Sputum induction safely achievable in severe asthmatics

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – Provided that an appropriate standardized protocol is employed, sputum samples can be safely obtained from patients with severe, hard-to-control asthma, according to Dutch researchers.

Dr. Anneke ten Brinke and colleagues at Leiden University Medical Center studied 93 patients with difficult-to-control disease. All were symptomatic despite regular use of inhaled corticosteroids and long-acting beta-2-agonists for more than a year, the researchers write in the American Journal of Respiratory and Critical Care Medicine for September 1.

Patients were pretreated with 400 µg of salbutamol (albuterol) and sputum induction was attempted using a "strict protocol" employing 0.9%, 3.00% and 4.5% saline inhalation. Samples were successfully obtained from 74% of patients.

However, 22% of these subjects showed a drop in lung function (FEV1) of more than 15% from baseline. This excessive bronchoconstriction was associated with increased rescue use of short-acting beta-2-agonists in the preceding 2 days, as well as a lower postbronchodilator FEV1 and greater sensitivity to histamine challenge.

The researchers conclude that overall, sputum induction can be "performed safely and successfully" in such patients, "provided that a strictly standardized protocol" is employed. However, they stress that, in particular, patients who have used rescue inhalers in the 2 days prior to the procedure "seem to be at increased risk for excessive bronchoconstriction."

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