Use of the Nijmegen questionnaire to detect hyperventilation in patients with asthma

Bruton, A. and Holgate, S.T. (2005) Use of the Nijmegen questionnaire to detect hyperventilation in patients with asthma. European Respiratory Society Annual Congress, Copenhagen, Denmark. 16 - 20 Sep 2005. (Submitted)

Abstract

The Nijmegen questionnaire has been validated as a screening tool for the detection of hyperventilation syndrome (HVS). Recently it has also been used to detect 'dysfunctional breathing' in patients with asthma, although it has never been validated for this purpose. The aim of this study was to administer the Nijmegen questionnaire to patients with a diagnosis of asthma confirmed by a bronchial challenge test, and compare this to an objective measure of hyperventilation i.e. end-tidal carbon dioxide (ETCO2). Patients with a clinical diagnosis of asthma were invited to attend. Data collection consisted of: lung function testing, skin prick testing, Nijmegen and HAD questionnaire administration, histamine challenge testing. ETCO2 data were collected non-invasively during 10 minutes of quiet breathing using a Rahn-Otis sampler and a rapid response CO2 analyser (PowerLab). 15 asthma patients with a positive histamine challenge have been recruited to date. Asthma severity ranges from mild to severe. Preliminary analysis suggests a significant negative correlation (r = 0.77, p = 0.001) between the Nijmegen score and ETCO2. No significant relationship has been found between either anxiety or asthma severity and these variables. The authors of the Nijmegen questionnaire used a score of 23 as the 'cut-off' to detect hyperventilation symptoms in patients with HVS. Our findings suggest that in people with asthma there may be a linear relationship between the Nijmegen score and ETCO2. A formal validation study will be necessary to confirm these findings.

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Contributors

Author: A. Bruton

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