Changes in Pulmonary Function and Controlled Ventilation-High Resolution CT of Chest After Antibiotic Therapy in Infants and Young Children with Cystic Fibrosis.

Abstract

BACKGROUND:

Infants with cystic fibrosis (CF) develop early progressive lung disease which may be asymptomatic. Infant pulmonary function tests (IPFT) and controlled ventilation-high resolution computed tomography (CV-HRCT) of chest can detect early asymptomatic lung disease. It is not well established that these objective measures can detect changes in lung disease after clinical interventions.

OBJECTIVE:

The purpose of this study was to evaluate usefulness of IPFT and CV-HRCT to detect changes in lung disease after intravenous (IV) antibiotic therapy in infants with early CF-related lung disease.

STUDY DESIGN:

IPFTs and CV-HRCT done before and after 2 weeks of IV antibiotics in infants at our institution over the last 12 years were compared. CV-HRCTs were compared using the modified Brody scoring system.

RESULTS:

The sample included 21 infants, mean age 85.2 ± 47.6 weeks. Mean change in weight was 0.4 ± 0.38 kg (p = 0.001). Significant changes in IPFT included mean % predicted FEV(0.5) (+13.5 %, p = 0.043), mean %FEF(25-75) (+30.2 %, p = 0.008), mean %RV/TLC (-11.2 %, p = 0.008), and mean %FRC/TLC (-4.5 %, p = 0.001). Total Brody scores improved from a median of 10 to 5 (p < 0.001) as did mean scores for airway wall thickening (p = 0.050), air trapping (p < 0.001), and parenchymal opacities (p = 0.003).

CONCLUSION:

IPFT and CV-HRCT can be used as objective measures of improvement in lung disease for infants with CF treated with antibiotics.

• Authors: Shahid I Sheikh, Frederick R Long, Robert Flucke, Nancy A Ryan-Wenger, Don Hayes Jr, Karen S McCoy
• Journal: Lung (Lung) Vol. 193 Issue 3 Pg. 421-8 (Jun 2015) ISSN: 1432-1750 [Electronic] United States
• PMID: 25762451 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents

Topics

• Administration, Intravenous
• Age Factors
• Anti-Bacterial Agents (administration & dosage)
• Child, Preschool
• Cystic Fibrosis (diagnostic imaging, drug therapy, microbiology, physiopathology)
• Early Diagnosis
• Female
• Humans
• Infant
• Lung (diagnostic imaging, drug effects, microbiology, physiopathology)
• Male
• Ohio
• Predictive Value of Tests
• Recovery of Function
• Respiration, Artificial (methods)
• Respiratory Function Tests
• Respiratory Mechanics
• Respiratory Tract Infections (diagnostic imaging, drug therapy, microbiology, physiopathology)
• Retrospective Studies
• Tomography, Spiral Computed (methods)
• Treatment Outcome