Bronchiectasis Nisha

7/24/2019 Bronchiectasis Nisha

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RONCHIECTASIS

Presented by ,

Mr. Maheboob

1styear M.sc Nursing

Govt college of nursing

Holenarsipur


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DEFINITION:

ronchiectasis

is defined as

er!anent,

abnor!a"

di"atation of one

or !ore "ar#e

bronchi$


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DEFINITION:

ronchiectasis is defined as

abnor!a" and irre%ersib"e

di"atation of the bronchi and

bronchio"es reater than '!! in

dia!eter( de%e"oin# secondary to

inf"a!!atory )ea*enin# of

bronchia" )a""s$


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ETIO+O-:

Bronchiectasis has both

con#enita" and ac./ired

ca/ses$
http://en.wikipedia.org/wiki/Congenitalhttp://en.wikipedia.org/wiki/Acquiredhttp://en.wikipedia.org/wiki/Acquiredhttp://en.wikipedia.org/wiki/Congenital


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THE YELLOWISH DISCOLORATION OF LUNG PARENCHYMA REFLECTS OBSTRUCTIVE PNEUMONIA.


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AC01IRED CA1SES

Tuberculosis,

pneumonia,

inhaled foreign bodies,

allergic bronchopulmonaryaspergillosis

and bronchioltumoursare the major

acquired causes of Bronchiectasis.
http://en.wikipedia.org/wiki/Tuberculosishttp://en.wikipedia.org/wiki/Allergic_bronchopulmonary_aspergillosishttp://en.wikipedia.org/wiki/Allergic_bronchopulmonary_aspergillosishttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Lung_cancerhttp://en.wikipedia.org/wiki/Allergic_bronchopulmonary_aspergillosishttp://en.wikipedia.org/wiki/Allergic_bronchopulmonary_aspergillosishttp://en.wikipedia.org/wiki/Allergic_bronchopulmonary_aspergillosishttp://en.wikipedia.org/wiki/Allergic_bronchopulmonary_aspergillosishttp://en.wikipedia.org/wiki/Tuberculosis


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INFECTIE C!"#E# !##$CI!TE% &IT'B($NC'IECT!#I# INC)"%E

infections caused by

the #taphylococcus,

*lebsiella, or

Bordetellapertussis,

the causati+e agent

of hooping cough.
http://en.wikipedia.org/wiki/Staphylococcushttp://en.wikipedia.org/wiki/Klebsiellahttp://en.wikipedia.org/wiki/Bordetella_pertussishttp://en.wikipedia.org/wiki/Bordetella_pertussishttp://en.wikipedia.org/wiki/Whooping_coughhttp://en.wikipedia.org/wiki/Whooping_coughhttp://en.wikipedia.org/wiki/Bordetella_pertussishttp://en.wikipedia.org/wiki/Bordetella_pertussishttp://en.wikipedia.org/wiki/Bordetella_pertussishttp://en.wikipedia.org/wiki/Klebsiellahttp://en.wikipedia.org/wiki/Staphylococcus


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!#-I(!TI$N $F !$NI!!N% $T'E( T$/IC 0!#E#,

pulmonary aspiration,

alcoholism, heroin1drug use2,

+arious allergies all appear to be

lin3ed to the de+elopment of

Bronchiectasis
http://en.wikipedia.org/wiki/Ammoniahttp://en.wikipedia.org/wiki/Pulmonary_aspirationhttp://en.wikipedia.org/wiki/Alcoholismhttp://en.wikipedia.org/wiki/Heroinhttp://en.wikipedia.org/wiki/Allergyhttp://en.wikipedia.org/wiki/Allergyhttp://en.wikipedia.org/wiki/Heroinhttp://en.wikipedia.org/wiki/Alcoholismhttp://en.wikipedia.org/wiki/Pulmonary_aspirationhttp://en.wikipedia.org/wiki/Ammonia


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Childhood

!cquired Immune %e4ciency #yndrome 1!I%

#2

, hich predisposes patients to a +ariety of

pulmonary ailments, such as pneumoniaand

other opportunistic infections.

In5ammatory boel disease, especially

ulcerati+e colitis.

! 'iatalherniacan cause Bronchiectasis

hen the stomach acid that is aspirated
http://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/Pneumoniahttp://en.wikipedia.org/wiki/Opportunistic_infectionshttp://en.wikipedia.org/wiki/Inflammatory_bowel_diseasehttp://en.wikipedia.org/wiki/Ulcerative_colitishttp://en.wikipedia.org/wiki/Hiatal_herniahttp://en.wikipedia.org/wiki/Hiatal_herniahttp://en.wikipedia.org/wiki/Hiatal_herniahttp://en.wikipedia.org/wiki/Hiatal_herniahttp://en.wikipedia.org/wiki/Ulcerative_colitishttp://en.wikipedia.org/wiki/Inflammatory_bowel_diseasehttp://en.wikipedia.org/wiki/Opportunistic_infectionshttp://en.wikipedia.org/wiki/Pneumoniahttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/AIDS


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CONENITA+CA1SES

*artagener syndrome primary immunode4ciencies

&illiams6Campbell syndrome and

arfan7s syndrome.

-atients ith alpha 86antitrypsin

de4ciency ha+e been found to be

particularly susceptible to

bronchiectasis,
http://en.wikipedia.org/wiki/Primary_ciliary_dyskinesiahttp://en.wikipedia.org/wiki/Primary_immunodeficiencieshttp://en.wikipedia.org/wiki/Williams-Campbell_syndromehttp://en.wikipedia.org/wiki/Marfan_syndromehttp://en.wikipedia.org/wiki/Marfan_syndromehttp://en.wikipedia.org/wiki/Alpha_1-antitrypsinhttp://en.wikipedia.org/wiki/Alpha_1-antitrypsinhttp://en.wikipedia.org/wiki/Marfan_syndromehttp://en.wikipedia.org/wiki/Marfan_syndromehttp://en.wikipedia.org/wiki/Williams-Campbell_syndromehttp://en.wikipedia.org/wiki/Primary_immunodeficiencieshttp://en.wikipedia.org/wiki/Primary_immunodeficiencieshttp://en.wikipedia.org/wiki/Primary_ciliary_dyskinesiahttp://en.wikipedia.org/wiki/Primary_ciliary_dyskinesia


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MORPHOLOGI!L "#P$%

Cylindrical or tubularbronchiectasis

aricose

saccular or cystic bronchiectasis


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Three diferent patterns o

bronchiectasis have been described

cylindrical bronchiectasis: theinvolved bronchi appear uniformly

dilatedvaricose bronchiectasis:the

aected bronchi have an irregular or

PATTERNS OF

BRONC!ECTAS!S


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#LIN&RI!L OR "'('L!R (RONHI$"!%I%


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)aricose bronchiectasis

*. &iagnosis 9 ChestCT


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Sacc/"ar &cystic( bronchiectasis:

The bronchi have a ballooned

appearance at the periphery"endin# in blind sacs $itho%t

reco#ni&able bronchial str%ct%resdistal to the sacs


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C:#TIC B($NC'IECT!#I#


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Cystis ; saccular

bronchiectasis

*. &iagnosis 9 ChestCT


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D/e to etio"o#ica" factor

Inf"a!!ation of bronchia" )a""

ca/sin#

+oss of s/ortin# str/ct/re

Res/"t in

Thic* s/t/! that obstr/ct the bronchi

The bronchia" )a"" beco!e

er!anent"y dia"ated and distorted


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PATHOPH-SIO+O-

&ilation an+ +istortion ofthe bronchi

&a,age of air-ayepitheliu,

&ilation an+ hyperplasiaof bloo+ capillary


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Bronchiectasis Pathophysiology

Airway Injury +

Secretion Stimuli

Secretion Stasis Infection

Airway Destruction +

Airway Dilation


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C)INIC!) !NIFE#T!TI$N

1. The produ!"o# o$ %&r'e (u!"!"e) o$ puru%e#! do$!e# $ou%*)+e%%"#' )pu!u+.

The +olume of sputum can be used for

estimating the se+erity of the disease

ild < 8= m)

oderate 8=>8?= m)

#e+ere @8?= m)


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A. Chro#" ou'h

,. He+op!-)"): Fre(ue#! More o++o#%- "# dr- &r"e!-

U)u&%%- +"%d /0%ood )!re&"#' o$ puru%e#!)pu!u+2

M&))"e he+op!-)") ") u)u&%%- $ro+

d"%&!ed 0ro#h"&% &r!er"e) or 0ro#h"&%*pu%+o#&r- &)!o+o)e) u#der )-)!e+"pre))ure


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4. Reurre#! p#eu+o#"&3

same segment

5. S-)!e+" +"$e)!&!"o#):

fever, weight loss


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SINS AND S-2PTO2S

Chronic cough ith foul smelling sputumproduction,

#ome people ith bronchiectasis mayproduce frequent green;yello sputum 1up

to A=ml 1 o2 daily2. Bronchiectasis may also present ith

hemoptysis -neumonia Bad breathindicati+e of acti+e infection. Frequent bronchial infections and

breathlessness are to possible indicators

of bronchiectasis.
http://en.wikipedia.org/wiki/Hemoptysishttp://en.wikipedia.org/wiki/Bad_breathhttp://en.wikipedia.org/wiki/Bad_breathhttp://en.wikipedia.org/wiki/Hemoptysis


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DIANOSTIC E3A+1ATION:

History an+ physical ea,ination hest /ray " 0co,puterise+ to,ography scan (loo+ tests "esting of the ,ucus to i+entify any

bacteria present hec2ing oygen levels in the bloo+ Lung function tests 0spiro,etry.


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&ilate+ bronchus

(RONHI$"!%I%


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CO2P+ICATIONS

Progressive suppuration. Hae,optysis3 ,a4or pul,onary

hae,orrhage. OP&3 e,physe,a3 chronic respiratory insu5ciency


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C$-)IC!TI$N

)ocal complication

Recurrent pneu,onia

Lung abcess

$,pye,a

He,optysis

Pul,onary hypertension


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#ystemic complication

Hypoproteine,ia 6a,yloi+osis

Generali7e+ e+e,a 0188g,

sputu,9*:; g proteinprotein loosing

pneu,opathy


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TREAT2ENT

Treat!ent of bronchiectasis inc"/des

contro""in# infectionsand bronchia"

secretions,

re"ie%in# air)ay obstr/ctions,

re!o%a" of affected ortions of "/n# by

s/r#ica" re!o%a" or artery e!bo"i4ation

re%entin#co!"ications$
http://en.wikipedia.org/wiki/Infectionhttp://en.wikipedia.org/wiki/Complication_(medicine)http://en.wikipedia.org/wiki/Complication_(medicine)http://en.wikipedia.org/wiki/Infection


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TREAT2ENT

Theray has se%era" !a5or #oa"s:

/12Tre&!+e#! o$ "#$e!"o#4 p&r!"u%&r%- dur"#' &u!e

e5&er0&!"o#)

/62I+proed %e&re o$ !r&heo0ro#h"&% )ere!"o#)

/,2 Redu!"o# o$ "#$%&++&!"o#

/72 Tre&!+e#! o$ "de#!"$"&0%e u#der%-"#' pro0%e+


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TREAT2ENT

2edica" !ana#e!ent

8.I!ro%in# the draina#e of air)ay

82 epectorant

A2 bronchodilators

G2 postural drainage


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'$ Antibiotic

The choice of antibiotics sho/"d

be acc/rate"y by the res/"ts of

s/t/! c/"t/re and dr/#

sensiti%ity test$

E!irica" theray

666antise/do!ona" antibiotics$


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ANT!B!OT!CS ARE TE CORNERSTONE OF BRONC!ECTAS!S 'ANA(E'ENT

Antibiotics are /sed on"y d/rin# ac/te

eisodes

Choice of an antibiotic sho/"d be #/ided

by #ra!7s stain and c/"t/re of s/t/!

E!iric co%era#e &a!o8ici""in, co6

tri!o8a4o"e,"e%of"o8acin( is often #i%en

initia""y


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B($NC'$%I)!TE(

ronchodi"ators to i!ro%e

obstr/ction and aid c"earance

of secretions are /sef/" in

atients )ith air)ay

hyerreacti%ity and re%ersib"e

airf"o) obstr/ction


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S/r#ica" !ana#e!ent is indicated

9$ Rec/rrent and refractory c"inica"

sy!to!s are d/e to a foca" area

of disease in%o"%e!ent$

'$ 2assi%e he!otysis

2ana#e!ent of he!otysis


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S%r#ical resection

Bronchial arterial embolization Altho%#h resection )ay be

s%ccess%l i disease islocali&ed" e)boli&ation is

preerable $ith $idespread


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N1RSIN 2ANAE2ENT:

History and hysica" e8a!ination

Obtain history re#ardin# a!o/nt

and characteristics of s/t/!

rod/ced, inc"/din# hae!otysis$

A/sc/"tate "/n#s for diff/se rhonchi

and crac*"es$


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N'R%ING &I!GNO%I%

IneHecti+e !iray Clearance related

to tenacious and copious secretions

Bronchiectasis Nisha

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