Investigation of respiratory rate in patients with cystic fibrosis using a minimal-impact biomotion system

Svenja Straßburg,Sivagurunathan Sutharsan,Christoph Schöbel,Matthias Welsner,Jürgen Götze,Florian Stehling,Gerhard Weinreich,Carolin-Maria Linker,Sebastian Brato,Christian Taube

doi:10.1186/s12890-022-01855-w

Abstract

BackgroundIn this study we tested the hypothesis that in patients with cystic fibrosis (pwCF) respiratory rate (RR) is associated with antibiotic treatment, exacerbation status, forced expiratory volume in one second (FEV1) and C-reactive protein (CRP).MethodsBetween June 2018 and May 2019, we consecutively enrolled pwCF who were referred to our hospital. We determined RR and heart rate (HR) by using the minimal-impact system VitaLog during the hospital stay. Furthermore, we performed spirometry and evaluated CRP.ResultsWe included 47 patients: 20 with pulmonary exacerbation and 27 without. RR decreased in patients with exacerbation (27.5/min (6.0/min) vs. 24.4/min (6.0/min), p = 0.004) and in patients with non-exacerbation (22.5/min (5.0/min) vs. 20.9/min (3.5/min), p = 0.024). Patients with exacerbation showed higher RR than patients with non-exacerbation both at the beginning (p = 0.004) and at the end of their hospital stay (p = 0.023). During the hospital stay, HR did not change in the total cohort (66.8/min (11.0/min) vs. 66.6/min (12.0/min), p = 0.440). Furthermore, we did not find significant differences between patients with exacerbation and patients with non-exacerbation (67.0/min (12.5/min) vs. 66.5/min (10.8/min), p = 0.658). We observed a correlation of ρ = -0.36 between RR and FEV1. Moreover, we found a correlation of ρ = 0.52 between RR and CRP.ConclusionIn pwCF requiring intravenous therapy, respiratory rate is higher at their hospital admittance and decreased by the time of discharge; it is also associated with C-reactive protein. Monitoring RR could provide important information about the overall clinical conditions of pwCF.

Highlights

In this study we tested the hypothesis that in patients with cystic fibrosis respiratory rate (RR) is associated with antibiotic treatment, exacerbation status, forced expiratory volume in one second (FEV1) and C-reac‐ tive protein (CRP)
Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene influence the conductance of chloride and bicarbonate ions through the cell membrane leading to dehydration of the epithelial liquid film in affected organs
Our study cohort consisted of patients who received prophylactic antibiotic treatment in hospital 57% (27/47) and patients suffering from an acute exacerbation 43% (20/47)

Summary

Introduction

In this study we tested the hypothesis that in patients with cystic fibrosis (pwCF) respiratory rate (RR) is associated with antibiotic treatment, exacerbation status, forced expiratory volume in one second (FEV1) and C-reac‐ tive protein (CRP). Cystic fibrosis (CF) is an autosomal recessive disease leading to shorter life expectancy. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene influence the conductance of chloride and bicarbonate ions through the cell membrane leading to dehydration of the epithelial liquid film in affected organs. CF related bacterial overgrowth is associated with frequent pulmonary exacerbations that require antibiotic treatment. Typical exacerbation symptoms are more frequent cough, increased purulent secretion, fever, weight loss, reduced resilience, decline of lung function and tachypnoea [7]

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Discussion

Conclusion