Bronchial provocation in childhood and adolescence. Consensus statement of the working group on lung function of the Society of Pediatric Pneumology

Abstract

Bronchial provocation tests play an important role in the diagnostics and therapy monitoring of children and adolescents with obstructive airway diseases. Corresponding recommendations were published by the working group on lung function of the Society of Pediatric Pneumology in this journal in 1999. The recommendations have been revised with respect to the further developments in methods and evidence in recent years. A literature search was carried out and an expert consensus statement was formulated. Revised recommendations and reference values are given for the indications, practical execution and assessment of the most important provocation tests (i.e. methacholine, exercise challenge, hypertonic saline, mannitol and allergen extracts). It is absolutely necessary that the patient history and the clinical symptoms are taken into consideration for the selection of procedures and interpretation of the results. Standardized bronchial provocation with the direct and indirect tests described here allow valid functional diagnostics even in childhood and adolescence and belong to the diagnostic repertoire of every pediatric pneumological practice and outpatient clinic.