Frequency of care outside infection phases

Question

Hello,
I am contacting you to compare practice in France and in the Czech Republic concerning the frequency of care, especially nasal aspiration. We live in the Czech Rep. and our 5-week-old baby was diagnosed to suffer from CF. We have 3 sessions per day (breathing physiotherapy, inhalation and nasal aspiration) as a precaution. Our child has not congested roads and resents the nasal aspiration. We want the best for her but we wonder if having nasal aspirates 3 per day (and inhalations) is no exaggeration as there are no obvious signs of the disease? Is this practice common in Europe in general? Thank you in advance

Answer

Hello

Data from monitoring of CF infants showed that it was possible to find anomalies in the breathing tests and signs of pulmonary inflammation despite the absence of respiratory symptoms and that from the age of 3 months.

All European recommendations for the treatment of CF infants (Sermet-Gaudelus JCF 2010) state that the airway drainage necessary measures must be implemented regularly, but there is a debate about the frequency in children with no symptoms.

North American guidelines state that measures to protect the respiratory capital must be implemented (including bronchial drainage) but without that the frequency of interventions is specified.

You have therefore understood that the cleansing action of the upper airways and bronchial drainage is important, but the frequency of their achievement remains at the behest of your CF doctor. Personally, twice-daily washing the nasal cavities seem sufficient in the absence of cold, and do not necessarily require nasal aspirations. Inhalations mean that your baby breathes a product. At present, it is not recommended nor in Europe nor in North America.

Best regard

Dr Philippe Reix

08.04.2016