Eucapnic Hyperventilation (Eucapnic Voluntary Hyperventilation [EVH]) Periprocedural Care

Updated: Dec 31, 2022
  • Author: Rakesh Vadde, MBBS; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Periprocedural Care

Patient Education and Consent

Educate patients about the various steps of eucapnic hyperventilation (eucapnic voluntary hyperventilation). Patient should be aware of the possible complications of test including asthmalike symptoms, which include chest tightness, cough, and shortness of breath. These complications can be reversed with an inhaled short-acting bronchodilator.

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Equipment

The images below depict eucapnic hyperventilation (eucapnic voluntary hyperventilation) equipment.

Eucapnic Hyperventilation. Equipment for eucapnic Eucapnic Hyperventilation. Equipment for eucapnic hyperventilation test.
Eucapnic Hyperventilation. Patient undergoing euca Eucapnic Hyperventilation. Patient undergoing eucapnic hyperventilation procedure.
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Patient Preparation

Patients can eat a normal breakfast or lunch before eucapnic hyperventilation (eucapnic voluntary hyperventilation); however, they should avoid heavy meals or any alcoholic drinks. Patients should avoid spicy foods and caffeine-containing drinks (which may cause heartburn, indigestion, or reflux) on the day of the procedure. Patients should also avoid any strenuous exercise or excess exposure to cold/hot air within 4 hours prior to the test.

Smoking can interfere with spirometry and eucapnic hyperventilation results by producing false-positive results. If the patient smokes cigarettes or other tobacco products, they must abstain from it for at least 6 hours prior to examination.

Patients are not routinely recommended to withhold inhaled and oral steroids for the test, however the anti-inflammatory effects of these agents can affect the bronchial response to the trigger. [13] Some medications can interfere with the test results and must be stopped prior to testing as summarized in the table below.

Table. Medications That Must Be Stopped Prior to Eucapnic Hyperventilation. (Open Table in a new window)

Drug Category

Medication

Time prior to test

Inhaled bronchodilators

Albuterol

8 hours

Ipratropium

24 hours

Salmeterol

48 hours

Oral bronchodilators

Long-acting theophylline

48 hours

Inhaled glucocorticoid

 

2-3 weeks

Oral glucocorticoid

 

2-3 weeks

Mast cell stabilizers

Cromolyn sodium

8 hours

Antihistamines

Diphenhydramine

72 hours

Chlorpheniramine

72 hours

Hydroxyzine

72 hours

Cetirizine

72 hours

Leukotriene modifiers

Montelukast

24 hours

Zafirlukast

24 hours

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