Safety of sputum induction in moderate-to-severe smoking-related chronic obstructive pulmonary disease.
BACKGROUND
Investigation of the safety of sputum induction in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) has been limited.


OBJECTIVE
to evaluate this issue in 100 patients with a mean FEV1 of 1.2 (0.4) L. After 200 microg inhaled salbutamol, sputum induction was performed with inhaled saline in increasing and tailored concentrations (0.9% to 5%) until an adequate sample of sputum was obtained or the FEV1 fell by >20%.


RESULTS
Sputum induction was successful in 92% of occasions. The mean (SD) fall in FEV1 was 13.5 (8.6)%. Five patients had a fall >20% but all recovered to 10% of baseline after inhaled salbutamol. The magnitude of fall in FEV1 correlated weakly with salbutamol reversibility (r = 0.37, p < 0.001), baseline FEV1/VC (r = -0.32, p = 0.001) and baseline FEV1% predicted (r = -0.36, p = 0.003) but not with age, smoking history or post-Salbutamol FEV1. Principle


CONCLUSIONS
Sputum induction can be performed safely using a patient-tailored approach in patients with moderate-to-severe COPD, supporting its use in research and clinical practice.
Wilson
Andrew M
AM
School of Medicine Health Policy and Practice, University of East Anglia, UK. a.m.wilson@uea.ac.uk
Leigh
Richard
R
Hargreave
Frederick E
FE
Pizzichini
Marcia Margaret M
MM
Pizzichini
Emilio
E
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012449:Safety; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D012907:Smoking / Q000009:adverse effects*; D013183:Sputum / Q000187:drug effects / Q000378:metabolism*; D018709:Statistics, Nonparametric
D000318:Adrenergic beta-Agonists; D012462:Saline Solution, Hypertonic; D000420:Albuterol