3. Definition: Abnormal and permanent dilation of
bronchi.
• Focal or diffuse distribution
• Clinical consequences – chronic and recurrent
infection and Pooling of secretions in dilated
airways.
OR
Bronchiectasis is defined as permanent, abnormal
dilatation of one or more large bronchi.
6. 1. Tuberculosis,
2. Pneumonia,
3. Inhaled foreign bodies,
4. Allergic bronchopulmonary aspergillosis (fungi) and
bronchiol tumours are the major acquired causes of
bronchiectasis.
7. INFECTIVE CAUSES ASSOCIATED WITH
BRONCHIECTASIS INCLUDE
Infections caused by the staphylococcus, klebsiella, or
bordetella pertussis, the causative agent of whooping
cough
ASPIRATION OF AMMONIA AND OTHER TOXIC
GASES,
Pulmonary aspiration,
Alcoholism, heroin (drug use),
Various allergies all appear to be linked to the
development of Bronchiectasis.
8. Childhood Acquired Immune Deficiency Syndrome
(AIDS), which predisposes patients to a variety of
pulmonary ailments, such as pneumonia and other
opportunistic infections.
Inflammatory bowel disease, especially ulcerative
colitis.
A Hiatal hernia can cause Bronchiectasis when the
stomach acid that is aspirated into the lungs causes
tissue damage.
9. CONGENITAL CAUSES
Kartagener syndrome/ Immotile Ciliary Syndrome.
Primary immunodeficiencies.
Williams-Campbell syndrome and Marfan’s
syndrome.
Patients with alpha 1-antitrypsin deficiency have
been found to be particularly susceptible to
bronchiectasis,
10. Also known as Broncho-malacia is a disease of the
airways where cartilage in the bronchi is defective.
It is a form of congenital cystic bronchiectasis, leads
to collapse of the airways.
11. Disorder of connective tissue, resulting in abnormally
long and thin digits.
14. Most severe form of bronchiectasis. The bronchi are
severely dilated and the bronchi end blindly in a
dilated thick walled cyst.
15. The bronchi resemble like varicose veins and also like
serpentine. The luminal dilation is characterized by
alternating areas of luminal dilation and constriction,
creating a beaded appearance,
and the wall thickening is
irregular.
16.
17. Due to etiological factor
Inflammation of bronchial wall
(Causing)
Loss of supporting structure
(Result in)
Thick sputum that obstruct the bronchi
The bronchial wall become permanently dilated and
distorted/ twisted
18.
19.
20. 1. The production of large quantities of purulent and
often foul-smelling sputum.
The volume of sputum can be used for estimating the
severity of the disease
Mild < 10 mL
Moderate 10~150 mL
Severe >150 mL
21. 2. Chronic cough
3. Hemoptysis:
Frequent.
More commonly in dry variety.
Usually mild (blood streaking of purulent sputum)
Massive hemoptysis is usually from dilated bronchial
arteries or bronchial pulmonary anastomoses under
systemic pressure.
23. Chronic cough with foul smelling sputum production,
Some people with bronchiectasis may produce
frequent green/yellow sputum (up to 240ml (8 oz)
daily).
Pneumonia.
Frequent bronchial infections and breathlessness are
two possible indicators of
24. Dyspnoea, wheezing – widespread
bronchiectasis or underlying COPD.
Exacerbation of infection: Sputum volume
increase, purulence or blood.
25.
26. History and physical examination
Chest x-ray
Blood tests
Checking oxygen levels in the blood
Lung function tests (spirometry): Airflow
obstruction – FEV1 decreased.
27. CT Scan:
Peribronchial thickening
Dilated bronchioles
Sputum culture: Testing of the mucus to identify any
bacteria present
Pseudomonas
H.influenzae.
28. Bronchoscopy: Obstruction – foreign body, tumor
Immunoglobulin
Cilia function and structure – Kartagener
syndrome.
29. Goals: 1. Eliminate cause
2. Improve tracheo bronchial
clearance
3. Control infection
4. Reverse airflow obstruction
32. Antibiotics
(The choice of antibiotics should be accurately by the
results of sputum culture and drug sensitivity test.)
Initial Rx: Empiric coverage (amoxicillin,
cotrimoxazole, levofloxacin) is often given initially,
Septran
Pseudomonas – Quinolone, aminoglycoside,
3rd
generation cephalosporin, pipracillin.
33. SURGERY : Surgical management is indicated
Recurrent and refractory clinical symptoms are
due to a focal area of disease involvement.
Surgical resection
Bronchial artery embolization
Although resection may be successful if
disease is localized, embolization is preferable
with widespread disease.
Lung transplant
34. A catheter is used to deliver small particles that block
the blood supply to the particular part of body.
(Heamoptysis)
40. Natural therapy
Yoga
Healthy lifestyle
Emotional support
Drug free salt therapy
41. Salt therapy is a gentle, non-invasive and drug free
treatment assisting the body to cleanse itself of toxins
and naturally improve general health and wellbeing.
The therapy involves sitting and relaxing in a specially
designed salt room and breathing in the microscopic
salt particles which has a positive effect on the body.
The salt room itself is a micro climate that has been
created free of toxins and allergens which allows the
body to rest and start to naturally heal itself.
Salt has natural healing properties that help sufferers of
respiratory issues, skin problems and is also great for
overall health.
44. Goal: Improvement in gas exchange
Nursing intervention
1. Administer bronchodilators as prescribed.
Inhalation is the preferred route
Educate regarding types of indoor and outdoor air
pollution
2. Instruct and encourage patient in diaphragmatic
breathing and effective coughing.
45. Nursing Diagnosis: Ineffective airway
clearance related to increased mucus
production, ineffective cough,
bronchopulmonary infection, and other
complications
Goal: Achievement of airway clearance
46. 1. Adequately hydrate the patient.
2.Use of diaphragmatic breathing and coughing
techniques.
3. Assist in administering nebulizer .
47. 5. Avoid bronchial irritants such as cigarette smoke,
aerosols, extremes of temperature, and fumes.
6. Teach early signs of infection :
a. Increased sputum production
b.Change in color of sputum
c. Increased thickness of sputum
d.Increased shortness of breath, tightness in chest, or
fatigue
e. Increased coughing
f. Fever or chills
7. Administer antibiotics as prescribed.
48.
49. Bronchiectasis , an extreme form of
obstructive bronchitis, causes permanent ,
abnormal dilation and distortion of bronchi
and bronchioles. Management of
bronchiectasis is same as that for COPD
