Bronchiectasis
Bronchiectasis is a disease characterized by an abnormal widening of the bronchi. It can result from numerous etiologies including congenital defects and disease processes such as infection.
The widening of the bronchi interferes with the normal mucus clearance process and leads to pooling of secretions.
Bronchiectasis is also often characterized by the production of copious amounts of sputum, as the natural defense mechanisms of the lung attempt to clear the invading organisms. This exacerbates the secretion retention.
Because of the excessive production of pulmonary mucus and because these secretions are not adequately cleared, patients with bronchiectasis are very susceptible to pulmonary infection. Recurrent pneumonia is common.
The bronchiectasis process is thus a vicious cycle of overproduction of thick and purulent mucus, inability to clear the secretions, bronchial wall damage, further mucus production and progressive compromise of the lung’s normal airway clearance mechanisms.
In addition to placing patients at risk for pulmonary infection, secretion retention results in impaired gas exchange.
Complications of bronchiectasis can include: hemoptysis and, in some cases, major pulmonary hemorrhage; obliteration of peripheral airways with associated extensive bronchitis and emphysema; and chronic respiratory insufficiency and cor pulmonale (right heart failure).
To clear excessive secretions, and minimize the complications of the disease, people with bronchiectasis often require frequent Airway Clearance Therapy.
Sources
Currie DC, Pavia D, Agnew JE, et al. Impaired tracheobronchial clearance in bronchiectasis. Thorax. 1987;42: 126-130. Murray JF. New presentations of bronchiectasis. Hospital Practice. March 30, 1991: 55-74. Trucksis M, Schwarz MN. Bronchiectasis: A current view. In JS Remington, MN Schwarz, eds. Current Clinical Topics in Infectious Diseases. New York, NY: McGraw-Hill 1991: 170-205.
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