TY - JOUR T1 - Chronic Pseudomonas aeruginosa Infection and Respiratory Muscle Impairment in Cystic Fibrosis JF - Respiratory Care DO - 10.4187/respcare.02549 SP - respcare.02549 AU - Theodore G. Dassios AU - Anna Katelari AU - Stavros Doudounakis AU - Gabriel Dimitriou Y1 - 2013/08/27 UR - http://rc.rcjournal.com/content/early/2013/08/27/respcare.02549.abstract N2 - Background: Chronic infection with Pseudomonas aeruginosa (Pa) in subjects with Cystic Fibrosis (CF) is associated with increased morbidity. Chronic infection can cause limb and respiratory muscle compromise. Respiratory muscle function can be assessed by maximal inspiratory pressure (Pimax), maximal expiratory pressure (Pemax) and pressure-time index of the respiratory muscles (PTImus). Our aim was to study the effect of chronic Pa infection on respiratory muscle function in CF subjects. Methods: This cross-sectional study assessed Pimax, Pemax, PTImus, FEV1, FVC, Maximal Expiratory Flow between 25 and 75% of VC, Body Mass Index and Upper Arm Muscle Area (UAMA) in 122 CF subjects who formed four groups matched for age and sex at different stages of Pa infection according to the Leeds criteria. Respiratory muscle function parameters were then compared in the ensuing groups according to Pa infection state. Results: Median Pimax was significantly lower in CF subjects with chronic Pa infection (Pimax= 62 cmH2O) compared to subjects that were never infected (Pimax=86 cmH2O, p=0.016), free of infection (Pimax=74 cmH2O, p=0.014) or intermittently infected (Pimax=72 cmH2O, p=0.016). Median PTImus was significantly increased in CF subjects with chronic Pa infection (PTImus=0.142) compared to subjects that were free of infection (PTImus= 0.102, p=0.006). Median UAMA was significantly lower in CF subjects with chronic Pa infection (UAMA=2219) compared to subjects that were never infected (UAMA=2754, p=0.032), free of infection (UAMA=2678, p=0.011) or intermittently infected (UAMA=2603, p=0.037). Multivariate logistic regression revealed Pa state of infection as a significant determinant of PTImus (p=0.025) independently of gender, UAMA and FEV1. Conclusions: These findings suggest that CF subjects with chronic Pa infection exhibit impaired respiratory muscle function and decreased inspiratory muscle strength and that chronic Pa infection independently impacts on respiratory muscle function in subjects with CF. ER -