A bronchiectasis (singular: dilatation, is female; it is synonymous with dilatation) of the bronchus is a persistent or progressive, irreversible expansion of the bronchial tree.
Bronchiectasis may develop as a result of:
- bronchial tree obstruction (e.g. after choking with a foreign body),
- damage to the bronchial walls in the course of acute and, above all, chronic inflammatory changes,
- developmental disorders (e.g., disorders of the development of connective tissue or cartilage scaffolding in a bronchial tree).
Regardless of the cause, the retention of secretions in the lumen of the bronchi leads to a chronic inflammatory process, bacterial superinfections and destruction of the bronchial tree.Persistence of lesions may cause abnormal remodeling and subsequent fibrosis of the segment or lobe of the lung, resulting in damaged bronchial tubes.
In this article, Niketrainers.com.co will tell you:
How common is bronchiectasis?
The frequency of bronchiectasis is difficult to define unequivocally. Since the 1950s, a significant reduction in the incidence of bronchiectasis has been observed, which can be mainly associated with the introduction of antibiotics for the treatment of inflammatory diseases of the respiratory system and with a reduction in the incidence oftuberculosis. Available literature data estimates the incidence of bronchiectasis from 3.7/100,000 in New Zealand children to 52/100,000 in US adults. The introduction of modern imaging methods to diagnostics may increase the number of diagnoses, especially in people with chronicbronchitisand adults with chronic obstructive pulmonary disease.
How is bronchiectasis manifested?
Symptoms depend on the severity of the disease.In the case of single or few bronchiectasis, the only symptom may be periodic expectoration of mucous or mucopurulent secretions. The development of multiple dilatations most often results in the daily expectoration of a large amount of purulent sputum. Less specific symptoms includedyspnoea, chest pain andhaemoptysis(less common in children).Recurrent respiratory infections, especially pneumonia, may be a symptom that may make you suspect bronchiectasis.occurring in the same location. In children, as in other chronic diseases, weight gain and growth may be inhibited. Very advanced bronchiectasis, such as a multi-lobar dilatation or a sac-like dilatation, can lead to the onset ofrespiratory failureand the development of the pulmonary heart.
What to do in the event of bronchiectasis symptoms?
The symptoms of bronchiectasis develop slowly and never happen suddenly. The beginning can be tricky and last for months or even years. The procedure depends primarily on the root cause of the appearance of dilated hair. Children with cystic fibrosis, immobile ciliary syndromes, α1-antitrypsin deficiency, or defects in the structure of the trachea or bronchi, usually remain under specialist care from early childhood. In other children, the persistence of symptoms in the form of expectoration of mucous or mucopurulent secretions always requires consultation with a pediatrician. A signal that should worry parents are recurrent severe infections of the respiratory system and inhibition of the child’s somatic development.
How does a doctor make a diagnosis of bronchiectasis?
A history of bronchiectasis is suspected (productive cough, chronic diseases mentioned above). The presence of auscultation changes in one area by a physician during physical examination may suggest a diagnosis. Additional examinations include, first of all, imaging examinations, including a routinechest radiographandcomputed tomography. In patients with diagnosed or seriously suspected bronchiectasis, bronchoscopy is also recommendedtoassess the degree of bronchodilation, exclude the presence of a foreign body and collect secretions for bacteriological examination.
What are the treatments for bronchiectasis?
The treatment of a child with bronchiectasis consists of several components. The basic ones include the treatment of the primary background of the observed changes (e.g. removal of a foreign body), or the chronic treatment of children with cystic fibrosis in order to prevent permanent colonization with bacteria.
Exacerbation of the bronchial disease in the course of respiratory system infection requires special measures. The introduction of effective antibiotic therapy for a period of 2–4 weeks (preceded by the collection of sputum for bacteriological tests) allows not only to control the infection, but also reduces the progress of bronchial destruction. An important element is mucolytic treatment with physiotherapy (postural drainage, tapping with vibration massage).
Interventional treatment is reserved for cases not amenable to conservative treatment. Removal of the damaged or fibrotic part of the lung parenchyma can prevent bleeding from the respiratory system and allow the baby to return to normal somatic development.
Very rarely, primarily in patients with cystic fibrosis, lung transplantation may be one effective treatment.
At home, after the diagnosis is made, it is necessary to conduct physiotherapy.
Is it possible to cure bronchiectasis completely?
Recovery depends on the underlying disease and the severity of the bronchiectasis. Minor bronchiectasis in a small space (e.g. cylindrical dilatation) caused by foreign body retention can be completely healed. Complete cure of larger dilatations, e.g. congenital or developing severe respiratory diseases (e.g. cystic fibrosis), is not possible and the aim of the therapy is to control the symptoms of the disease as effectively as possible and prevent further enlargement of the dilatation.
What should I do after bronchiectasis treatment?
In order to prevent respiratory system infections, which may lead to the development of chronic inflammatory changes in the lower respiratory tract, and thus favor the appearance of bronchiectasis, apart from the broadly understood infection prophylaxis, it is necessary to vaccinate children in accordance with the current vaccination schedule extended with additional vaccinations againstinfluenzaand pneumococcal. These vaccinations are compulsory for children already diagnosed with chronic diseases that can lead to the destruction of the bronchial walls and the development of dilatation.
Children with bronchiectasis should be under the constant care of a specialist pulmonologist.
