help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by JONES, P. D.
Right arrow Articles by HENRY, R. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by JONES, P. D.
Right arrow Articles by HENRY, R. L.

Am. J. Respir. Crit. Care Med., Volume 164, Number 7, October 2001, 1146-1149

The Tolerability, Safety, and Success of Sputum Induction and Combined Hypertonic Saline Challenge in Children

PETER D. JONES, ROBYN HANKIN, JODIE SIMPSON, PETER G. GIBSON, and RICHARD L. HENRY

Department of Paediatrics and Child Health, and School of Medical Practice, University of Newcastle, Newcastle, Australia; Airways Research Centre, John Hunter Hospital, Newcastle, Australia; and Department of Paediatrics, University of New South Wales, Sydney, Australia

Induced sputum using hypertonic saline (HS) is a useful research tool to study airway inflammation (AI). HS provocation testing can also be used to measure airway hyperresponsiveness (AHR). A combined HS challenge and sputum induction procedure has been developed to permit assessment of AI and AHR in a single test. The aim of this study is to report the success and tolerability of sputum induction alone, and in combination with a HS bronchial provocation challenge. Sputum induction alone was performed with beta 2-agonist pretreatment. In the combined challenge, no beta 2-agonist pretreatment was used. A high-output ultrasonic nebulizer with valve box and tubing were used to deliver 4.5% saline in doubling time periods from 0.5 s to 4 min. Outcomes assessed were completion of the test protocol, adequacy of sputum samples, decrease in FEV1, and adverse effects during the procedure. Fifty-three children who underwent a sputum induction alone, and 182 children who underwent a combined sputum induction and bronchial provocation using HS. Sputum induction alone was well tolerated, with 98% of children completing the procedure and only 4% experiencing a significant (> 15%) fall in FEV1. An adequate sample of sputum was obtained in 92% of children. The combined challenge was completed by 90% of children. A distressing cough occurred in 13% of children and irritation of the mucosa in 1% of children. In the combined challenge an adequate sample of sputum was obtained in significantly fewer children than with sputum induction alone (70% versus 92%, p < 0.05). Sputum cellular changes reflected the shorter nebulization time with sputum induction alone. We conclude that induction of sputum using HS after pretreatment with bronchodilator is well tolerated with a high success rate in children. Combining the HS challenge with sputum induction provides additional information and is a useful means of comparing AHR and AI simultaneously, but at the expense of having a reduced success rate in obtaining an adequate sample of sputum, as well as increased side effects.




This article has been cited by other articles:


Home page
 ChestHome page
J. M. Marchant, I. B. Masters, S. M. Taylor, N. C. Cox, G. J. Seymour, and A. B. Chang
Evaluation and Outcome of Young Children With Chronic Cough
Chest, May 1, 2006; 129(5): 1132 - 1141.
[Abstract] [Full Text] [PDF]

Home page
 Chronic Respiratory DiseaseHome page
R Ratnawati and P S Thomas
Exhaled nitric oxide in paediatric asthma
Chronic Respiratory Disease, July 1, 2005; 2(3): 163 - 174.
[Abstract] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. Zacharasiewicz, N. Wilson, C. Lex, E. M. Erin, A. M. Li, T. Hansel, M. Khan, and A. Bush
Clinical Use of Noninvasive Measurements of Airway Inflammation in Steroid Reduction in Children
Am. J. Respir. Crit. Care Med., May 15, 2005; 171(10): 1077 - 1082.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
J. Hirsch, K. C. Hansen, A. L. Burlingame, and M. A. Matthay
Proteomics: current techniques and potential applications to lung disease
Am J Physiol Lung Cell Mol Physiol, July 1, 2004; 287(1): L1 - L23.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
G.F. Joos and B. O'Connor
Indirect airway challenges
Eur. Respir. J., June 1, 2003; 21(6): 1050 - 1068.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
Leader of the Working Group:, P.G. Gibson, Members of the Working Group:, D.C. Grootendorst, R. Henry, I. Pin, P.L. Rytila, P. Wark, N. Wilson, and R. Djukanovic
Sputum induction in children
Eur. Respir. J., July 1, 2002; 20(37_suppl): 44S - 46s.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Pediatrics, Surfactant, and Cystic Fibrosis in AJRCCM 2001
Am. J. Respir. Crit. Care Med., March 1, 2002; 165(5): 619 - 630.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2001 American Thoracic Society 		  Solid Organ Transplant for the Intensivist 2008