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Pulmonary Exacerbation Nuts and Bolts

Pulmonary Exacerbation Nuts and Bolts. D.B. Sanders, MD UW-Madison Parent Webinar. Definition/Epidemiology. An acute worsening of signs and symptoms Cough, increased sputum, decreased energy, decreased appetite, weight loss Can include coughing up blood, shortness of breath, chest pain

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Pulmonary Exacerbation Nuts and Bolts

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  1. Pulmonary ExacerbationNuts and Bolts D.B. Sanders, MD UW-Madison Parent Webinar

  2. Definition/Epidemiology • An acute worsening of signs and symptoms • Cough, increased sputum, decreased energy, decreased appetite, weight loss • Can include coughing up blood, shortness of breath, chest pain • Usually accompanied by an acute decrease in lung function (usually, FEV1) • 35-40% of patients with CF require IV antibiotics each year • Many more require oral or inhaled antibiotics

  3. What causes a pulmonary exacerbation? • Anything that disrupts the bacteria that can be found in the lungs of people with CF: • New bacteria (Pseudomonas aeruginosa) • Old bacteria, new growth, or new virulence • Viral infections (influenza) • Not taking medications regularly • Other: pollution, allergies, reflux (heartburn), ABPA

  4. Why are exacerbations important? • You don’t feel good • Missed work, missed school, missed activities • May require hospitalization • May lead to more decline in lung function • ~25% of patients don’t immediately recover all of their lung function after they are hospitalized for an exacerbation

  5. Why are exacerbations important?

  6. What to do? • If you are having symptoms of an exacerbation: • Increase chest PT to 3-4 times per day • Make sure you are taking all of your medications • Call us if symptoms are really bad, or if they’re not getting better after 4-5 days

  7. What are our options? • We may prescribe oral or inhaled antibiotics over the phone • We may ask you to come to clinic for a visit • We may decide to admit you to the hospital • In the hospital: • We use IV antibiotics (usually 2) • We give chest PT 4 times per day • We make sure to increase nutrition • We try to make sure you get rest

  8. How can you prevent an exacerbation? • Take your medications and do your chest PT • Maintain your weight • Get the flu vaccine every year • Avoid people with colds/wash your hands • Let us know early

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