Email the author The Effect of Pulmonary Rehabilitation on The Duration of Antibiotic Switches, IL-10 Levels and PEFR Values in Hospitalized Community Pneumonia Patients
Abstract
Methods: The study was conducted in May-November 2019 at Saiful Anwar Hospital Malang, with 40 pneumonia patients in the non-intensive care and divided in two groups which contains of 20 patients. This study uses consecutive simple random sampling. In treatment group, pulmonary rehabilitation consists of breathing exercise, effective cough techniques, clapping, postural drainage and breathing muscle exercises with spirometry incentive tools. The pulmonary rehabilitation treatment was done by Medical Rehabilitation Department of Saiful Anwar Malang Hospital. IL-10 levels and PEFR values on the zero and fifth days of treatment were measured.
Results: The duration of antibiotic switches received pulmonary rehabilitation was shorter 5.05 days (P<0.001). The IL-10 level of conventional therapy group before therapy was 20.76 pg/ml and after therapy was 18.33 pg/ml (P=0.852). The IL-10 level of the group that received both conventional therapy and pulmonary rehabilitation before treatment was 27.38 pg/ml and after treatment was 13.74 pg/ml (P=0.135). IL-10 level of fifth day between the two groups (P=0.779). The PEFR values of the conventional therapy group and conventional therapy with pulmonary rehabilitation showed a significant increase PEFR value (P <0.001) while the fifth day PEFR value between the two groups (P = 0.164).
Conclusions: Pulmonary rehabilitation as adjuvant therapy could shorten the duration of antibiotic switches by 2.21 days. There is a reduction in IL-10 level on the fifth day compared to day zero in both groups but not significant. There is a significant increase PEFR level on the fifth day compared to zero day in both groups but not significant.
Keywords
Full Text:
PDF (Bahasa Indonesia)References
Soedarsono. Pneumonia. In: Wibisono MJ, Winariani, Hariadi S, editors. Buku Ajar Ilmu Penyakit Paru. 2013. Surabaya: Departemen Ilmu Penyakit Paru FK Unair, Surabaya; 2013.p.153-74.
Perhimpunan Dokter Paru Indonesia. Pneumonia Komunitas: Pedoman Diagnosis dan Penatalaksanaan di Indonesia. Jakarta: Perhimpunan Dokter Paru Indonesia; 2018.p.3-35.
Iyer SS, Cheng G. Role of interleukin 10 transcriptional regulation in inflammation and autoimmune disease. CritRev Immunol. 2012;32(1):23-63.
Van der Schans CP. Conventional chest physical therapy for obstructive lung disease. Respir Care. 2007;52(9):1198-206.
Chawla S, Narwal R, Rawat J. Comparison of inspiratory muscle training and rib raising technique in pulmonary diseases subjects. Indian J Physiother Occup Ther. 2013;7(2):145.
Stoller JK. Murray & Nadel’s Textbook of Respiratory Medicine. Ann. Am. Thorac. Soc. 2015 Aug;12(8):1257-8.
Uranga A, España PP, Bilbao A, Quintana JM, Arriaga I, Intxausti M, et al. Duration of antibiotic treatment in community-acquired pneumonia: a multicenter randomized clinical trial. JAMA intern Med. 2016;176(9):1257-65.
Carratalà J, Garcia-Vidal C, Ortega L, Fernández-Sabé N, Clemente M, Albero G, et al. Effect of a 3-step critical pathway to reduce duration of intravenous antibiotic therapy and length of stay in community-acquired pneumonia: a randomized controlled trial. Arch Intern Med. 2012 ;172(12):922-8.
Zobel K, Martus P, Pletz MW, Ewig S, Prediger M, Welte T, et al Interleukin 6, lipopolysaccharide-binding protein and interleukin 10 in the prediction of risk and etiologic patterns in patients with community-acquired pneumonia: results from the German competence network CAPNETZ. BMC Pulm Med. 2012;12(1):1-10.
Glynn P, Coakley R, Kilgallen I, Murphy N, O’Neill S. Circulating interleukin 6 and interleukin 10 in community acquired pneumonia. Thorax. 1999;54(1):51-5.
Antunes G, Evans SA, Lordan JL, Frew AJ. Systemic cytokine levels in community-acquired pneumonia and their association with disease severity. Eur Respir J. 200;20(4):990-5.
Calbo E, Alsina M, Rodríguez-Carballeira M, Lite J, Garau J. Systemic expression of cytokine production in patients with severe pneumococcal pneumonia: Effects of treatment with a β-lactam versus a fluoroquinolone. Antimicrob Agents Chemother. 2008;52(7):2395-402.
Menendez R, Reyes S, Martínez R, Sahuquillo-Arce JM, Marcos MA, Filella X, et al. Cytokine systemic pattern and causal microorganism in community acquired pneumonia. D25 Community Acquired Pneumonia: controversies in management Am J Resp Crit Care. 2010;181:A5480.
Mocellin S, Panelli MC, Wang E, Nagorsen D, Marincola FM. The dual role of IL-10. Trends immunol. 2003;24(1):36-43.
Ryerson CJ, Cayou C, Topp F, Hilling L, Camp PG, Wilcox PG, et al. Pulmonary rehabilitation improves long-term outcomes in interstitial lung disease: a prospective cohort study. Respir Med. 2014;108(1):203-10.
Tanaka T, Narazaki M, Kishimoto T. IL-6 in inflammation, immunity, and disease. CSH Perspect Biol. 2014;6(10):1-17.
Mat-Nor MB, Ralib AM, Abdulah NZ, Pickering JW. The diagnostic ability of procalcitonin and interleukin-6 to differentiate infectious from noninfectious systemic inflammatory response syndrome and to predict mortality. J Crit Care. 2016;33:245-51.
Boomer JS, Green JM, Hotchkiss RS. The changing immune system in sepsis: is individualized immuno-modulatory therapy the answer?. Virulence. 2014;5(1):45-56.
Liu W, Mu X, Wang X, Zhang P, Zhao L, Li Q. Effects of comprehensive pulmonary rehabilitation therapy on pulmonary functions and blood gas indexes of patients with severe pneumonia. Exp and Ther Med. 2018;16(3):1953-7.
McCarthy C, Brennan JR, Brown L, Donaghy D, Jones P, Whelan R, et all. Use of a care bundle in the emergency department for acute exacerbations of chronic obstructive pulmonary disease: a feasibility study. Int J Chron Obstruct Pulmon Dis. 2013;8:605-11.
Huppmann P, Sczepanski B, Boensch M, Winterkamp S, Schönheit-Kenn U, Neurohr C, et all. Effects of inpatient pulmonary rehabilitation in patients with interstitial lung disease. Eur Respir J. 2013;42(2):444-53.
Struik FM, Lacasse Y, Goldstein RS, Kerstjens HA, Wijkstra PJ. Nocturnal noninvasive positive pressure ventilation in stable COPD: a systematic review and individual patient data meta-analysis. Respir Med. 2014;108(2):329-37.
Tokarski S, Tokarska K, Schwarz E, Obrebska A, Mejer A, Kowalski J. Blood gas analysis, blood saturation and chosen parameters of spirometric examination in NSCLC patients undergoing chemotherapy and pulmonary rehabilitation. Pol Merkur Lekarski: 2014;36(214):249-53.
Cecily HSJ, Alotaibi AA. Effectiveness of breathing exercises on pulmonary function parameters and quality of life of patients with chronic obstructive pulmonary disease. Int J Health Sci Res. 2013;3(11):80-5.
Holland AE, Hill CJ, Jones AY, McDonald CF. Breathing exercises for chronic obstructive pulmonary disease: review. Cochrane Database Syst Rev. 2012(10):1-90.
Spruit MA, Pitta F, Garvey C, ZuWallack RL, Roberts CM, Collins EG, et all. Differences in content and organisational aspects of pulmonary rehabilitation programmes. Eur Respir J. 2014;43(5):1326-37.
Paltiel W, Rasmi M, Noa BY, Avi D, Margalit W. The cumulative effect of long-acting bronchodilators, exercise, and inspiratory muscle training on the perception of dyspnea in patients with advanced COPD: clinical investigations. Chest. 2000;118(3):672-8.
Guyatt G, Keller J, Singer J, Halcrow S, Newhouse M. Controlled trial of respiratory muscle training in chronic airflow limitation. Thorax. 1992;47(8):598-602.
Ramírez-Sarmiento A, Orozco-Levi M, Güell R, Barreiro E, Hernandez N, Mota S, Sangenis M, Broquetas JM, Casan P, Gea J. Inspiratory muscle training in patients with chronic obstructive pulmonary disease: structural adaptation and physiologic outcomes. Am J Res Crit Care Med. 2002;166(11):1491-7.
Bakhtiar A, Tantri RIE. Faal paru dinamis. J Respir. 2017;3(3):57-64.
Tsirigotis P, Chondropoulos S, Gkirkas K, Meletiadis J, Dimopoulou I. Balanced control of both hyper and hypo-inflammatory phases as a new treatment paradigm in sepsis. J Thorac Dis. 2016;8(5):312-6.
Biron BM, Ayala A, Lomas-Neira JL. Biomarker for sepsis: what is and what might be. Biomark Insights. 2015;10(S4):7-17.
Celli BR, Zuwallack RL. Pulmonary rehabilitation. In: Broaddus VC, Mason RJ, Ernst JD, editors. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016.p.485-96.
Uekert SJ, Akan G, Evans M.D, Li Z, Roberg K, Tisler C, et al. Sex-related differences in immune development and the expression of atopy in early childhood. J Allergy Clin Immunol. 2006;118(6):1375-81.
Khotimah, S. Latihan endurance meningkatkan kualitas hidup lebih baik dari pada latihan pernafasan pada pasien PPOK di BP4 Yogyakarta. Sport and Fitness Journal. 2013;1(1):20-32.
Basuki N, Setiawan. Peningkatan kemampuan fungsional penderita PPOM melalui program rehabilitasi paru di rumah sakit dan di rumah. Jurnal Terpadu Ilmu Kesehatan. 2014;3(1):57-63.
DOI: https://doi.org/10.36497/jri.v40i4.129
Refbacks
- There are currently no refbacks.
Copyright (c) 2020 Mariyatul Khiptiyah, Iin Noor Chozin, Suryanti Dwi Pratiwi, Rahmad Rahmad, Harun Al Rasyid
INDEXING & PARTNER
| Jurnal Respirologi Indonesia pISSN: 0853-7704 - eISSN: 2620-3162 Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia Phone: +62-21-2247-4845 Email: editor@jurnalrespirologi.org |  An official publication by the Indonesian Society of Respirology (ISR) |
 Creative Commons Attribution-ShareAlike 4.0 International License Statcounter |