Get access

The safety of sputum induction in adults with acute exacerbation of COPD

Authors

  • Peng Gao,

    1. Department of Respiratory Medicine, The Second Affiliated Hospital of Jilin University, Changchun, Jilin, China
    2. JLU-Woolcock Joint Research Centre for Airway Disease, Changchun, Jilin, China
    3. Department of Respiratory Medicine, Changchun Central Hospital, Changchun, Jilin, China
    Search for more papers by this author
    • Gao Peng and Gibson Peter G contributed equally to this study.

  • Peter G Gibson,

    1. Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
    2. JLU-Woolcock Joint Research Centre for Airway Disease, Changchun, Jilin, China
    Search for more papers by this author
    • Gao Peng and Gibson Peter G contributed equally to this study.

  • Jie Zhang,

    Corresponding author
    1. Department of Respiratory Medicine, The Second Affiliated Hospital of Jilin University, Changchun, Jilin, China
    2. JLU-Woolcock Joint Research Centre for Airway Disease, Changchun, Jilin, China
    Search for more papers by this author
  • Xiaoyan He,

    1. Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
    2. JLU-Woolcock Joint Research Centre for Airway Disease, Changchun, Jilin, China
    Search for more papers by this author
  • Yuqiu Hao,

    1. Department of Respiratory Medicine, The Second Affiliated Hospital of Jilin University, Changchun, Jilin, China
    2. JLU-Woolcock Joint Research Centre for Airway Disease, Changchun, Jilin, China
    Search for more papers by this author
  • Ping Li,

    1. Department of Respiratory Medicine, The Second Affiliated Hospital of Jilin University, Changchun, Jilin, China
    2. JLU-Woolcock Joint Research Centre for Airway Disease, Changchun, Jilin, China
    Search for more papers by this author
  • Huan Liu

    1. Department of Respiratory Medicine, The Second Affiliated Hospital of Jilin University, Changchun, Jilin, China
    2. JLU-Woolcock Joint Research Centre for Airway Disease, Changchun, Jilin, China
    Search for more papers by this author

  • Authorship and contributorship: Dr Gao contributed to collecting data, data analysis, design of the study, and the writing of all sections of the manuscript, and approved the final version of the manuscript. Dr Gibson contributed to the data analysis, design of the study, and the writing of all sections of the manuscript, and approved the final version of the manuscript. Dr Zhang contributed to the study design, data analysis, and writing of the manuscript, and approved the final version of the manuscript; Dr Zhang is the guarantor of the entire manuscript. Dr He contributed to collecting data and design of the study, and approved the final version of the manuscript. Dr Li contributed to design of the study and the writing of the manuscript, and approved the final version of the manuscript. Dr Hao contributed to data collection, study design, data analysis, and the writing of the manuscript, and approved the final version of the manuscript. Dr Liu contributed to collecting data, analysis of patient samples, and design of the study, and approved the final version of the manuscript.

  • Ethics: The subjects in this study gave written consent, and the study was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Jilin University, Changchun, Jilin, China.

  • Conflict of interest: Jie Zhang has received funding support for the conduct of this study and received compensation for time, effort and travel expenses related to data discussions and presentations from Jilin Province Science Research Foundation, China. Also, she has received an unrestricted research grant from Professor Peter G Gibson. Peng Gao, Xiaoyan He, Yuqiu Hao, Ping Li and Huan Liu have no conflicts of interest to disclose. Peter G Gibson is a supporter for this study, and a member of Advisory Board, and has no conflicts of interest to disclose.

Jie Zhang, PhD, Department of Respiratory Medicine, The Second Affiliated Hospital of Jilin University, Changchun, Jilin, China. Tel: +86-43188796866, Fax: +86-43188796866, email: doctorzhangj@sina.com

Abstract

Introduction:  Induced sputum is a non-invasive method, and a useful tool to evaluate inflammatory cells and mediators in the airway lumen in the setting of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, the inhalation of hypertonic saline solution to induce sputum may cause a bronchoconstrictive response, so it is important to evaluate the success and safety of sputum induction (SI).

Objectives:  The aims of this study were to assess the safety and efficacy of SI in adults with AECOPD.

Methods:  Eighty-three AECOPD subjects and 26 healthy controls underwent a modified SI. The outcome measures included fall in lung function during induction and success of SI.

Results:  Adults hospitalized with AECOPD had moderate to very severe airflow obstruction. SI was successful in over 80% of subjects. The percentage decrease in forced expiratory volume in 1 s (FEV1) from baseline by the Global initiative for Chronic Obstructive Lung Disease (GOLD) category was median 1.2(interquartile range, 0.5–3.3)(GOLD II), 2.3(1.3–3.2)(GOLD III), 5.2(3.3–8.6)(GOLD IV) and 1.4(0.5–3.2)(control), respectively. A fall in FEV1 of >20% occurred in only one subject with AECOPD who was in GOLD category III. The decrease in percentage of FEV1 from baseline was greatest in the second stage of induction, and correlated with that of the final stage (r = 0.589; P = 0.01). The fall in FEV1 during induction increased with GOLD category (P < 0.05).

Conclusions:  SI can be safely and successfully performed in patients with moderate to very severe chronic obstructive pulmonary disease who experience an exacerbation using this modified induction protocol. The early decrease in FEV1 can be used to predict the maximum fall.

Please cite this paper as: Gao P, Gibson PG, Zhang J, He XY, Hao YQ, Li P and Liu H. The safety of sputum induction in adults with acute exacerbation of COPD. Clin Respir J 2013; 7: 101–109.

Ancillary