Treadmill Exercise or Methacholine:

Challenge testing in the Pediatric Pulmonary Function Lab is designed for the patient who needs more in-depth testing than the normal PFT to evaluate the absence or presence of hyperactivity of the airways.

BEST RESULTS:   patients should be 7 years of age or older.       These tests require repeated efforts and must be reproducible.

These patients can exhibit any or all of the following symptoms:

• Shortness of breath during or following exercise

•  Chronic Cough

• Chest pain

•  Negative response to bronchodilator, but continued symptoms

• Stridor or wheeze on inhalation or exhalation

The Pediatric Staff Pulmonologist orders the Challenge test after reviewing patient data.     

Call 734-936-9515 to initiate a pulmonary consult.

Testing can take up to 3 hours, the patient comes to the Pediatric Pulmonary Lab where all the procedures are performed under the supervision of a physician.

In both the exercise and methacholine challenges, the patient CAN CONTINUE ALL MEDICATIONS EXCEPT FOR ALBUTEROL which should be stopped 24 hours prior to testing.

Methacholine Challenge - (patient specific information)

The patient performs a series of forced vital capacity maneuvers (FVC) after increasing doses of methacholine are administered by nebulized mist treatment (NMT). Every patient is given a bronchodilator whether they react to the methacholine or not, followed by one last FVC before being discharged.

A challenge is considered positive if at any point in the testing the patient's FEV1 decreases by more than 20%. At which time the test is stopped and a bronchodilator is administered.

Methacholine Challenge - (Physician specific information)

The Methacholine Challenge is performed using the Sensormedics 6200 Autobox System.

The patient performs a series of forced vital capacity maneuvers (FVC) starting with three or more efforts to establish a baseline. Methacholine is administered by nebulized mist treatment (NMT) starting with .15 mg/ml of methacholine, increasing in 6 increments to 25 mg/ml of methacholine with a FVC performed 3 minutes post nebulization. Every patient is given a bronchodilator whether they react to the methacholine or not, followed by one last FVC before being discharged.

A challenge is considered positive if at any point in the testing the patient's FEV1 decreases by more than 20%. At which time the test is stopped and a bronchodilator is administered.

Treadmill Exercise Challenge - (patient specific information)               

Before testing the patient will be asked to change into exercise appropriate clothing; running shoes, shorts, T-shirt and for the comfort of the girls an athletic bra.

Preparation for the EKG involves scrubbing 10 different sites with alcohol and attaching EKG leads with a strong adhesive. A baseline EKG is performed followed by baseline blood pressure and FVC (forced vital capacity).

The treadmill exercise challenge measures pulmonary (FVC) & metabolic function (anaerobic threshold) and also measures cardiac function (EKG).

The patient will be asked to work as hard as they can up to and including feeling the "pain" of their symptoms. Ultimately the patient determines the end of the test and so the test is only as good as the patient effort. An EKG, blood pressure and a series of three FVC's will be performed at the end of exercise. If symptoms develop, a post testing bronchodilator will be administered.

Treadmill Exercise Challange - (physician specific information)

Before testing the patient will be asked to change into exercise appropriate clothing: running shoes, shorts, T-shirt and for the comfort of the girls, an athletic bra.

Preparation for the EKG involves scrubbing the chest in 10 different sites with alcohol and attaching EKG leads with a strong adhesive. A baseline EKG is performed followed by baseline blood pressure and FVC (forced vital capacity).

The treadmill exercise challenge is performed using the Sensormedic VMAX 229, which measures pulmonary (FVC) & metabolic function (anaerobic threshold) and also the Marquette Max 1, which measures cardiac function (EKG).

The patient will be asked to work as hard as they can up to and including feeling the "pain" of their symptoms.    Ultimately the patient determines the end of the test and so the test is only as good as the patient effort. An EKG, blood pressure and a series of three FVC's will be performed at the end of exercise. If symptoms develop, a post testing bronchodilator will be administered.