Induced sputum in adolescents with severe stable asthma. Safety and the relationship of cell counts and eosinophil cationic protein to clinical severity

Grootendorst, Diana C.; Bos, J.-W. Van Den; Romeijn, J. J.; Veselic-Charvat, Maud; Duiverman, E. J.; Vrijlandt, Elianne J.L.E.; Sterk, Peter J.; Roldaan, AC

doi:10.1183/09031936.99.13364799

Cited by 63 publications

(58 citation statements)

References 30 publications

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“…Despite the pre-treatment with 200 µg salbutamol, some of the patients developed an excessive drop of lung function parameters. This is in agreement with all the previous observations of pre-treatment not giving a complete protection against bronchospasm (7,11,15,16). Some authors have found that administration of nebulised salbutamol during the sputum induction could improve bronchoprotection in asthma patients (22).…”

Section: Discussionsupporting

confidence: 81%

“…This naturally resulted in longer inhalation times and higher concentrations inhaled. The proportion of inductions ending after the final, 5% saline, concentration was 50% in our study compared to 0%, 4% and 16% in other studies (11,17,22). Despite the pre-treatment with 200 µg salbutamol, some of the patients developed an excessive drop of lung function parameters.…”

Section: Discussionmentioning

confidence: 37%

“…As a relatively non-invasive procedure, which provides repeatable and valid results (6), sputum induction quickly gained an important place in clinical practice. Inhaled hypertonic saline, however, can cause adverse effects such as bronchial constriction and lung hyperinflation (7), and the safety of the method was thoroughly assessed in patients with airway obstruction characteristic for asthma (8,9,10,11) and COPD (12,13,14,5,16). Despite a number of studies, there are limited data on the safety of sputum induction in COPD patients with pronounced airway obstruction, making physicians hesitant to use this valuable diagnostic tool in such patients.…”

Section: Introductionmentioning

confidence: 99%

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The Tolerability and Safety of Repeated Sputum Induction in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease

Friedrich¹,

Popović‐Grle²,

Manojlović³

et al. 2016

IOSR

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 37%

Section: Introductionmentioning

confidence: 99%

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The Tolerability and Safety of Repeated Sputum Induction in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease

Friedrich¹,

Popović‐Grle²,

Manojlović³

et al. 2016

IOSR

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“…Although the drop in postsalbutamol forced expiratory volume in one second (FEV1) after inhalation was larger in asthmatics than in normals a fall exceeding 20% only occurred in 3/37 patients. Sputum induction using hypertonic saline is also efficacious and safe in adolescent asthmatics [13,14] and isotonic saline sputum induction appears to be safe in children with acute asthma [15]. Although the feasibility of sputum induction has been reported in patients with CF [16], a systematic study of sputum induction in young CF patients is lacking.…”

mentioning

confidence: 99%

Sputum induction in young cystic fibrosis patients

Boeck¹,

Alifier²,

Vandeputte³

2000

Eur Respir J

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A culture from the lower airway secretions is the optimal sample to guide antibiotic therapy in cystic fibrosis (CF) lung disease. The authors therefore examined whether sputum induction is an efficient, safe and acceptable procedure in CF children without spontaneous expectorations.Nineteen patients were studied. Their mean age (range) was 8.6 yrs (4.3±15.2 yrs). Their mean forced expiratory volume in one second (FEV1) was 88% predicted (46± 122%). NaCl solutions from 0.9±6% were inhaled, after baseline lung function tests before and after salbutamol.All patients did produce secretions. Alveolar macrophages were present in 16/19 induced samples. The procedure induced minor but significant bronchoconstriction: the mean change (range) in postsalbutamol FEV1 (% pred) was -7 (-24±16). Percutaneous oxygen saturation remained above 90% in all children. The test had to be discontinued in one child because of cough and wheeze. Acceptability of the procedure evaluated using a visual analogue scale from -7±7 showed a mean value (range) at the final concentration of -1.23 (-6.16±5.88).It is concluded that sputum induction is possible, safe and acceptable in cystic fibrosis children who do not expectorate spontaneously. Chronic lower respiratory tract infection is the predominant manifestation of cystic fibrosis (CF). In young CF patients it is important to recognize and treat lung infection as early as possible, since with correct treatment Pseudomonas aeruginosa colonization can be avoided or delayed [1,2]. A culture from the lower airway secretions is necessary to guide antimicrobial therapy. Sputum cultures are considered a valuable substitute for a lower airway sample obtained by bronchoscopy or thoracotomy, since results from both sites will correspond in over 70% of cases [3].Many young CF patients do not produce sputum. Since oropharyngeal cultures have only a poor positive predictive value [4,5], bronchoalveolar lavage (BAL) remains the standard technique to obtain a lower airway sample in these patients. It is, however, an expensive, time consuming, unpleasant and potentially harmful procedure.Recently, in patients infected with Pneumocystis carinii and Mycobacteria [6±8], sputum induction during hypertonic saline inhalation was proven to provide information comparable to that obtained by bronchoscopy and BAL. Similarly, cytological evaluation of induced sputum is considered helpful in patients with asthma and lung malignancies [9±11]. Sputum induction using hypertonic saline is efficacious in >90% of adult asthmatics [12]. Although the drop in postsalbutamol forced expiratory volume in one second (FEV1) after inhalation was larger in asthmatics than in normals a fall exceeding 20% only occurred in 3/37 patients. Sputum induction using hypertonic saline is also efficacious and safe in adolescent asthmatics [13,14] and isotonic saline sputum induction appears to be safe in children with acute asthma [15]. Although the feasibility of sputum induction has been reported in patients with CF [16], a systemati...

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“…Safety and practicality are the most obvious. The method of obtaining induced sputum is relatively noninvasive and can be carried out at random [2] and repeatedly in subjects with varying disease severity [3][4][5][6][7][8][9][10][11][12][13]. Therefore, it is not surprising that the examination of induced sputum has become the most clinically applicable method for the assessment of airway inflammation.…”

mentioning

confidence: 99%