Respiratory muscle activity in the assessment of bronchial responsiveness in asthmatic children.

We investigated whether an increase in transcutaneous electromyographic (EMG) activity of the diaphragm and intercostal muscles corresponds with the concentration of histamine that induces a 20% fall in the forced expiratory volume in one second (FEV1; PC20). Eleven asthmatic children (mean age 11.9 yr) were studied after they were given histamine challenge. EMG activity at PC20 or at the highest histamine concentration was compared with activity at baseline by calculating the ratio of the mean peak-to-peak excursion at the highest histamine dose to that at baseline [EMG activity ratio (EMGAR)]. In all children reaching PC20, an increase in diaphragmatic and intercostal EMGAR was observed. No increase was found at the dose step before PC20 was reached. In six challenges, no fall in FEV1 was induced, and no increase in EMGAR was seen. In two challenges, no fall in FEV1 was induced, but increase in diaphragmatic or intercostal EMGAR was observed. Increase in the electrical activity of the diaphragm and intercostal muscles in asthmatic children corresponds closely to a 20% fall in FEV1 induced by histamine challenge.