A Small Device May Deliver King-Sized Solutions for Patients With an Exacerbation of Cystic Fibrosis.

Abstract

Aim: The aim is to examine whether using a portable spring-infusor device to deliver antibiotics compared with a standard infusion pump (SIP) translated to (i) improve health outcomes, (ii) reduce the length of stay (LoS), and (iii) reduce cost for treatment of exacerbations of cystic fibrosis (CF). Methods: An observational cohort study was conducted between December 2020 and June 2022 with participants aged 8-19 years admitted for exacerbation of CF. An activity monitor was fitted to participants to measure physical activities for the final 5 days of hospital admission. LoS was measured (days). Group allocation was according to participant preference. Costs were compared between the two groups for LoS, pump cost, and preparation and administration of antibiotics. Results:Twenty-seven of 30 eligible participants were approached, and 22 consented. Data were captured for 16 participants (spring-infusor n = 9): 10 female; mean (SD) age 14.5 (2.1) years. Average step count was negatively associated with age (rho = 0.50), and greater overall in participants using spring-infusors (mean 5324 (SD 2873) steps) versus SIPs (4806 (3116) steps) - mean (95% CI) increase in the spring-infusor group of 3246 (54-6438) for participants of the same age. LoS was longer on average in the SIP group, (mean (SD) LoS: 16.1 (4.3) versus 12.4 (1.7)). The estimated cost saving for a child using a spring-infusor was AUS$12,000. Conclusion:Results from the study suggest that children hospitalised for exacerbations of CF are more active if they receive antibiotics via a spring-infusor device compared with a SIP, and have reduced hospital stay that results in cost saving to the hospital. What is already known? Spring-infusors are small, portable, and mechanical devices to deliver intravenous antibiotics to patients. Spring-infusors are preferred by patients with CF at Perth Children's Hospital Physical activity in children with CF is recommended, including during hospital admissions to promote wellbeing, quality of life, and health outcomes. What this paper adds? Children hospitalised for exacerbations of CF may be more active if they receive antibiotics via a portable spring-infusor device compared with a SIP. Children using spring-infusors had reduced hospital stays that results in cost saving to the hospital. Children hospitalised for exacerbations of CF step on average, fewer than 5000 steps per day, which is well below recommendations.