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

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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.

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Acknowledgment

The authors greatly appreciated the outstanding assistance of Linda Combs in the preparation and development of the manuscript.

Disclosure

There are no conflicts of interest to declare.

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Authors and Affiliations

  1. Advanced Lung Disease and Lung Transplant Programs, C424 University of Kentucky Medical Center, 800 Rose Street, Lexington, KY, 40536, USA

    Don Hayes Jr.

  2. Department of Pharmaceutical Sciences-Drug Development Division, University of Kentucky College of Pharmacy, 789 South Limestone St., 331 Biological Pharmaceutical Bldg, Lexington, KY, 40536-0596, USA

    Heidi M. Mansour

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  1. Don Hayes Jr.
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  2. Heidi M. Mansour
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Correspondence to Don Hayes Jr..

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Hayes, D., Mansour, H.M. Improved Outcomes of Patients with End-stage Cystic Fibrosis Requiring Invasive Mechanical Ventilation for Acute Respiratory Failure. Lung 189, 409–415 (2011). https://doi.org/10.1007/s00408-011-9311-6

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  • DOI: https://doi.org/10.1007/s00408-011-9311-6

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