title: Effect of airway clearance techniques on the efficacy of the sputum induction procedure.
abstract: Sputum induction is used in the early identification of tuberculosis (TB) and pneumocystis infections of the lung. Although manual physiotherapy techniques to clear the airways are often incorporated in the sputum induction procedure, their efficacy in this setting is unknown. This randomised, crossover trial enrolled adults referred for sputum induction for suspected TB and pneumocystis infections of the lung. All participants underwent two sputum induction procedures, inhaling 3% saline via ultrasonic nebuliser. During one randomly allocated procedure, airway clearance techniques (chest wall percussion, vibration, huffing) were incorporated. In total, 59 participants completed the trial. The airway clearance techniques had no significant effect on how the test was tolerated, the volume expectorated or the quality of the sample obtained (assessed by the presence of alveolar macrophages). The techniques did not significantly affect how often the test identified a suspected organism, nor the sensitivity or specificity of sputum induction. In conclusion, the study was unable to demonstrate any effect of airway clearance techniques on the sputum induction procedure. The results provide some justification for not including airway clearance techniques as part of the sputum induction procedure.
authors.affiliation: Dept of Respiratory Medicine, Level 11, Edinburgh Building, Royal Prince Alfred Hospital, Missenden Road, Camperdown NSW 2050, Australia. elkinsm@med.usyd.edu.au
authors.forename: M R
authors.initials: MR
authors.lastname: Elkins
authors.forename: T
authors.initials: T
authors.lastname: Lane
authors.forename: H
authors.initials: H
authors.lastname: Goldberg
authors.forename: J
authors.initials: J
authors.lastname: Pagliuso
authors.forename: L A
authors.initials: LA
authors.lastname: Garske
authors.forename: E
authors.initials: E
authors.lastname: Hector
authors.forename: L
authors.initials: L
authors.lastname: Marchetto
authors.forename: J A
authors.initials: JA
authors.lastname: Alison
authors.forename: P T P
authors.initials: PT
authors.lastname: Bye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance; D010812:Physical Stimulation / Q000379:methods*; D016720:Pneumocystis Infections / Q000175:diagnosis* / Q000382:microbiology*; D015203:Reproducibility of Results; D012138:Respiratory Therapy / Q000379:methods; D012680:Sensitivity and Specificity; D012965:Sodium Chloride; D013048:Specimen Handling / Q000379:methods; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology*
chemical_list: D012965:Sodium Chloride