Efectos de la antibioterapia y la técnica fisioterápica respiratoria en pacientes con fibrosis quística tratados por exacerbación pulmonar aguda: estudio experimental

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 (SpO₂), 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 SpO₂ (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 SpO₂ (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.