ATS Treatment of Exercise-induced Bronchoconstriction Guideline Summary

Diagnosis

The diagnosis of EIB is established by changes in lung function provoked by exercise, not on the basis of symptoms.
Serial lung function measurements after a specific exercise or hyperpnea challenge are used to determine if EIB₁ is present and to quantify the severity of the disorder. It is preferable to assess FEV, because this measurement has better repeatability and is more discriminating than peak expiratory flow rate.
The airway response is expressed as the percent fall in FEV₁ from the baseline value. The difference between the pre-exercise FEV₁ value and the lowest FEV₁ value recorded within 30 minutes after exercise is expressed as a percentage of the pre-exercise value. The criterion for the percent fall in FEV used to diagnose ₁EIB is ≥10%.
The severity of EIB can be graded as follows:

For patients with EIB, the ATS₂ recommends administration of an inhaled short-acting β-agonist (SABA) before exercise. (S, H)

The SABA is typically administered 15 minutes before exercise.

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Treatment of Exercise-induced Bronchoconstriction