Antibiotic Therapy and Effects of Respiratory Physiotherapy Techniques in Cystic Fibrosis Patients Treated for Acute Lung Exacerbations: an Experimental Study

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 CH'S (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 1 min (FEV1) (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 FEE. 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. (C) 2009 SEPAR. Published by Elsevier Espana, S.L. All rights reserved.