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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Intravenous antibiotics in combination with intensive respiratory physiotherapy were evaluated for acute lung exacerbations in chronic infections of <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> in cystic fibrosis patients&#46; Forced expiratory technique &#40;FET&#41; was assessed during hospital stay and discharge&#46; The aim of this study was 1&#41; to evaluate the immediate effects of FET and of 2&#41; Intravenous antibiotics in combination with daily respiratory physiotherapy &#40;IA&#43;RPT&#41; on parameters of lung function&#44; body anthropometry and clinical scores of cystic fibrosis patients with acute lung exacerbation with chronic infection by <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>&#44; during hospital stay and at hospital discharge after clearing the infection&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Patients and method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Eighteen patients between 7&#8211;28 years old were included in a prospective non-controlled clinical study&#46; Body anthropometry values&#44; Cystic Fibrosis Clinical Score &#40;CFCS&#41; exacerbation&#44; Cystic Fibrosis Foundation Score &#40;CFFS&#41;&#44; and severity scores &#40;SS&#41; were evaluated before and after admission&#46; Oxygen saturation &#40;SpO<span class="elsevierStyleInf">2</span>&#41;&#44; heart &#40;HR&#41; and respiratory rate &#40;RR&#41; were evaluated before and after FET&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">CFCS &#40;32&#46;4&#43;7&#46;2&#41; and CFFS &#40;6&#46;4&#43;1&#46;7&#41; had decreased at hospital discharge for 18&#46;9&#43;3&#46;3 and 0&#46;3&#43;0&#46;5&#44; respectively &#40;p &#60; 0&#46;001&#41;&#46; IA&#43; RPT reduced RR means &#40;p &#61; 0&#46;003&#41; and increased SpO<span class="elsevierStyleInf">2</span> &#40;p &#61; 0&#46;006&#41;&#44; forced expiration volume at 1 min &#40;FEV<span class="elsevierStyleInf">1</span>&#41; &#40;p &#61; 0&#46;021&#41; and nutritional values &#40;p &#61; 0&#46;002&#41;&#46; During admission&#44; FET immediately improved HR &#40;p &#61; 0&#46;028&#41;&#44; RR &#40;p &#61; 0&#46;001&#41; and SpO<span class="elsevierStyleInf">2</span> &#40;p &#61; 0&#46;015&#41;&#44; despite significant maximum voluntary ventilation reduction &#40;p &#61; 0&#46;028&#41;&#59; after the infection was treated the FET did not significantly alter parameters&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">IA&#43;RPT improved clinical conditions of cystic fibrosis patients&#46; FET improved cardiorespiratory variables of patients at risk for infection&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se evalu&#243; el tratamiento con antibi&#243;ticos intravenosos en combinaci&#243;n con la fisioterapia respiratoria intensiva para las exacerbaciones pulmonares agudas de las infecciones cr&#243;nicas por <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> en pacientes con fibrosis qu&#237;stica&#46; Durante la hospitalizaci&#243;n y el alta se evalu&#243; la t&#233;cnica de espiraci&#243;n forzada &#40;TEF&#41;&#46; El objetivo de este estudio fue 1&#41; valorar los efectos inmediatos de la TEF y de 2&#41; los antibi&#243;ticos intravenosos combinados con la fisioterapia respiratoria diaria &#40;AI&#43;FTR&#41; sobre los par&#225;metros de funci&#243;n pulmonar&#44; antropometr&#237;a corporal y puntuaciones cl&#237;nicas de pacientes con fibrosis qu&#237;stica y exacerbaciones pulmonares agudas de una infecci&#243;n cr&#243;nica por <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> en la hospitalizaci&#243;n y el momento del alta hospitalaria tras remisi&#243;n de la infecci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En un estudio cl&#237;nico prospectivo&#44; no controlado&#44; se incluyeron 18 pacientes&#44; de 7-28 a&#241;os de edad&#46; Antes y despu&#233;s de la hospitalizaci&#243;n se evaluaron los valores antropom&#233;tricos corporales&#44; exacerbaci&#243;n de la puntuaci&#243;n Cystic Fibrosis Clinical Score&#44; Cystic Fibrosis Foundation Score y puntuaciones de gravedad &#40;PG&#41;&#46; Antes y despu&#233;s de la TEF&#44; se evaluaron la saturaci&#243;n de ox&#237;geno &#40;SpO<span class="elsevierStyleInf">2</span>&#41;&#44; FC y FR&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">En el momento del alta hospitalaria&#44; la Cystic Fibrosis Clinical Score &#40;32&#44;4 &#43; 7&#44;2&#41; y Cystic Fibrosis Foundation Score &#40;6&#44;4 &#43; 1&#44;7&#41; hab&#237;an disminuido 18&#44;9 &#43; 3&#44;3 y 0&#44;3 &#43; 0&#44;5&#44; respectivamente &#40;p &#60; 0&#44;001&#41;&#46; La AI&#43;FTR redujo la FR media &#40;p &#61; 0&#44;003&#41; y aument&#243; la SpO2 &#40;p &#61; 0&#44;006&#41;&#44; el volumen espiratorio forzado en el primer segundo &#40;p &#61; 0&#44;021&#41; y los valores nutricionales &#40;p &#61; 0&#44;002&#41;&#46; En el momento de la hospitalizaci&#243;n&#44; la TEF mejor&#243; de inmediato la FC &#40;p &#61; 0&#44;028&#41;&#44; FR &#40;p &#61; 0&#44;001&#41; y la SpO<span class="elsevierStyleInf">2</span> &#40;p &#61; 0&#44;015&#41;&#44; a pesar de un reducci&#243;n significativa de la ventilaci&#243;n voluntaria m&#225;xima &#40;p &#61; 0&#44;028&#41;&#59; tras la remisi&#243;n de la infecci&#243;n&#44; la TEF no alter&#243; significativamente los par&#225;metros&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La AI&#43;FTR mejor&#243; el estado cl&#237;nico de los pacientes con fibrosis qu&#237;stica&#46; La TEF mejor&#243; las variables cardiorrespiratorias de los pacientes con riesgo de infecci&#243;n&#46;</p>"
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Journal Information
Vol. 46. Issue 6.
Pages 310-316 (June 2010)
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Vol. 46. Issue 6.
Pages 310-316 (June 2010)
Original Article
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Antibiotic therapy and Effects of Respiratory Physiotherapy Techniques Cystic Fibrosis Patients Treated for Acute Lung Exacerbation: an Experimental Study
Efectos de la antibioterapia y la técnica fisioterápica respiratoria en pacientes con fibrosis quística tratados por exacerbación pulmonar aguda: estudio experimental
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Camila Isabel da Silva Santosa,
Corresponding author
, Maria Angela Gonçalves de Oliveira Ribeirob, André Moreno Morcilloc, Antônio Fernando Ribeiroc, José Dirceu Ribeiroc
a Paediatric Physiotherapy Service of Faculty of Medical Sciences, University of Campinas (UNICAMP) de São Paulo (SP), State University of Santa Catarina (UDESC) (SC), Brazil
b Paediatric Physiotherapy Service, Center for Pediatric Research (CIPED) of Faculty of Medical Sciences, University of Campinas (UNICAMP) de São Paulo (SP), State University of Santa Catarina (UDESC) (SC), Brazil
c Department of Pediatrics/CIPED of Faculty of Medical Sciences, University of Campinas (UNICAMP) de São Paulo (SP), State University of Santa Catarina (UDESC) (SC), Brazil
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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 (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.

Keywords:
Cystic fibrosis
Paediatric
Chest physiotherapy
Pseudomonas aeruginosa
Resumen
Introducción

Se evaluó el tratamiento con antibióticos intravenosos en combinación con la fisioterapia respiratoria intensiva para las exacerbaciones pulmonares agudas de las infecciones crónicas por Pseudomonas aeruginosa en pacientes con fibrosis quística. Durante la hospitalización y el alta se evaluó la técnica de espiración forzada (TEF). El objetivo de este estudio fue 1) valorar los efectos inmediatos de la TEF y de 2) los antibióticos intravenosos combinados con la fisioterapia respiratoria diaria (AI+FTR) sobre los parámetros de función pulmonar, antropometría corporal y puntuaciones clínicas de pacientes con fibrosis quística y exacerbaciones pulmonares agudas de una infección crónica por Pseudomonas aeruginosa en la hospitalización y el momento del alta hospitalaria tras remisión de la infección.

Pacientes y métodos

En un estudio clínico prospectivo, no controlado, se incluyeron 18 pacientes, de 7-28 años de edad. Antes y después de la hospitalización se evaluaron los valores antropométricos corporales, exacerbación de la puntuación Cystic Fibrosis Clinical Score, Cystic Fibrosis Foundation Score y puntuaciones de gravedad (PG). Antes y después de la TEF, se evaluaron la saturación de oxígeno (SpO2), FC y FR.

Resultados

En el momento del alta hospitalaria, la Cystic Fibrosis Clinical Score (32,4 + 7,2) y Cystic Fibrosis Foundation Score (6,4 + 1,7) habían disminuido 18,9 + 3,3 y 0,3 + 0,5, respectivamente (p < 0,001). La AI+FTR redujo la FR media (p = 0,003) y aumentó la SpO2 (p = 0,006), el volumen espiratorio forzado en el primer segundo (p = 0,021) y los valores nutricionales (p = 0,002). En el momento de la hospitalización, la TEF mejoró de inmediato la FC (p = 0,028), FR (p = 0,001) y la SpO2 (p = 0,015), a pesar de un reducción significativa de la ventilación voluntaria máxima (p = 0,028); tras la remisión de la infección, la TEF no alteró significativamente los parámetros.

Conclusión

La AI+FTR mejoró el estado clínico de los pacientes con fibrosis quística. La TEF mejoró las variables cardiorrespiratorias de los pacientes con riesgo de infección.

Palabras clave:
Fibrosis quística
Pediátrico
Fisioterapia torácica
Pseudomonas aeruginosa
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