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    Bronchiectasis

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    Bharat Gaikwad
    1. Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi and bronchioles due to destruction of the elastic and muscular structures of the bronchial walls. 2. It can be caused by a variety of factors including infections, genetic disorders like cystic fibrosis, and inflammatory conditions. 3. Symptoms include daily cough with sputum, blood in sputum, breathing difficulties, and recurring lung infections. Diagnosis involves tests like chest x-ray, CT scan, and pulmonary function tests. 4. Treatment involves airway clearance techniques, antibiotics to treat infections, immunizations, nutrition support, and surgery in severe cases. The goal is to manage symptoms, prevent

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    Bronchiectasis

    Uploaded by

    Bharat Gaikwad
    35 views17 pages
    1. Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi and bronchioles due to destruction of the elastic and muscular structures of the bronchial walls. 2. It can be caused by a variety of factors including infections, genetic disorders like cystic fibrosis, and inflammatory conditions. 3. Symptoms include daily cough with sputum, blood in sputum, breathing difficulties, and recurring lung infections. Diagnosis involves tests like chest x-ray, CT scan, and pulmonary function tests. 4. Treatment involves airway clearance techniques, antibiotics to treat infections, immunizations, nutrition support, and surgery in severe cases. The goal is to manage symptoms, prevent

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    1. Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi and bronchioles due to destruction of the elastic and muscular structures of the bronchial walls. 2. It can be caused by a variety of factors including infections, genetic disorders like cystic fibrosis, and inflammatory conditions. 3. Symptoms include daily cough with sputum, blood in sputum, breathing difficulties, and recurring lung infections. Diagnosis involves tests like chest x-ray, CT scan, and pulmonary function tests. 4. Treatment involves airway clearance techniques, antibiotics to treat infections, immunizations, nutrition support, and surgery in severe cases. The goal is to manage symptoms, prevent

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    35 views17 pages

    Bronchiectasis

    Uploaded by

    Bharat Gaikwad
    1. Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi and bronchioles due to destruction of the elastic and muscular structures of the bronchial walls. 2. It can be caused by a variety of factors including infections, genetic disorders like cystic fibrosis, and inflammatory conditions. 3. Symptoms include daily cough with sputum, blood in sputum, breathing difficulties, and recurring lung infections. Diagnosis involves tests like chest x-ray, CT scan, and pulmonary function tests. 4. Treatment involves airway clearance techniques, antibiotics to treat infections, immunizations, nutrition support, and surgery in severe cases. The goal is to manage symptoms, prevent

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 17

    BRONCHIECTASI

    S
    Definition

     Bronchiectasis is characterized by permanent , abnormal


    dilation of one or more large bronchi.
    Or
    Bronchiectasis is a chronic , irreversible dilation of the bronchi
    and bronchioles .
    Etiopathophysiology

     The pathophysiogic change that results in dilation is


    destruction of the elastic and muscular structures supporting
    the bronchial wall.
     The disease process results in a reduced ability to clear
    mucus from the lungs and decreased expiratory air.
     The variety of pathophysiogic process can result in bronchiectasis.
     Primary disorders of structures in the bronchi.
     Disease of mucus clearance (cystic fibrosis) infections.
     Etiologies (severe childhood bronchial infections ) and inflammatory
    disease (ulcerative colitis).
     Diffuse airway injury.
     Pulmonary infections (complications of long term pulmonary
    infection).
     Genetic disorder( cystic fibrosis).
     Abnormal host defence.
     Idiopathic cause.
    Types of Bronchiactasis
    1. Cylindrical or Tubular – dilatation is mild & both bronchi retain their
    regular relatively straight outline.
    2. Varicose – Is greater and local constrictions are present .
    3. Saccular / cystic – Most severe form & is characterized by large areas of
    distal ‘ grape like’ bronchial dilatation & loss of bronchial subdivision.
    SIGN & SYMPTOMS
     Cough & daily mucopurulent sputum production, often lasting month
    to years.
     Blood streaked sputum or hemoptysis from airway damage associated
    with acute infection.
     Dyspnea , pleuritic chest pain , wheezing , fever, weakness, fatigue &
    weight loss.

    Exacerbation of bronchiectasis from acute bacterial infections may


    produce the following –
     Increased sputum production over baseline .
     A foul odour of sputum.
     Low grade fever.
     Increased shortness of breath , dyspnea , wheezing or pleuritic pain.
    Findings on physical examination are nonspecific and may
    include the following :

     Crackles , rhonchi , scattered wheezing & inspiratory squeaks on


    auscultation.
     Digital clubbing 2- 3% of patients .
     Cynosis and plethora with polycythemia from chronic hypoxia
     Wasting and weight loss.
     Nasal polyp and sings of chronic sinusitis.
    INVESTIGATION

    1. CBC Count
    2. Sputum analysis.
    3. Chest x-ray
    4. Computes tomography.
    5. Quantitative immunoglobulin levels
    6. Quantitative alpha 1-antitrypsin levels.
    7. Sweat test
    8. PFT
    MANAGEMENT

     SUPPORTIVE TREATMENT –
     Smoking cessation
     Adequate nutritional intake with supplementation , if necessary
     Immunization for influenza and pneumococcal pneumonia .
     Confirmation of immunization for measles , rubella and pertussis.
     Oxygen therapy is reserved for patients who are hypoxemic with severe
    disease and end stage complications such as cor pulmonale.
     ANTIBIOTIC THERAPY :

    Acceptable choices for the outpatient who is mild to moderately ill include any
    of the following

     Amoxicillin
     Tetracycline
     Azithromycin or clarithromycin
     A 2nd generation cephalosporine
     Fluroquinolone.
    In gen. the duration of antibiotic therapy for mild to moderate illness is 7-10
    days.
    For patients with moderate to severe symptoms

    Parenteral antibiotics such as an aminoglycoside


     Gentamycin , Tobramycin
     3rd gen cephalosporin
     Fluroquinolone

     H-influenzae , H-parainfluenzae – most common organism


    Amoxicillin 500mg tds for 10 – 14 days.
    Ps.Aeruginosa common in severe disease – ciprofloxacin 500mg bd for 2 week
    I.V. antibiotics – ceftadizime 2gm tds ,
    gentamicin
    Acute exacerbations
    Hospitalization in all severely ill patients , when chest pain limits coughing and
    sputum clearence ( this increases risk of pneumonia ) and iv antibiotics are
    required .

    Prophylactic therapy
    One guideline for therapy is when there are exacerbation every 2 months that
    prevent participation in normal activation of 2 weeks or more during the
    exacerbation .
    Continuous therapy is considered in patients who persistently expectorate purulent
    sputum . aggressive treatment is warranted because persistent infection causes
    tissue destruction.
    Bilateral lung transplantation has been used when respiratory failure develops
    despite optimal medical management.
    General supportive treatment

     Adequate nutrition
     Eradication of chronic nocturnal post- nasal discharge and
    treatment of sinusitis.
     Avoidance of smoking.
     Adequate hydration.
    Surgical

    Indication for surgical resection.

     Bronchiactasis confined to one segment or lobe of the lung causing


    recurrent or persistent symptoms.
     Uncontrollable hemoptysis ( excision or bronchial artery embolization)
     Occasionally for chronic fungal superinfection e.g.aspergilloma.
    THANK YOU !

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