Cystic fibrosis: Improving outcomes in patients with end-stage disease

http://www.ncbi.nlm.nih.gov/pubmed/21805164

Lung. 2011 Jul 30. [Epub ahead of print]
Improved Outcomes of Patients with End-stage Cystic Fibrosis Requiring Invasive Mechanical Ventilation for Acute Respiratory Failure.
Hayes D Jr, Mansour HM.
Source
Advanced Lung Disease and Lung Transplant Programs, C424 University of Kentucky Medical Center, 800 Rose Street, Lexington, KY, 40536, USA, don.hayes@uky.edu.

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 (FEV(1) = 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.