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Schultz A, Balaguruswamy S, Dentice R, Dobler CC, Geake J, Gibson P, Goulter P, Jayaram L, Laird PJ, Middleton PG, Seale H. Thoracic Society of Australia and New Zealand position statement: The safe clinical use of sputum induction for bio-sampling of the lower airways in children and adults. Respirology 2024; 29:372-378. [PMID: 38556839 DOI: 10.1111/resp.14707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/11/2024] [Indexed: 04/02/2024]
Abstract
Sputum induction is widely used in clinical settings for collection of biological samples from the lower airways. However, in recent years sputum induction has been associated with serious adverse events and even death. This position statement was commissioned by the Thoracic Society of Australia and New Zealand to address major adverse events of two deaths associated with sputum induction that have occurred in Australia in 2021, and outlines best practice for the safe use of sputum induction. The statement resulted from systematic literature searches by a multi-disciplinary group including respiratory physicians, nurses and physiotherapists (paediatric and adults focused). Consumers had input to an advanced draft of the position statement. The position statement covers indications for sputum induction, informed consent, scope of practice of personnel administering the procedure, infection control considerations, details about the sputum induction procedure, safety considerations and risk assessment in clinical settings.
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Affiliation(s)
- André Schultz
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, Western Australia, Australia
- Division of Paediatrics, Faculty of Medicine, University of Western Australia, Perth, Western Australia, Australia
- Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Sathya Balaguruswamy
- Department of Respiratory and Sleep Medicine, Westmead Hospital, Sydney, New South Wales, Australia
| | - Ruth Dentice
- Department of Physiotherapy, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Claudia C Dobler
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
- Department of Respiratory Medicine, Liverpool Hospital, Sydney, New South Wales, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - James Geake
- Department of Thoracic and Sleep Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Peter Gibson
- Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, New Lambton Heights, New South Wales, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Patricia Goulter
- Physiotherapy Department, Te Whatu Ora (Health New Zealand), Wellington, New Zealand
| | - Lata Jayaram
- Department of Respiratory and Sleep Medicine, Western Health, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Victoria, Australia
| | - Pamela J Laird
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, Western Australia, Australia
- Division of Paediatrics, Faculty of Medicine, University of Western Australia, Perth, Western Australia, Australia
- Department Physiotherapy, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Peter G Middleton
- Westmead Clinical School, University of Sydney, Department of Respiratory and Sleep Medicine, Westmead Hospital, Sydney, New South Wales, Australia
- Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - Helen Seale
- Department of Physiotherapy, The Prince Charles Hospital, Brisbane, Queensland, Australia
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Laird PJ, Chang AB, Walker R, Barwick M, Whitby J, Cooper MN, Gill F, McKinnon E, Schultz A. Evaluation of the implementation and clinical effects of an intervention to improve medical follow-up and health outcomes for Aboriginal children hospitalised with chest infections. The Lancet Regional Health - Western Pacific 2023. [DOI: 10.1016/j.lanwpc.2023.100708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Laird PJ, Walker R, McCallum G, Toombs M, Barwick M, Morris P, Aitken R, Cooper M, Norman R, Patel B, Lau G, Chang AB, Schultz A. Change in health outcomes for First Nations children with chronic wet cough: rationale and study protocol for a multi-centre implementation science study. BMC Pulm Med 2022; 22:492. [PMID: 36581812 PMCID: PMC9798941 DOI: 10.1186/s12890-022-02219-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 11/02/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In children, chronic wet cough may be a sign of underlying lung disease, including protracted bacterial bronchitis (PBB) and bronchiectasis. Chronic (> 4 weeks in duration) wet cough (without indicators pointing to alternative causes) that responds to antibiotic treatment is diagnostic of PBB. Timely recognition and management of PBB can prevent disease progression to irreversible bronchiectasis with lifelong consequences. However, detection and management require timely health-seeking by carers and effective management by clinicians. We aim to improve (a) carer health-seeking for chronic wet cough in their child and (b) management of chronic wet cough in children by clinicians. We hypothesise that implementing a culturally integrated program, which is informed by barriers and facilitators identified by carers and health practitioners, will result in improved lung health of First Nations children, and in the future, a reduced the burden of bronchiectasis through the prevention of the progression of protracted bacterial bronchitis to bronchiectasis. METHODS This study is a multi-centre, pseudorandomised, stepped wedge design. The intervention is the implementation of a program. The program has two components: a knowledge dissemination component and an implementation component. The implementation is adapted to each study site using a combined Aboriginal Participatory Action Research and an Implementation Science approach, guided by the Consolidated Framework of Implementation Research. There are three categories of outcome measures related to (i) health (ii) cost, and (iii) implementation. We will measure health-seeking as the proportion of parents seeking help for their child in a 6-month period before the intervention and the same 6-month period (i.e., the same six calendar months) thereafter. The parent-proxy, Cough-specific Quality of Life (PC-QoL) will be the primary health-related outcome measure. DISCUSSION We hypothesise that a tailored intervention at each site will result in improved health-seeking for carers of children with a chronic wet cough and improved clinician management of chronic wet cough. In addition, we expect this will result in improved lung health outcomes for children with a chronic wet cough. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry; ACTRN12622000430730 , registered 16 March 2022, Retrospectively registered.
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Affiliation(s)
- Pamela J. Laird
- grid.414659.b0000 0000 8828 1230Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA Australia ,grid.410667.20000 0004 0625 8600Perth Children’s Hospital, Perth, WA Australia ,grid.1012.20000 0004 1936 7910Division of Paediatrics, Faculty of Medicine, University of Western Australia, Perth, Australia
| | - Roz Walker
- grid.1012.20000 0004 1936 7910School of Indigenous Studies, Poche Centre for Indigenous Health, University of Western Australia, Perth, WA Australia ,grid.1012.20000 0004 1936 7910School of Population Health, University of Western Australia, Perth, WA Australia ,grid.1025.60000 0004 0436 6763Ngangk Yira Institute for Change, Murdoch University, Perth Western, Australia
| | - Gabrielle McCallum
- grid.1043.60000 0001 2157 559XChild Health Division Menzies School of Health Research, Charles Darwin University, NT Darwin, Australia
| | - Maree Toombs
- grid.1003.20000 0000 9320 7537Faculty of Medicine, University of Queensland, Brisbane, QLD Australia
| | - Melanie Barwick
- grid.42327.300000 0004 0473 9646Hospital for Sick Children, Toronto, Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Peter Morris
- grid.1043.60000 0001 2157 559XChild Health Division Menzies School of Health Research, Charles Darwin University, NT Darwin, Australia
| | - Robyn Aitken
- grid.1043.60000 0001 2157 559XChild Health Division Menzies School of Health Research, Charles Darwin University, NT Darwin, Australia ,grid.1014.40000 0004 0367 2697College of Medicine and Public Health, Flinders University, Adelaide, SA Australia ,grid.1043.60000 0001 2157 559XCharles Darwin University College of Indigenous Future, Arts & Society, Darwin, NT Australia
| | - Matthew Cooper
- grid.414659.b0000 0000 8828 1230Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA Australia
| | - Richard Norman
- grid.1032.00000 0004 0375 4078School of Population Health, Curtin University, Perth, WA Australia
| | - Bhavini Patel
- Northern Territory Department of Health, Darwin, NT Australia
| | - Gloria Lau
- grid.414659.b0000 0000 8828 1230Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA Australia ,grid.410667.20000 0004 0625 8600Perth Children’s Hospital, Perth, WA Australia
| | - Anne B. Chang
- grid.1043.60000 0001 2157 559XChild Health Division Menzies School of Health Research, Charles Darwin University, NT Darwin, Australia ,grid.240562.7Department of Respiratory Medicine, Queensland Children’s Hospital, Brisbane, QLD Australia ,grid.1003.20000 0000 9320 7537Australian Centre For Health Services Innovation, Qld University of Technology, Brisbane, QLD Australia
| | - André Schultz
- grid.414659.b0000 0000 8828 1230Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA Australia ,grid.410667.20000 0004 0625 8600Perth Children’s Hospital, Perth, WA Australia ,grid.1012.20000 0004 1936 7910Division of Paediatrics, Faculty of Medicine, University of Western Australia, Perth, Australia
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