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Chronic Pseudomonas aeruginosa infection and respiratory muscle impairment in cystic fibrosis.
Respir Care. 2014 Mar; 59(3):363-70.RC

Abstract

BACKGROUND

Chronic infection with Pseudomonas aeruginosa in patients with cystic fibrosis (CF) is associated with increased morbidity. Chronic infection can cause limb and respiratory muscle compromise. Respiratory muscle function can be assessed via maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), and the pressure-time index of the respiratory muscles (PTImus). We studied the effect of chronic P. aeruginosa infection on respiratory muscle function in patients with CF.

METHODS

This cross-sectional study assessed PImax, PEmax, PTImus, FEV1, FVC, maximum expiratory flow during the middle half of the FVC maneuver, body mass index, and upper arm muscle area in 122 subjects with CF, in 4 subgroups matched for age and sex at different stages of P. aeruginosa infection, according to the Leeds criteria. We compared respiratory muscle function in the subgroups according to P. aeruginosa infection state.

RESULTS

Median PImax was significantly lower in CF subjects with chronic P. aeruginosa infection (PImax = 62 cm H2O), compared to subjects who were never infected (PImax = 86 cm H2O, P = .02), free of infection (PImax = 74 cm H2O, P = .01), or intermittently infected (PImax = 72 cm H2O, P = .02). Median PTImus was significantly increased in CF subjects with chronic P. aeruginosa infection (PTImus = .142), compared to subjects who were free of infection (PTImus = .102, P = .006). Median upper-arm muscle area was significantly lower in CF subjects with chronic P. aeruginosa infection (upper-arm muscle area = 2,219 mm(2)), compared to subjects who were never infected (2,754 mm(2), P = .03), free of infection (2,678 mm(2), P = .01), or intermittently infected (2,603 mm(2), P = .04). Multivariate logistic regression revealed P. aeruginosa state of infection as a significant determinant of PTImus (P = .03) independently of sex, upper-arm muscle area, and FEV1.

CONCLUSIONS

CF subjects with chronic P. aeruginosa infection exhibited impaired respiratory muscle function and decreased inspiratory muscle strength, and chronic P. aeruginosa infection independently impacts respiratory muscle function in subjects with CF.

Authors+Show Affiliations

Department of Paediatrics, University of Patras Medical School, Patras, Greece.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23983273

Citation

Dassios, Theodore G., et al. "Chronic Pseudomonas Aeruginosa Infection and Respiratory Muscle Impairment in Cystic Fibrosis." Respiratory Care, vol. 59, no. 3, 2014, pp. 363-70.
Dassios TG, Katelari A, Doudounakis S, et al. Chronic Pseudomonas aeruginosa infection and respiratory muscle impairment in cystic fibrosis. Respir Care. 2014;59(3):363-70.
Dassios, T. G., Katelari, A., Doudounakis, S., & Dimitriou, G. (2014). Chronic Pseudomonas aeruginosa infection and respiratory muscle impairment in cystic fibrosis. Respiratory Care, 59(3), 363-70. https://doi.org/10.4187/respcare.02549
Dassios TG, et al. Chronic Pseudomonas Aeruginosa Infection and Respiratory Muscle Impairment in Cystic Fibrosis. Respir Care. 2014;59(3):363-70. PubMed PMID: 23983273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic Pseudomonas aeruginosa infection and respiratory muscle impairment in cystic fibrosis. AU - Dassios,Theodore G, AU - Katelari,Anna, AU - Doudounakis,Stavros, AU - Dimitriou,Gabriel, Y1 - 2013/08/27/ PY - 2013/8/29/entrez PY - 2013/8/29/pubmed PY - 2014/12/15/medline KW - Pseudomonas aeruginosa KW - cystic fibrosis KW - respiratory muscles SP - 363 EP - 70 JF - Respiratory care JO - Respir Care VL - 59 IS - 3 N2 - BACKGROUND: Chronic infection with Pseudomonas aeruginosa in patients with cystic fibrosis (CF) is associated with increased morbidity. Chronic infection can cause limb and respiratory muscle compromise. Respiratory muscle function can be assessed via maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), and the pressure-time index of the respiratory muscles (PTImus). We studied the effect of chronic P. aeruginosa infection on respiratory muscle function in patients with CF. METHODS: This cross-sectional study assessed PImax, PEmax, PTImus, FEV1, FVC, maximum expiratory flow during the middle half of the FVC maneuver, body mass index, and upper arm muscle area in 122 subjects with CF, in 4 subgroups matched for age and sex at different stages of P. aeruginosa infection, according to the Leeds criteria. We compared respiratory muscle function in the subgroups according to P. aeruginosa infection state. RESULTS: Median PImax was significantly lower in CF subjects with chronic P. aeruginosa infection (PImax = 62 cm H2O), compared to subjects who were never infected (PImax = 86 cm H2O, P = .02), free of infection (PImax = 74 cm H2O, P = .01), or intermittently infected (PImax = 72 cm H2O, P = .02). Median PTImus was significantly increased in CF subjects with chronic P. aeruginosa infection (PTImus = .142), compared to subjects who were free of infection (PTImus = .102, P = .006). Median upper-arm muscle area was significantly lower in CF subjects with chronic P. aeruginosa infection (upper-arm muscle area = 2,219 mm(2)), compared to subjects who were never infected (2,754 mm(2), P = .03), free of infection (2,678 mm(2), P = .01), or intermittently infected (2,603 mm(2), P = .04). Multivariate logistic regression revealed P. aeruginosa state of infection as a significant determinant of PTImus (P = .03) independently of sex, upper-arm muscle area, and FEV1. CONCLUSIONS: CF subjects with chronic P. aeruginosa infection exhibited impaired respiratory muscle function and decreased inspiratory muscle strength, and chronic P. aeruginosa infection independently impacts respiratory muscle function in subjects with CF. SN - 1943-3654 UR - https://www.unboundmedicine.com/medline/citation/23983273/Chronic_Pseudomonas_aeruginosa_infection_and_respiratory_muscle_impairment_in_cystic_fibrosis_ L2 - http://rc.rcjournal.com/cgi/pmidlookup?view=short&pmid=23983273 DB - PRIME DP - Unbound Medicine ER -