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Home-spirometry exacerbation profiles in children with cystic fibrosis

Benoit Bouteleux1, Fabien Beaufils2,3,4, Michael Fayon2,3,4

  • 1Cabinet Resp'Air, Talence, France.

Pediatric Pulmonology
|November 28, 2023
PubMed

Insights

Home spirometry aids early detection of pulmonary exacerbations (PEx) in children with cystic fibrosis (CF). A lung function threshold can identify patients with a poor response to intravenous antibiotics, guiding earlier interventions.

Area of Science:

  • Pediatric Pulmonology
  • Cystic Fibrosis Research
  • Respiratory Medicine

Background:

  • Pulmonary exacerbations (PEx) significantly impact cystic fibrosis (CF) progression in children.
  • Persistent lung function decline may follow acute PEx management.
  • The role of telemonitoring in PEx detection and management remains debated.

Purpose of the Study:

  • To identify symptoms and telemonitoring spirometry characteristics linked to outcomes after PEx management.
  • To establish predictors of treatment response in children with CF experiencing PEx.

Main Methods:

  • Retrospective analysis of severe PEx in children with CF (CwCF) treated with intravenous antibiotics (IV ATB).
  • Utilized home telemonitoring data, including symptoms and spirometry (FEV1), collected pre- and post-treatment.
  • Defined patient response profiles based on FEV1 recovery after IV ATB.

Main Results:

  • A significant FEV1 decline preceded IV ATB initiation by 8 days.
  • 41% of IV ATB courses did not restore baseline FEV1.
  • Greater FEV1 drop and delayed treatment correlated with poor response; <94% FEV1 recovery by day 14 indicated a non-responder profile.

Conclusions:

  • Home spirometry can enable earlier PEx recognition and intervention in CwCF.
  • A specific FEV1 recovery threshold identifies patients with suboptimal response to IV ATB.
  • Findings support integrating telemonitoring for proactive PEx management in CF.
Abstract

Keywords:
antibioticcystic fibrosisexacerbationpediatricsspirometrytelemedicine

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