nach oben

Lung

Erschienen in:

01.10.2011

Improved Outcomes of Patients with End-stage Cystic Fibrosis Requiring Invasive Mechanical Ventilation for Acute Respiratory Failure

verfasst von: Don Hayes Jr., Heidi M. Mansour

Erschienen in: Lung | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Study Objectives

The aim of this study was to determine the effects of an antibiotic strategy with intravenous (IV) continuous infusion of a β-lactam (CIBL) antibiotic and high-dose extended-interval (HDEI) tobramycin upon outcomes in patients with cystic fibrosis (CF) requiring invasive mechanical ventilation (IMV) for acute respiratory failure.

Design

The study was a retrospective review from June 1, 2006, to December 1, 2010, of patients at a university hospital with an adult CF center.

Results

The study population included adult CF patients requiring IMV. A total of 15 hospitalizations with IMV episodes were reviewed, involving 10 adult (31.4 ± 11.1 years) CF patients with end-stage lung disease (FEV₁ = 23.6 ± 7.8% predicted) and malnutrition (body mass index = 20.5 ± 3.1). Each patient survived to discharge and to follow-up 6 months later without the need for lung transplantation during the study period.

Conclusions

A novel antibiotic strategy with a CIBL antibiotic and HDEI tobramycin improved survival in a small cohort of critically ill CF patients with end-stage lung disease and malnutrition requiring IMV.

Boat TF, Cheng PW (1989) Epithelial cell dysfunction in cystic fibrosis: implications for airways disease. Acta Paediatr Scand Suppl 363:25–29; discussion 29–30PubMed

Matsui H, Randell SH, Peretti SW, Davis CW, Boucher RC (1998) Coordinated clearance of periciliary liquid and mucus from airway surfaces. J Clin Invest 102(6):1125–1131PubMedCrossRef

Puchelle E, Bajolet O, Abély M (2002) Airway mucus in cystic fibrosis. Paediatr Respir Rev 3:115–119PubMedCrossRef

Ulrich M, Worlitzsch D, Viglio S et al (2010) Alveolar inflammation in cystic fibrosis. J Cyst Fibros 9:217–227PubMedCrossRef

Davis PB (1999) Clinical pathophysiology and manifestations of lung disease. In: Yankaskas JR, Knowles MR (eds) Cystic fibrosis in adults, 1st edn. Lippincott-Raven, Philadelphia, pp 45–67

Davis PB, di Sant’Agnese PA (1974) Assisted ventilation for patients with cystic fibrosis. JAMA 239:1851–1854CrossRef

Lloyd-Still JD, Khaw KT, Shwachman H (1974) Severe respiratory disease in infants with cystic fibrosis. Pediatrics 53:678–682PubMed

Garland JS, Chan YM, Kelly KJ, Rice TB (1989) Outcome of infants with cystic fibrosis requiring mechanical ventilation for respiratory failure. Chest 96:136–138PubMedCrossRef

Sood N, Paradowski LJ, Yankaskas JR (2001) Outcomes of intensive care unit care in adults with cystic fibrosis. Am J Respir Crit Care Med 163:335–338PubMed

10.

Berlinski A, Fan LL, Kozinetz CA, Oermann CM (2002) Invasive mechanical ventilation for acute respiratory failure in children with cystic fibrosis: outcome analysis and case-control study. Pediatr Pulmonol 34:297–303PubMedCrossRef

11.

Vedam H, Moriarty C, Torzillo PJ, McWilliam D, Bye PT (2004) Improved outcomes of patients with cystic fibrosis admitted to the intensive care unit. J Cyst Fibros 3:8–14PubMedCrossRef

12.

Slieker MG, van Gestel JP, Heijerman HG et al (2006) Outcome of assisted ventilation for acute respiratory failure in cystic fibrosis. Intensive Care Med 32:754–758PubMedCrossRef

13.

Rosenstein BJ, Cutting GR (1998) The diagnosis of cystic fibrosis: a consensus statement. Cystic Fibrosis Foundation Consensus Panel. J Pediatr 132:589–595PubMedCrossRef

14.

Padoan R, Cambisano W, Costantini D et al (1987) Ceftazidime monotherapy vs. combined therapy in Pseudomonas pulmonary infections in cystic fibrosis. Pediatr Infect Dis J 6:648–653PubMedCrossRef

15.

Leeder JS, Spino M, Isles AF, Tesoro AM, Gold R, MacLeod SM (1984) Ceftazidime disposition in acute and stable cystic fibrosis. Clin Pharmacol Ther 36:355–362PubMedCrossRef

16.

Rappaz I, Decosterd LA, Bille J, Pilet M, Bélaz N, Roulet M (2000) Continuous infusion of ceftazidime with a portable pump is as effective as thrice-a-day bolus in cystic fibrosis children. Eur J Pediatr 159:919–925PubMedCrossRef

17.

Roosendaal R, Bakker-Woudenberg IA, Van den Berghe Van-Raffe M, Vink-van den Berg JC, Michel BM (1989) Impact of the dosage schedule on the efficacy of ceftazidime, gentamicin and ciprofloxacin in Klebsiella pneumoniae pneumonia and septicemia in leukopenic rats. Eur J Clin Microbiol Infect Dis 8:878–887PubMedCrossRef

18.

Craig WA, Ebert SC (1992) Continuous infusion of beta-lactam antibiotics. Antimicrob Agents Chemother 36:2577–2583PubMed

19.

Daenen S, Erjavec Z, Uges DR, De Vries-Hospers HG, De Jonge P, Halie MR (1995) Continuous infusion of ceftazidime in febrile neutropenic patients with acute myeloid leukemia. Eur J Clin Microbiol Infect Dis 14:188–192PubMedCrossRef

20.

Nicolau DP, Nightingale CH, Banevicius MA, Fu Q, Quintiliani R (1996) Serum bactericidal activity of ceftazidime: continuous infusion versus intermittent injections. Antimicrob Agents Chemother 40:61–64PubMed

21.

Vogelman B, Craig WA (1986) Kinetics of antimicrobial activity. J Pediatr 108(5 Pt 2):835–840PubMed

22.

Vondracek TG (1995) Beta-lactam antibiotics: is continuous infusion the preferred method of administration? Ann Pharmacother 29:415–424PubMed

23.

Rafati MR, Rouini MR, Mojtahedzadeh M et al (2006) Clinical efficacy of continuous infusion of piperacillin compared with intermittent dosing in septic critically ill patients. Int J Antimicrob Agents 28:122–127PubMedCrossRef

24.

Lau WK, Mercer D, Itani KM et al (2006) Randomized, open-label, comparative study of piperacillin-tazobactam administered by continuous infusion versus intermittent infusion for treatment of hospitalized patients with complicated intra-abdominal infection. Antimicrob Agents Chemother 50:3556–3561PubMedCrossRef

25.

Roberts JA, Paratz J, Paratz E, Krueger WA, Lipman J (2007) Continuous infusion of beta-lactam antibiotics in severe infections: a review of its role. Int J Antimicrob Agents 30:11–18PubMedCrossRef

26.

Roberts JA, Webb S, Paterson D, Ho KM, Lipman J (2009) A systematic review on clinical benefits of continuous administration of beta-lactam antibiotics. Crit Care Med 37:2071–2078PubMedCrossRef

27.

Riethmueller J, Junge S, Schroeter TW et al (2009) Continuous vs thrice-daily ceftazidime for elective intravenous antipseudomonal therapy in cystic fibrosis. Infection 37:418–423PubMedCrossRef

28.

Hubert D, Le Roux E, Lavrut T et al (2009) Continuous versus intermittent infusions of ceftazidime for treating exacerbation of cystic fibrosis. Antimicrob Agents Chemother 53:3650–3656PubMedCrossRef

29.

Paradisi F, Corti G (1995) Once-daily dosing regimen for aminoglycoside plus betalactam combination therapy of serious lower respiratory tract infections. J Chemother 7:338–343PubMed

30.

Powell SH, Thompson WL, Luthe MA et al (1983) Once-daily vs. continuous aminoglycoside dosing: efficacy and toxicity in animal and clinical studies of gentamicin, netilmicin, and tobramycin. J Infect Dis 147:918–932PubMedCrossRef

31.

Bates RD, Nahata MC, Jones JW et al (1997) Pharmacokinetics and safety of tobramycin after once-daily administration in patients with cystic fibrosis. Chest 112:1208–1213PubMedCrossRef

32.

Bragonier R, Brown NM (1998) The pharmacokinetics and toxicity of once-daily tobramycin therapy in children with cystic fibrosis. J Antimicrob Chemother 42:103–106PubMedCrossRef

33.

Vic P, Ategbo S, Turck D et al (1998) Efficacy, tolerance, and pharmacokinetics of once daily tobramycin for pseudomonas exacerbations in cystic fibrosis. Arch Dis Child 78:536–539PubMedCrossRef

34.

Aminimanizani A, Beringer PM, Kang J, Tsang L, Jelliffe RW, Shapiro BJ (2002) Distribution and elimination of tobramycin administered in single or multiple daily doses in adult patients with cystic fibrosis. J Antimicrob Chemother 50:553–559PubMedCrossRef

35.

Smyth A, Tan KH, Hyman-Taylor P et al (2005) Once versus three-times daily regimens of tobramycin treatment for pulmonary exacerbations of cystic fibrosis–the TOPIC study: a randomised controlled trial. Lancet 365:573–578PubMed

36.

Riethmueller J, Ballmann M, Schroeter TW et al (2009) Tobramycin once- vs thrice-daily for elective intravenous antipseudomonal therapy in pediatric cystic fibrosis patients. Infection 37:424–431PubMedCrossRef

37.

Burkhardt O, Lehmann C, Madabushi R, Kumar V, Derendorf H, Welte T (2006) Once-daily tobramycin in cystic fibrosis: better for clinical outcome than thrice-daily tobramycin but more resistance development? J Antimicrob Chemother 58:822–829PubMedCrossRef

38.

Soulsby N, Bell S, Greville H, Doecke C (2009) Intravenous aminoglycoside usage and monitoring of patients with cystic fibrosis in Australia. What’s new? Intern Med J 39:527–531PubMedCrossRef

39.

Prescott WA Jr, Nagel JL (2010) Extended-interval once-daily dosing of aminoglycosides in adult and pediatric patients with cystic fibrosis. Pharmacotherapy 30:95–108PubMedCrossRef

40.

Contopoulos-Ioannidis DG, Giotis ND, Baliatsa DV, Ioannidis JP (2004) Extended-interval aminoglycoside administration for children: a meta-analysis. Pediatrics 114:e111–e118PubMedCrossRef

41.

Smyth AR, Bhatt J (2010) Once-daily versus multiple-daily dosing with intravenous aminoglycosides for cystic fibrosis. Cochrane Database Syst Rev (1):CD002009

42.

Flume PA, Mogayzel PJ Jr, Robinson KA et al (2009) Cystic fibrosis pulmonary guidelines: treatment of pulmonary exacerbations. Am J Respir Crit Care Med 180:802–808PubMedCrossRef

Titel: Improved Outcomes of Patients with End-stage Cystic Fibrosis Requiring Invasive Mechanical Ventilation for Acute Respiratory Failure
verfasst von: Don Hayes Jr.
Heidi M. Mansour
Publikationsdatum: 01.10.2011
Verlag: Springer-Verlag
Erschienen in: Lung / Ausgabe 5/2011
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI: https://doi.org/10.1007/s00408-011-9311-6

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Study Objectives

Design

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2011

Bilateral Multiple Inflammatory Myofibroblastic Tumors of the Lung Successfully Treated with Corticosteroids

Comparison Between Cardiopulmonary Exercise Testing Parameters and Computed Tomography Findings in Patients with Thoracic Sarcoidosis

The Management of Surgical Patients with Obstructive Sleep Apnea

Value of Impedance Cardiography in Patients Studied for Pulmonary Hypertension

Adhesion Molecules Affected by Treatment of Lung Cancer Cells with Epidermal Growth Factor