The Effect of Outpatient Management of Cystic Fibrosis Exacerbation on Pulmonary Function Tests: A Clinical Trial

Background: Cystic fibrosis (CF) is an inherited disease which involves multiple organs including respiratory tract. It results in chronic respiratory signs and symptoms which exacerbate with frequent lung infections. The majority of exacerbations require hospitalization and intravenous antibiotic therapy as part of the management. The aim of this survey was to study the effectiveness of outpatient management of pulmonary exacerbations on pulmonary function tests. Methods: This randomized clinical trial included all CF patients older than 6 years old who presented with a pulmonary exacerbation and were able to perform Spirometric tests. All eligible CF patients first referred to pulmonary function tests center to determine forced expiratory volume in the first second (FEV1), residual volume (RV), total lung capacity (TLC) and airway specific resistance (SRaw). Then, they were treated outpatiently for 2 to 4 weeks and after that, they underwent all the tests again; and the participants' improvements in pulmonary function tests after outpatient treatment were investigated. Result: In this study, 32 patients were enrolled including 13 women (40.6%) and 19 men (59.4%). Mean and standard deviation (SD) of pulmonary variable, before and after the treatment were investigated. All of them were statistically significant. Sub-analysis of data based on gender was also performed showing that outpatient treatment led to significant improvements in all of the variables except for the percentage of RV in females (p value = 0.08). Conclusion: The findings revealed that outpatient management of CF exacerbations effectively improved values of FEV1, SRaw and TLC along with reducing RV values and air trapping. Thus, applying this method on appropriately selected CF patients, may prevent unnecessary hospitalization and subsequent disadvantages.