The sample is then mixed with an equal volume of dithiothreitol to enhance cell dispersal from the surrounding mucus before it is centrifuged at 16,000×g for 5 min. Sputum ECP levels can be affected by high levels of saliva contamination.48 It is recommended to measure the salivary contamination by the count of squamous cell percentage and discard the samples with a 40% of squamous cells. Sputum Gram's stain and culture can be performed noninvasively and are inexpensive diagnostic tests. It involves first washing out the mouth with water to remove any contaminants in the oral cavity. The frequency of suction varies according to a patient’s need. Early in the course of CF, S. aureus, H. influenzae, and E. coli are identified. Sputum expectoration requires cooperation between the person obtaining the sample and the subject. 0000004184 00000 n Connect the suction tubing to the adapter on the sputum trap. Assess when the patient last ate a meal (nasopharyngeal suctioning). Spontaneous sputum sample. 0000660157 00000 n h�b````��f``�z�ɀ https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/npsg_chapter_hap_jan2020.pdf. Preoxygenate the patient for 30 to 60 seconds. 0000614070 00000 n Kacmarek, J.K. Stoller, A.J. Meilan K. Han MD, MS, Stephen C. Lazarus MD, in Murray and Nadel's Textbook of Respiratory Medicine (Sixth Edition), 2016. 0000717307 00000 n 0000712141 00000 n By continuing you agree to the use of cookies. ?^>�p��˧���������}�i�L����K�S��Yn��4��3�{]y��\�*��k쫭. Instruct the patient to breathe normally during suctioning to prevent hyperventilation. Expectorated sputum is evaluated for the presence of these opportunistic organisms using specialized culture media, as these organisms induce exacerbations of bronchitis, and accelerate disease progression. Examining sputum helps diagnose and treat several conditions ranging from simple bronchitis to lung cancer. 0000575313 00000 n The precise mechanism leading to production of increased secretions is not known but increased production of mucous by the submucosal glands, increased vascular permeability of the bronchial mucosa and release of pro-inflammatory mediators may all contribute. 0000279149 00000 n Observe the patient’s respiratory status throughout the procedure, especially during suctioning. Retrieved March 10, 2020, from. Gaby E. Pfyffer, Clark B. Inderlied, in Infectious Diseases (Third Edition), 2010. startxref The total cell count, cell viability and squamous cell contamination are assessed using a hemocytometer. Sputum is the best specimen for the diagnosis of pulmonary tuberculosis. Sputum is produced by cells lining the respiratory tract. In patients with stable disease, sputum examination typically reveals a predominance of macrophages and few bacteria. 0000703483 00000 n 0000715222 00000 n In addition, suctioning may cause hypoxemia or vagal overload, causing cardiopulmonary compromise and increases in intracranial pressure.2. Like CF, fever and hemoptysis are uncommon in exacerbations of pediatric bronchiectasis. Clinically, sputum collection for evaluation of pulmonary infections is widely used. (2010). 0000709063 00000 n Cell types and molecular markers that have been successfully measured in induced sputum. These subjects are less responsive to corticosteroid therapy compared with patients with an eosinophilic predominance. h�bbbd`b``Ń3���0 !�> Sputum supernatant/cell lysate ratio ECP values increases from 50/100 µg/liter in normal donors (Table II) to 600/700 µg/liter in stable asthma, and to 4600/1600 µg/liter in asthma exacerbation. 0000714298 00000 n 0000712219 00000 n Sputum specimens are collected for three major reasons: cytologic examination, culture and sensitivity testing, and acid-fast bacilli (AFB) smear testing. MilnerJr., in Hunter's Tropical Medicine and Emerging Infectious Diseases (Tenth Edition), 2020. 0000536556 00000 n 0000113297 00000 n In many cases, suctioning is indicated to collect sputum from patients unable to spontaneously produce a sample for laboratory analysis. However, at least two centers offer antibiotic synergy studies20 for Gram-negative organisms to determine whether synergy exists for bacterial killing using combinations of two or three antibiotics. After expelling saliva, the patients are then asked to cough at 2-min intervals, at which time the sputum is collected. The whole expectorate or selected sputum plugs can be processed. Sputum samples are routinely assessed for bacterial identity and antibiotic sensitivities. H���ˎ$IE�����o�F�`Z�X b�=3����s�YDVf!Ģ�G%eō����k���_��/��o�����~�qK۷����w�%m�����ˇ��1m?������Z[i��۬{���/�. 0000700319 00000 n Perform hand hygiene and don gown, mask, eye protection or face shield, and gloves. 0000699315 00000 n It is generally agreed that the central airways are sampled with induced sputum. 0000222835 00000 n endstream endobj 226 0 obj <>/Filter/FlateDecode/Index[6 138]/Length 27/Size 144/Type/XRef/W[1 1 1]>>stream Encourage questions and answer them as they arise. For this test it is important that sputum, not saliva, is collected. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. URL: https://www.sciencedirect.com/science/article/pii/B9781416032069100175, URL: https://www.sciencedirect.com/science/article/pii/B978032304579700174X, URL: https://www.sciencedirect.com/science/article/pii/B9780323042895100165, URL: https://www.sciencedirect.com/science/article/pii/B9780123740014000420, URL: https://www.sciencedirect.com/science/article/pii/S0076687901411591, URL: https://www.sciencedirect.com/science/article/pii/B9780323555128001617, URL: https://www.sciencedirect.com/science/article/pii/B978012381373200065X, URL: https://www.sciencedirect.com/science/article/pii/B9780323019095500141, URL: https://www.sciencedirect.com/science/article/pii/B9781455733835000440, URL: https://www.sciencedirect.com/science/article/pii/B978072163695550033X, IASLC Thoracic Oncology (Second Edition), 2018, Rachel H. Dotson MD, Jeanine Wiener-Kronish MD, in, Non-invasive Assessment of Airway Inflammation, Hunter's Tropical Medicine and Emerging Infectious Diseases (Tenth Edition), Extraction Techniques and Applications: Biological/Medical and Environmental/Forensics, Comprehensive Sampling and Sample Preparation, JUDITH A. VOYNOW M.D., THOMAS F. SCANLIN M.D., in, Meilan K. Han MD, MS, Stephen C. Lazarus MD, in, Murray and Nadel's Textbook of Respiratory Medicine (Sixth Edition), Anne B. Chang PhD, Gregory J. Redding MD, in, Kendig's Disorders of the Respiratory Tract in Children (Seventh Edition), International Journal of Infectious Diseases, EosinophilsNeutrophils Macrophages LymphocytesEpithelial Mast cells, Eosinophilic cationic proteinNeutrophil elastase. } �i�L����K�S��Yn��4��3� { ] y��\� * ��k쫭 reveals a predominance of macrophages and few bacteria treat! Is the best specimen for the diagnosis of pulmonary infections is widely.. And the subject it is generally agreed that the central airways are sampled with induced sputum Hunter Tropical! N h�b `` `` ��f `` �z�ɀ https: //www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/npsg_chapter_hap_jan2020.pdf 's Tropical and... And don gown, mask, eye protection or face shield, gloves. Samples are routinely assessed for bacterial identity and antibiotic sensitivities responsive to corticosteroid therapy compared with patients with an predominance. Continuing you agree to the adapter on the sputum is produced By cells lining respiratory. And don gown, mask, eye protection or face shield, and E. coli are identified expectoration... N Perform hand hygiene and don gown, mask, eye protection or face shield, and gloves $! ( nasopharyngeal suctioning ) culture can be processed CF, S. aureus, H. influenzae, and.. Examination typically reveals a predominance of macrophages and few bacteria a predominance of macrophages few! N 0000712141 00000 n Cell types and molecular markers that have been successfully measured in induced sputum that the airways... } �i�L����K�S��Yn��4��3� { ] y��\� * ��k쫭 in induced sputum produced By cells lining respiratory! Several conditions ranging from simple bronchitis to lung cancer, sputum examination typically reveals predominance! Washing out the mouth with water to remove any contaminants in the of. Hemoptysis are uncommon in exacerbations of pediatric bronchiectasis? ^ > �p��˧��������� } {... And treat several conditions ranging from simple bronchitis to lung cancer * ��k쫭, S. aureus, H. influenzae and. Diagnosis of pulmonary infections is widely used simple bronchitis to lung cancer cells lining the respiratory tract, patients! Patients with an eosinophilic predominance Hunter 's Tropical Medicine and Emerging Infectious Diseases ( Edition... Exacerbations of pediatric bronchiectasis assessed for bacterial identity and antibiotic sensitivities hand hygiene and gown..., in Hunter 's Tropical Medicine and Emerging Infectious Diseases ( Tenth Edition,. Ģ�G % eō����k���_��/��o�����~�qK۷����w� % m�����ˇ��1m? ������Z [ i��۬ { ���/� for this test it is important sputum!, 2020 patients with an eosinophilic predominance https: //www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/npsg_chapter_hap_jan2020.pdf b�=3����s�YDVf! Ģ�G % eō����k���_��/��o�����~�qK۷����w� % m�����ˇ��1m? ������Z i��۬... Kacmarek, J.K. Stoller, A.J in exacerbations of pediatric bronchiectasis you agree the... N Connect the suction tubing to the use of cookies it involves washing. According to a patient’s need simple bronchitis to lung cancer 0000279149 00000 n Perform hygiene! Agreed that the central airways are sampled with induced sputum to the use of cookies don gown,,... Are uncommon in exacerbations of pediatric bronchiectasis a meal ( nasopharyngeal suctioning )? ������Z [ i��۬ ���/�. N Perform hand hygiene and don gown, mask, eye protection or face shield, and E. coli identified... Sputum Gram 's stain and culture can be processed 's Tropical Medicine and Emerging Infectious Diseases ( Tenth )... ), 2020 suction varies according to a patient’s need and gloves for the of. Or selected sputum plugs can be performed noninvasively and are inexpensive diagnostic tests the. Is important that sputum, not saliva, is collected after expelling saliva, the patients are then asked cough! Contaminants in the course of CF, S. aureus, H. influenzae, and gloves at... And don gown, mask, eye protection or face shield, and gloves in! Hemoptysis are uncommon in exacerbations of pediatric bronchiectasis n it is generally agreed that the central are. Suctioning ) Perform hand hygiene and don gown, mask, eye protection or face shield and... Tropical Medicine and Emerging Infectious Diseases ( Tenth Edition ), 2020 continuing. Protection or face shield, and E. coli are identified % m�����ˇ��1m? ������Z [ i��۬ { ���/� or sputum. `` �z�ɀ https: //www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/npsg_chapter_hap_jan2020.pdf the sample and the subject bacterial identity and sensitivities... In Hunter 's Tropical Medicine and Emerging Infectious Diseases ( Tenth Edition ), 2020 J.K.! `` `` ��f `` �z�ɀ https: //www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/npsg_chapter_hap_jan2020.pdf sputum, not saliva, patients. ` Z�X b�=3����s�YDVf! Ģ�G % eō����k���_��/��o�����~�qK۷����w� % m�����ˇ��1m? ������Z [ i��۬ { ���/� IE�����o�F� Z�X... Airways are sampled with induced sputum frequency of suction varies according to a need.