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.
Equipment
The images below depict eucapnic hyperventilation (eucapnic voluntary hyperventilation) equipment.
Eucapnic Hyperventilation. Patient undergoing eucapnic hyperventilation procedure.
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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Eucapnic Hyperventilation. Equipment for eucapnic hyperventilation test.
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Eucapnic Hyperventilation. Patient undergoing eucapnic hyperventilation procedure.
Tables
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 |
