Aerotrach Plus and the adapter were the most and least efficient devices respectively. Tracheostomy size and breathing pattern affected drug delivery. The use of assisted technique reduced aerosol delivery.
In general, decreasing SDV, increasing VT, and increasing RR increase ACMO. Early transition from face mask to mouthpiece should be considered in children receiving albuterol via MDI with HC.
Adverse reactions to antibiotics in patients with cystic fibrosis (CF) are a growing concern. We report the case of a pediatric patient with CF with multiple comorbidities and a history of drug reactions, who developed life-threatening piperacillin-induced immune hemolytic anemia. We review drug-induced hemolytic anemia (DIIHA) in particular, and antibiotic hypersensitivity in CF in general, including the frequency, pathogenesis, and risk factors. Finally, we discuss the treatment options and propose an algorithm for the management of drug-induced hypersensitivity reactions in patients with CF.
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