ASTHMA INDUCED BY ICE WATER INGESTION IN ETHNIC CHINESE ASTHMATIC-CHILDREN - A CHALLENGE

The purpose of this study was to investigate the relationship between ice water ingestion and the induction of asthmatic symptoms and signs in ethnic Chinese asthmatic children. Sixty asthmatic children with a positive history of exacerbation of symptoms after drinking ice water were divided randomly into two groups: 34 children were instructed to drink 250 ml of 0-4 degrees C ice water within one minute, and 26 to d rink 250 ml of 25 degrees C warm water. All of the asthmatic children were stable when studied. Twenty-three healthy children as controls we re asked to drink 250 ml of 0-4 degrees C ice water. The three groups had forced expiratory volume in one second (FEV1) performed at baselin e and at 5, 15, 30, 60, and 90 minutes after challenge. After the spir ometric test at 90 minutes the patients of the two asthmatic groups re ceived three puffs (0.6 mg) of hexoprenaline MDI and a further spirome tric test was performed 5 min after the inhalation. Cough and wheeze w ere monitored throughout the course of the test. The mean FEV1 after c hallenge decreased significantly only in the ice-water asthmatic group (p=0.004). Compared with the baseline data, the mean FEV1 at various periods after challenge was only significantly decreased at 60 min (p= 0.035). After hexoprenaline inhalation the FEV1 significantly increase d in the two asthmatic groups (p<0.001). A significant difference in F EV1 change was noted among the three groups (p=0.015). Nine cases (26% ) from the ice water asthmatic group, three (12%) from the warm-water asthmatic group, and none of the ice-water normal control group showed a decrease of FEV1 greater than 15% (p=0.018). The greatest differenc e occurred between the two ice water groups. All six cases who develop ed symptoms after challenge, accompanied by a simultaneous decrease of FEV1 greater than 15%, belonged to the ice-water asthmatic group. For ty-seven percent of the ice-water asthmatic group and 4% each of the t wo other groups had cough and/or wheeze after challenge (p=0.0002). In conclusion: Ice water ingestion may induce or exacerbate asthma in et hnic Chinese asthmatic children.