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Distress during airway sampling in children with cystic fibrosis
  1. Jun Ting Chau1,
  2. Karen Peebles1,
  3. Yvonne Belessis2,3,
  4. Adam Jaffe2,3,
  5. Michael Doumit2,3
  1. 1 Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
  2. 2 Department of Respiratory Medicine, Sydney Children’s Hospital Randwick, Sydney, New South Wales, Australia
  3. 3 School of Women’s and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Michael Doumit, Department of Respiratory Medicine, Sydney Children’s Hospital Randwick, Sydney, NSW 2031, Australia; michael.doumit{at}


Background Oropharyngeal suction and oropharyngeal swab are two methods of obtaining airway samples with similar diagnostic accuracy in children with cystic fibrosis (CF). The primary aim was comparing distress between suctioning and swabbing. A secondary aim was establishing the reliability of the Groningen Distress Rating Scale (GDRS).

Methods Randomised oropharyngeal suction or swab occurred over two visits. Two physiotherapists and the child’s parent rated distress using the GDRS. Heart rate (HR) was also measured.

Results 24 children with CF, mean age of 3 years, participated. Both physiotherapist and parent rating showed significantly higher distress levels during suction than swab. Inter-rater reliability for the GDRS was very good between physiotherapists, and good between physiotherapist and parents.

Conclusion The study found that oropharyngeal swab is less distressing in obtaining samples than oropharyngeal suction and that the GDRS was reliable and valid.

  • paediatric
  • oropharyngeal
  • suction
  • swab
  • sputum

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  • Contributors Study design and planning, application for ethics approval, participant recruitment: YB, AJ, MD. Data collection (hear rate, distress rating, airway sampling): MD, JTC. Statistical analysis and interpretation: JTC under the guidance from MD and KP. Composition of manuscript: JTC under the guidance of MD and KP, further reviewed by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Sydney Children’s Hospitals Network Human Research Ethics Committee (HREC reference LNR/14/SCHN/385).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Complete data set from this study is encrypted and stored within the Sydney Children’s Hospital’s password-protected drives. Identifiable information from the main data set was removed for blinding but to also further privacy, confidentiality and security. Hard copies of data are locked in filing cabinets in the Physiotherapy Department offices that require a swipe car access. The data will be stored for a minimum of 5 years from date of publication as per recommendations by the National Health and Medical Research Council. Unpublished data include timings of procedures, patient and probe positioning and microbiological yield from samples obtained.

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