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Although the ability of Aspergillus organisms to colonize the respiratory tract in patients with cystic fibrosis (CF) is well recognized, the contribution of Aspergillus to the disease process is poorly understood. Using sera from 147 CF patients (age 5 to 43 yr), we measured IgE antibody (ab) to Aspergillus fumigatus and five common inhalant allergens with a radioallergosorbent test (RAST). Total IgE levels and IgG ab to radio-labeled Asp f I, an allergen purified from A. fumigatus and a potent inhibitor of protein synthesis, were also measured. Thirty (20%) of the patients had IgE ab to A. fumigatus, and 22 (15%) of these patients had developed total IgE levels > or = 400 IU/ml, raising the consideration of a diagnosis of allergic bronchopulmonary aspergillosis (ABPA). Five of the 22 patients developed these IgE responses by age 5 yr and 14 by age 10 yr. The proportion of patients with IgE ab to one or more of the other allergens tested was not significantly different from that of control subjects without respiratory symptoms. A striking proportion (84%) of CF sera contained IgG ab to Asp f I, compared with 6% of sera from control patients and 20% of sera from allergic children with asthma (n = 25), only one of whom had IgE ab to A. fumigatus. In an examination of additional sera from young CF patients, IgG anti-Asp f I ab was detected in 41% of these sera from patients 5 yr of age or older, increasing to 98% of 89 sera from patients older than age 10.(ABSTRACT TRUNCATED AT 250 WORDS)

Discussion The quantitative carbon dioxide analyser is one of the most valuable monitors we have in clincial anaesthesia. Unfortunately, because of their size and cost, these monitors are not available in all areas where tracheal intuhation is carried out. Few hospitals can supply every operating room, emergency room or "crash cart" with one of these devices, and they are not practical for use by medical personnel in "field" settings or by paramedics in their work environment. The pH-sensitive chemical indicator, on the other hand, is small, inexpensive and easy to use, and would be ideal for all the above situations. It is not a replacement for the quantitative carbon dioxide analyser, but if used in conjunction with the usual methods of detecting correct tube placement, it should reduce the number of undiagnosed oesophagcal intubations. References t PotlardBJ, Juntas F. Accidental intubatian of the oesophagus.

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