tailieunhanh - Novel method for sputum induction using the Lung Flute in patients with suspected pulmonary tuberculosis

Sputum examination is a key diagnostic procedure for patients suspected of having pulmonary TB, including those for whom bronchoscopy is In addition, early identification of persons with TB remains the most effective way of preventing TB transmission. However, some patients are unable to produce sputum for examination. In such cases, sputum induction by aerosol inhalation and/or gastric aspiration has been The Lung Flute (Medical Acoustics, Buffalo, NY, USA) is a small self-powered audio device that generates sound with a frequency of 18–22 Hz with an output of 110–115 dB using a pressure of cm H2O. This sound wave, when generated at the mouth by mild exhalation, travels back down the tracheobronchial tree. | SHORT COMMUNICATION Novel method for sputum induction using the Lung Flute in patients with suspected pulmonary tuberculosis Akira FUJITA KENGO MURATA AND Mikio TAKAMORI Department of Pulmonary Medicine Tokyo Metropolitan Fuchu Hospital Tokyo Japan ABSTRACT Background and objective The Lung Flute is a small self-powered audio device that generates sound waves which vibrate in tracheobronchial secretions. This was a preliminary trial to evaluate the usefulness of the Lung Flute for sputum sampling in patients suspected of pulmonary tuberculosis TB . Methods Thirty-four patients who were not expectorating sputum but for whom sputum examination was required for the differential diagnosis of TB or other diseases were enrolled in the study. Patients were instructed to blow out fast and hard through the Lung Flute and to repeat this for a total 20 sets of two blows each. Results Using the Lung Flute sputum samples were collected within 10 or 20 min from 30 of 34 patients 88 . The device permitted a rapid diagnosis of TB in seven of 15 confirmed TB cases. In three patients acidfast bacillus smears were positive. In four patients acid-fast bacillus smears were negative but PCR tests for TB were positive. Hyperventilation-related symptoms occurred in three patients. Conclusions The application of the Lung Flute may represent a promising technique for the rapid diagnosis of pulmonary TB. Key words audio device diagnosis polymerase chain reaction sputum induction tuberculosis. INTRODUCTION Tuberculosis TB is a major health problem in the Western Pacific region which accounts for about one- Correspondence Akira Fujita 2-9-2 Musashidai Fuchu-shi Tokyo 183-8524 Japan. Email akifuji@ Conflict of interest statement The authors did not receive research funding from Medical Acoustics LCC and Medical Acoustics LCC did not influence the outcome of studies or the results reported in this paper. Received 25 May 2008 invited to revise 9 June 2008 10 November 2008 .

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