Persistent Atelectasis in a Patient With Cystic Fibrosis: Are Antibiotics Always Needed?

Should atelectasis be considered a pulmonary complication and indicator of poor prognosis in cystic fibrosis?

“…Various studies emphasized therapies that promote the elimination of secretions. 4,13,20,28,31 In our case, there were no differences in the recommended treatments needed to achieve clinical or radiological improvement by the end of study. It is therefore unclear whether patients who do not use the clearance technique could have significantly worsened and not recovered from this complication.…”

“…Another explanation could be that this technique was recommended later. Nevertheless, our opinion, as well as that of other authors, 13,16,29,30 is that bronchoscopy should be recommended earlier in an attempt to resolve lung collapse to prevent long-term atelectasis.…”

“…Although there were no significant differences according to the use of bronchoscopy, future studies could help resolve this issue, as other authors have proposed. 13,16,29,30 We conclude that patients with CF who have moderate-to-severe pulmonary obstruction or who have been previously diagnosed with ABPA could develop pulmonary atelectasis. Once pulmonary atelectasis has occurred, patients' condition worsens, they experience more exacerbations, they are placed on transplantation waiting lists, they undergo transplantation or other operations, and they are at increased risk of death.…”

“…The study included two patient groups. First, the case group consisted of children and adults with a history of persistent or long-term atelectasis that did not improve with standard treatment 13 who underwent follow-up for at least 2 years after the onset of this respiratory complication (all patients with atelectasis from each unit were included regardless of age). Persistent atelectasis was defined as a complete or partial collapse of the lungs that might affect gas exchange.…”

“…Radiological improvement was considered if the images were reduced or disappeared, according to the radiologist's opinion. 13,16 All patients were treated in an outpatient clinic.…”