Web Cast Focuses on Finding and Treating Lung Infections

August 23, 2007

During the most recent CF Foundation Web cast, “Navigating the Hills and Valleys of CF Lung Disease,” experts from the Akron Children’s Hospital in Ohio discussed innovative ways for early detection of lung infections and pulmonary exacerbations.

On hand to answer questions from the largest live audience in Web cast history were Dr. Nathan Kraynack, director of the pediatric program at Akron, Betsy Bryson, pediatric nurse practitioner and clinical nurse manager, and Chris Singh, adult nurse practitioner and clinic coordinator.

“We hope that people spend most of their time on the ‘hills,’ at the peak of health, but we know that if they start to slip into a ‘valley,’ we need to help get them back up that hill as quickly as possible,” Kraynack stated.

Key to the care center’s success was its ability to recognize what areas of care needed improvement and the commitment of its staff to ensure that changes were made. After reviewing the CF Patient Registry, the care center staff realized that their patients’ lung health was below the national average.

“We looked at ourselves and found that not everyone diagnosed a pulmonary exacerbation the same way,” noted Kraynack. Targeting these differences was the first step in finding common ground and the best paths for treating exacerbations before they became a bigger problem.

By analyzing specific health criteria, the care center was able to standardize their definition of an exacerbation. They developed a list of areas to monitor and “score,” including systemic symptoms, pulmonary symptoms and results from various tests such as oxygen saturation and lung function. When a patient’s score reached a certain point, an exacerbation was diagnosed and treated. Within a year, lung function values at Akron’s pediatric clinic increased from 83 percent to 92 percent—surpassing the national average for ages 6-18.

During the Web cast, nurse practitioner Bryson spoke about things patients could do to improve their health. She provided tips for cleaning equipment and avoiding germs. She stressed the importance of maintaining a regular therapy routine. “If you miss once or twice, you probably won’t notice a big difference, but over time, a lot of damage can occur. Everyone has a role in keeping lungs healthy—the care center, parents and the person with CF.”

The experts also discussed the treatment of pulmonary exacerbations, including the pros and cons of hospital care and home therapies. “Home IV antibiotics are more convenient, and almost always less expensive, but the attention and support a hospital can offer can make it preferable, and sometimes necessary,” Singh said. “Just because you may feel better doesn’t necessarily mean your lung health has improved. That’s why close monitoring by professionals can be so important.” He emphasized that untreated exacerbations can lead to permanent loss of lung function.

By taking the necessary steps to improve the quality of CF care, Akron Children’s Hospital’s care center staff have seen marked improvement in their patients’ health.

“Navigating the Hills and Valleys of CF Lung Disease” will soon be available on the Foundation’s Web site. To view previous Web casts, click here.