Preventative care is essential in PCD to slow the progression of the damage done to the body as a result of PCD. Lung tune up, a phrase coined by the Cystic Fibrosis community ages ago, has proven to be an effective preventative treatment in CF. As PCD has no specific treatments, a lot of PCD treatments are borrowed from CF research and CF treatments. Lung tune ups are basically a treatment plan that last from four to six weeks where the patient gets intense airways clearance at least four times a day, IV and inhaled antibiotics with the antibiotics being guided by the patient’s previous and current culture results, and lots of additional rest balanced with activity to aide in airway clearance. The thought behind lung tune ups is to give the patient a boost with antibiotics and increased airway clearance before the patient becomes exhausted and depletes their energy reserves to fight infections. This boost will hopefully aide the patient in keeping up with their peers. Lung tune ups are great for those patients who are less than compliant with their treatment plans, and younger patients who’s treatment plans rely on others to preform.
Lung tune ups historically were carried out only on an inpatient basis, in North America, back when airway clearance techniques were solely done by hand. Caregivers had a hard time sticking to at least four treatments a day requirement of lung tune ups, because the caregivers arms would tire out. IV antibiotics or intravenous antibiotics had to be administered by licensed nurses, as the medications are caustic to the veins and require frequent replacements of peripheral IVs. Inhaled antibiotics had to be closely monitored and adjusted on a patient by patient basis. IV medications required close doctor monitoring and adjustments as well. All these things could be accomplished easily in a traditional hospital setting. Think of lung tune ups as a sort of boot camp for your respiratory system, it takes many people to accomplish the goals of a lung tune up.
With the invention of airway clearance devices, such as the vest airway clearance machine and hand held percussors, coupled with research into cross contamination and infection control; lung tune ups began to shift focus in the modern world. Now a days most specialist shy away from doing lung tune ups on a complete inpatient basis and started leaning towards completing tune ups at home. Some patients to this day are still treated for a tune up as before on a total inpatient basis for the complete duration of their lung tune up; especially the children. However most young adults and adults can begin their tune ups with a brief three to six day hospital stay and then complete the tune ups in the privacy of their own homes. IV antibiotics can be delivered via a PICC Line or a Port-o-cath while being monitored by a home care nurse with the guidance of the patient’s doctor. Airway clearance machines all but eliminate the problem of fatigue during tune ups for the caregiver. There is also less risk of the patient being exposed to more germs and bacteria that they would be exposed to during an inpatient stay. Lung tune ups at home are also more cost effective for the insurance companies and the patient in question as well. Other patient advantages to doing lung tune ups at home is increased rest, decreased stress, patients can remain social, and patients can go to work or school as they are able to.
As we look to the future in regards to lung tune ups, some facilities and specialist are shifting towards what is best for the patient; especially considering the emergence of more and more antibiotic resistant super bugs. Airways clearance machines are also becoming more common place in the everyday treatment of other respiratory diseases other than CF and PCD. These advances are helping to eliminate the need for lung tune ups anywhere but the patient’s home. Inhaled antibiotics have shown success at treating lung bacteria at its source instead of relying on systemic treatment via IV antibiotics. And the convenience of machines to complete airway clearance make patients less at the mercy of others when it comes to getting their airway clearance done. Hopefully future advances in respiratory care will lessen the burden on PCD patients and their caregivers.
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