Document 0873
 DOCN  M9470873
 TI    Effect of sputum induction on arterial oxygen saturation and spirometry
       in HIV-infected patients.
 DT    9409
 AU    Leigh TR; Kirby K; Gazzard BG; Collins JV; Dept of Respiratory Medicine,
       Chelsea and Westminster Hospital,; London, UK.
 SO    Eur Respir J. 1994 Mar;7(3):453-8. Unique Identifier : AIDSLINE
       MED/94283558
 AB    We wanted to study the effect of sputum induction on forced expiratory
       volume in one second (FEV1) and on oxygen saturation in normal controls,
       asymptomatic human immunodeficiency virus (HIV)-seropositive
       individuals, and HIV-seropositive patients under investigation for
       suspected Pneumocystis carinii pneumonia (PCP). Over a five month
       period, sputum induction with ultrasonically nebulized 3% saline was
       performed on 110 HIV-seropositive patients with suspected PCP, 10
       asymptomatic HIV-seropositive patients, and 15 normal controls. Oxygen
       saturation (peak, trough and change in oxygen saturation (delta O2)) was
       measured throughout the procedure using pulse oximetry, and these
       results compared with the chest radiograph and the final pulmonary
       diagnosis. In addition, the effect of sputum induction on FEV1 was
       measured in the 15 control subjects and 10 asymptomatic HIV-seropositive
       patients. Compared with bronchoalveolar lavage, sputum induction had a
       diagnostic sensitivity for PCP of 76%. Chest radiography was 79%
       sensitive, and had specificity of 83%. Patients with PCP had lower peak
       and trough oxygen saturation values compared with the non-PCP group
       (mean peak 95 vs 97%; mean trough 88 vs 91%), and greater falls in O2
       saturation during the procedure (mean delta O2 7.6 vs 5.5%). One subject
       desaturated to 76%, requiring supplemental oxygen. Sputum induction
       caused significant but temporary falls in FEV1 both in control and
       HIV-seropositive groups (mean maximum fall in FEV1 10.4 vs 12.5%). We
       conclude that although sputum induction causes significant falls in
       oxygen saturation and FEV1, it remains sensitive and safe, and provides
       a useful alternative to bronchoscopy for the diagnosis of PCP.
 DE    Adult  AIDS-Related Opportunistic Infections/*DIAGNOSIS/PHYSIOPATHOLOGY
       Bronchoalveolar Lavage Fluid/MICROBIOLOGY  Forced Expiratory Volume
       Human  Male  Nebulizers and Vaporizers  Oxygen/BLOOD  Pneumonia,
       Pneumocystis carinii/*DIAGNOSIS/PHYSIOPATHOLOGY  Saline Solution,
       Hypertonic/DIAGNOSTIC USE  Sensitivity and Specificity  Spirometry
       Sputum/*MICROBIOLOGY  Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).