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The following is a summary of “Abbreviated Methacholine Challenge Test is Safe for Children,” published in the August 2024 issue of Pediatrics by Hevroni et al.

This prospective, observational study aimed to evaluate the safety and efficiency of an abbreviated methacholine challenge test (MCT) protocol in children aged 6 to 18. The abbreviated protocol initiated with a methacholine dose of 0.03 mg/ml, escalating in fourfold increments, with a dose doubling approach employed if the forced expiratory volume at 1 second (FEV1) decline exceeded 10%. The study assessed the safety of this approach by monitoring for adverse events, specifically focusing on decreases in FEV1 greater than 40%, hypoxemia, and uncontrollable cough. 

The number of methacholine doses administered and the overall test duration were recorded and compared to estimated outcomes derived from the standard, full-length MCT protocol. A total of 112 participants, with a mean age of 13.7 years (±3.3), completed the abbreviated MCT protocol. Among these, 57 participants (51%) responded positively to the test. The study found no significant clinical adverse events related to the abbreviated protocol. Notably, 2.7% of participants experienced an exaggerated response, consistent with findings from the full-length MCT protocol. 

The abbreviated protocol demonstrated an estimated average time savings of 18 minutes and 19 seconds per participant, reducing the test length by 22 minutes and 47 seconds for negative results and by 14 minutes and 34 seconds for positive outcomes. These findings indicate that the abbreviated MCT protocol is safe and effective, significantly shortening the duration of the MCT while maintaining safety and diagnostic accuracy for pediatric patients.

Source: sciencedirect.com/science/article/abs/pii/S0022347624003536