como, Italy; University of Palermo, Palermo, Italy; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
2. Azienda Ospedaliera Universitaria, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Martino, Genova, Italy
3. University of Genoa; Azienda Ospedaliera Universiatria, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
Chapter keywords
Bronchoprovocation challenge test, bronchial hyperresponsiveness, spirometry, eucapnic voluntary hyperpnea, EVH, isocapnic voluntary hyperventilation, airway responsiveness, cold air challenge test


The objective of this chapter is to introduce the bronchoprovocation challenge test. A bronchoprovocation challenge test is a tool used to assess bronchial hyperresponsiveness. The test requires the administration of an agent able to irritate airways and cause their narrowing in susceptible subjects. The main indication for bronchoprovocation challenge test is the confirmation of a diagnosis of asthma in subjects with a clinical suspicion but without functional evidence of airway obstruction (normal spirometry). This chapter also covers the bronchial hyperresponsiveness, specific and nonspecific airway responsiveness, contraindications and precautions, pharmacologic challenge tests, exercise challenge test, cold air challenge test, eucapnic voluntary hyperpnea (EVH) and antigen challenge test. Bronchial (or airway) hyperresponsiveness is a condition in which the airways respond more than usual to irritative stimuli. Eucapnic voluntary hyperpnea (EVH), also known as isocapnic voluntary hyperventilation, is another type of challenge for assessing airway hyperresponsiveness.

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