[Early detection of exacerbation of lung infections in patients with cystic fibrosis by means of daily spirometry].
The clinical course of cystic fibrosis is characterised by pulmonary involvement with mucus retention, chronic pulmonary infection and parenchymal inflammation. Recurrent infectious exacerbations are usually accompanied by a fall in lung volumes. This pilot study investigated whether exacerbations can be detected early by daily spirometry. Ten patients with cystic fibrosis (5 female; 5 male; mean age 24.9 years) performed daily spirometry using a portable transtelephonic spirometer (Spirophone). Infectious exacerbations were diagnosed on clinical grounds and treated without knowledge of the spirometry results. Data of 9 patients recorded over a period of 5-11 months were analysed. One patient was excluded due to non-compliance. A total of 20 infectious exacerbations occurred during the observation period. A fall of at least 20% in one or more of the following parameters was observed in 90% (18/20) of exacerbations: FVC, FEV1, PEF, and FEF25/75. A daily drop in lung volumes of 0.7% to 1.2% was recorded beginning at a median of 33 (20 to 120) days before infectious exacerbations were diagnosed. There was a 2-3% daily improvement in spirometric data under treatment with antibiotics.


CONCLUSIONS
Daily spirometry allows early recognition of pulmonary infectious exacerbations in patients with cystic fibrosis. Daily spirometry may be used as an indicator for early antibiotic treatment.
Izbicki
G
G
Abteilung für Pneumologie, Universitätsspital Basel.
Trachsel
D
D
Rutishauser
M
M
Perruchoud
A P
AP
Tamm
M
M
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000175:diagnosis / Q000503:physiopathology*; D003550:Cystic Fibrosis / Q000150:complications* / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000382:microbiology* / Q000503:physiopathology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D010865:Pilot Projects; D012648:Self Care; D013147:Spirometry / Q000379:methods*