[Antibiotic therapy and effects of respiratory physiotherapy techniques in cystic fibrosis patients treated for acute lung exacerbations: an experimental study].

Abstract

INTRODUCTION:

Intravenous antibiotics in combination with intensive respiratory physiotherapy were evaluated for acute lung exacerbations in chronic infections of Pseudomonas aeruginosa in cystic fibrosis patients. Forced expiratory technique (FET) was assessed during hospital stay and discharge. The aim of this study was 1) to evaluate the immediate effects of FET and of 2) Intravenous antibiotics in combination with daily respiratory physiotherapy (IA+RPT) on parameters of lung function, body anthropometry and clinical scores of cystic fibrosis patients with acute lung exacerbation with chronic infection by Pseudomonas aeruginosa, during hospital stay and at hospital discharge after clearing the infection.

PATIENTS AND METHOD:

Eighteen patients between 7-28 years old were included in a prospective non-controlled clinical study. Body anthropometry values, Cystic Fibrosis Clinical Score (CFCS) exacerbation, Cystic Fibrosis Foundation Score (CFFS), and severity scores (SS) were evaluated before and after admission. Oxygen saturation (SpO(2)), heart (HR) and respiratory rate (RR) were evaluated before and after FET.

RESULTS:

CFCS (32.4+7.2) and CFFS (6.4+1.7) had decreased at hospital discharge for 18.9+3.3 and 0.3+0.5, respectively (p<0.001). IA+ RPT reduced RR means (p=0.003) and increased SpO(2) (p=0.006), forced expiration volume at 1min (FEV(1)) (p=0.021) and nutritional values (p=0.002). During admission, FET immediately improved HR (p=0.028), RR (p=0.001) and SpO(2) (p=0.015), despite significant maximum voluntary ventilation reduction (p=0.028); after the infection was treated the FET did not significantly alter parameters.

CONCLUSION:

IA+RPT improved clinical conditions of cystic fibrosis patients. FET improved cardiorespiratory variables of patients at risk for infection.

• Authors: Camila Isabel da Silva Santos, Maria Angela Gonçalves de Oliveira Ribeiro, André Moreno Morcillo, Antônio Fernando Ribeiro, José Dirceu Ribeiro
• Journal: Archivos de bronconeumologia (Arch Bronconeumol) Vol. 46 Issue 6 Pg. 310-6 (Jun 2010) ISSN: 1579-2129 [Electronic] Spain
• Vernacular Title: Efectos de la antibioterapia y la técnica fisioterápica respiratoria en pacientes con fibrosis quística tratados por exacerbación pulmonar aguda: estudio experimental.
• PMID: 20417019 (Publication Type: Journal Article)
• Copyright: 2009 SEPAR. Published by Elsevier Espana. All rights reserved.

Chemical References

• Anti-Bacterial Agents

Topics

• Acute Disease
• Adolescent
• Adult
• Anti-Bacterial Agents (therapeutic use)
• Child
• Chronic Disease
• Combined Modality Therapy
• Cystic Fibrosis (complications)
• Female
• Humans
• Lung Diseases (drug therapy, etiology, therapy)
• Male
• Prospective Studies
• Pseudomonas Infections (drug therapy, etiology, therapy)
• Pseudomonas aeruginosa
• Respiratory Therapy
• Young Adult