A culture front the lower airway secretions is the optimal sample to guide
antibiotic therapy in cystic fibrosis (CF) lung disease, The authors theref
ore 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% pr
edicted (46-122%), NaCl solutions from 0.9-6% were inhaled, after baseline
lung function tests before and after salbutanol.
All patients did produce secretions, Alveolar macrophages were present in 1
6/19 induced samples. The procedure induced minor but significant bronchoco
nstriction: 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 fro
m -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 c
ystic fibrosis children who do not expectorate spontaneously.