American Thoracic Societv（美国胸Societv）.pdf

American Thoracic Societv Guidelines for Methacholine and Exercise Challenge Testing-1999 THIS OFFICIAL STA.TEMENT OF THE AMERICAN THORACIC SOCIETY WAS ADORED BY THE ATS BOARD OF D IRECTORS , JULY 1999 I. Purpose and Scope The bronchial challenge tests chosen for review are the two II. Methacholine Challenge Testing most widely used, with enough information in the literature to A. Indications evaluate their utility. Of the two, methacholine challenge test- B. Contraindications ing is better established; a number of aspects in the exercise C. Technician Training/Qualifications challenge protocol will benefit from further evaluation. We do D. Safety not cover specific challenges with allergens, drugs, or occupa- E. Patient Preparation tional sensitizers, and recommend that such tests be performed F. Choice and Preparation of Methacholine only in laboratories with considerable experience in their tech- G. Dosing Protocols niques. For more extensive details or other challenge proce- 1. Two-Minute Tidal Breathing Dosing Protocol dures the reader is referred to previously published guidelines 2. Five-Breath Dosimeter Protocol for bronchial challenge testing (l-5) and reviews on the gen- H. Nebulize