Randomized trial of physiotherapy and hypertonic saline techniques for sputum induction in asthmatic children and adolescents

Authors

  • Egberto Luiz Felicio-Júnior Hospital do Servidor Publico do Estado de Sao Paulo
  • Viviani Barnabe Hospital do Servidor Publico do Estado de Sao Paulo
  • Francine Maria de Almeida Universidade de Sao Paulo, Faculdade de Medicina
  • Monise Dematte Avona Universidade Cidade de Sao Paulo
  • Isabella Santos de Genaro Hospital do Servidor Publico do Estado de Sao Paulo
  • Adriana Kurdejak Universidade Cidade de Sao Paulo
  • Miriam Cardoso Neves Eller Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas
  • Karina Pierantozzi Verganid Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas
  • Joaquim Carlos Rodrigues Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas
  • Iolanda de Fatíma Lopes Calvo Tibério Universidade de São Paulo, Faculdade de Medicina
  • Milton de Arruda Martins Universidade de São Paulo, Faculdade de Medicina
  • Beatriz Mangueira Saraiva-Romanholo Hospital do Servidor Publico do Estado de Sao Paulo https://orcid.org/0000-0003-0853-9708

DOI:

https://doi.org/10.6061/clinics/2020/e1512

Keywords:

Asthma, Children, Hypertonic Saline Solution, Sputum Induction, Physical Therapy Techniques

Abstract

OBJECTIVES: This study aimed to analyze the efficiency of physiotherapy techniques in sputum induction and in the evaluation of pulmonary inflammation in asthmatic children and adolescents. Although hypertonic saline (HS) is widely used for sputum induction (SI), specific techniques and maneuvers of physiotherapy (P) may facilitate the collection of mucus in some asthmatic children and adolescents. METHODS: A randomized crossover study was performed in patients with well-controlled asthma, and 90 sputum samples were collected. Children and adolescents were assessed using spirometry and randomized at entry into one of three sputum induction techniques: (i) 3% hypertonic saline – HS technique; (ii) physiotherapy (oscillatory positive expiratory pressure, forced expiration, and acceleration of expiratory flow) – P technique; and (iii) hypertonic saline + physiotherapy – HSP technique. ClinicalTrials.gov: NCT03136042. RESULTS: The total cells (mL) and the percentage (%) of differential inflammatory cells were similar in all techniques. The sputum weight (g) in the HSP technique was significantly higher than that in the HS technique. In all techniques, the percentage of viable cells was 450%, and there was no difference between the HS and P techniques. Moreover, sputum induction did not cause any alterations in the pulmonary function of patients. CONCLUSION: The physiotherapy sputum collection technique was effective in obtaining viable cells from mucus samples and yielded the same amount of sputum as the gold standard technique (hypertonic saline). In addition, the physiotherapy maneuvers were both safe and useful for sputum induction in asthmatic children and adolescents with well-controlled asthma.

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Published

2020-02-28

How to Cite

Felicio-Júnior, E. L., Barnabe, V., Almeida, F. M. de, Avona, M. D., Genaro, I. S. de, Kurdejak, A., Eller, M. C. N., Verganid, K. P., Rodrigues, J. C., Tibério, I. de F. L. C., Martins, M. de A., & Saraiva-Romanholo, B. M. (2020). Randomized trial of physiotherapy and hypertonic saline techniques for sputum induction in asthmatic children and adolescents. Clinics, 75, e1512. https://doi.org/10.6061/clinics/2020/e1512

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Section

Original Articles