Understanding the Bronchiectasis Prognosis Now! Here! The article below will discuss the bronchiectasis prognosis of in a complete and detailed. Before you find out about the bronchiectasis prognosis, would be better if you also have to know some things about bronchiectasis such as epidemiology, definition, and fatofisiologi Pathogenesis, pathology, etiology and predisposing factors, clinical features, clinical manifestations, physical examination, diagnosis and treatment of bronchiectasis.

1. Understanding the Bronchiectasis Prognosis
Understanding the Bronchiectasis Prognosis Now! Here!
The article below will discuss the bronchiectasis prognosis of in a complete and detailed.
Before you find out about the bronchiectasis prognosis, would be better if you also have to know some
things about bronchiectasis such as epidemiology, definition, and fatofisiologi Pathogenesis, pathology,
etiology and predisposing factors, clinical features, clinical manifestations, physical examination,
diagnosis and treatment of bronchiectasis .
Epidemiology of bronchiectasis
Before you know about bronchiectasis prognosis then the first thing you need to know the epidemiology
bronchiectasis. Worldwide incidence of bronchiectasis is still high, usually occurring in underdeveloped
countries or developing countries. In the era before antibiotics the symptoms usually appear in the first
decade of life. Currently moving towards the onset of adulthood. With limited data, some studies
estimate that between 60-80 years of age is the age most affected by the frequency of bronchiectasis
disease.
Definition of bronchiectasis
The next thing you should know before bronchiectasis prognosis is the definition of bronchiectasis
bronchiectasis. Bronchiectasis was first introduced by Laenec in 1819. Bronchiectasis is a chronic
respiratory disease (the bronchi and the tree/bronchioles) with characteristics of a permanent abnormal
dilatation accompanied by damage to the bronchial wall. Usually found in the area varied changes
including trans mural inflammation, mucosal edema (cylindrical bronchiectasis), ulceration (cystic
bronchiectasis) with neovascularization and the incidence of recurrent obstructs due to infection
(bronchiectasis varicose) resulting in changes in bronchial wall architecture and function. Circumstances
which often induce the occurrence of bronchiectasis are infection, failure drainage secretions, and
airway obstruction or interference with the individual’s defense mechanisms.
Etiology bronchiectasis
Exact cause of bronchiectasis is not known, but many factors which may result in bronchiectasis, both
hereditary factors and acquired factors and it is important for bronchiectasis prognosis.
I. Congenital Factor
This rationale first put forward by Grawitz 1880, later followed by Sourbruch. Sourbruch suggests that
8% of cases of bronchiectasis are a congenital abnormality. Wayne and Taussing reported 2 cases of
bronchiectasis as a result of congenital abnormalities in both cases the type of bronchiectasis was
saccular type appealable. On examination bronkografi. Bronchial collapse seemed at the time of
expiration and inspiration at the time of the occurrence of dilatation. This description Underclassman
signs of bronchial cartilage deficiency.
www.bronchiectasisprognosis.com

2. Other bronchiectasis congenital abnormalities are associated with Kartagener syndrome. It is said in the
literature only 20% of patients with dextrocardia suffer from bronchiectasis. Olen therefore of opinion
on Congenital bronchiectasis is still controversial, whether it occurs congenital bronchiectasis or occur
after birth but that symptoms are shown at an early age is very little life and symptoms of bronchiectasis
was evident after the patient has an infection such as pertussis, influenza and morbili. Other
abnormalities associated with congenital factor are sequestering lung, pulmonary cystic fibrosis,
hypogammaglobulinemia and peripheral nerve disorders bronchial wall.
Factor of obstruction and infection
Obstruction and infection factors play an important role in the occurrence of bronchiectasis.
a) Obstruction:
Obstruction can occur at most of the small bronchi branch or on one branch of a large bronchus.
Bronchial obstruction in the small branches can be caused by aspiration of mucus into the bronchial
lumen, which causes the collapse in the distal part of the obstruction. This situation will cause
obstruction of the proximal intraluminal pressure will increase, thus resulting in dilatation of the bronchi
in case of infection in the bronchial dilatation as well as destruction of the bronchial wall occurs, there
will be a permanent dilatation of bronchi This situation usually occurs in children who suffer. Pneumonia
and bronchopneumonia who received inadequate treatment.Bronchial obstruction in a large branch in
causing collapse of the distal obstruction.If there is infection and destruction of bronchial wall collapse
in the bronchi that will happen permanent dilatation of bronchi. Obstruction factors are factors that
contribute to the occurrence of persistent infection in a state of obstruction, drainage of secretions in
the distal part of the state suffers when this happens continuously will cause bronchial dilatation and
destruction.
b) Factors of infection:
Acute respiratory tract infections such as bronchopneumonia peribronkial can cause tissue destruction.
Peribronkial tissue damage will cause the withdrawal of the bronchial wall causing dilatation of the
bronchi.
Pathogenesis bronchiectasis
Iranian classification of bronchiectasis is presented, but is deemed to include broader aspects is the
classification of Reid and it is important for bronchiectasis prognosis. Reid in 1950 divided into 3 types of
bronchiectasis:
1. Silindris - cylindrical bronchiectasis
www.bronchiectasisprognosis.com

3. 2. Varicose
3. Victim or saccular
Silindris type is often associated with pulmonary parenchymal damage there is the addition of bronchial
diameter occurs in varicose type bronchiectasis bronchial dilatation is accompanied by a local
constriction in the walls of the tipi bronchus cystic dilatation of progressive dilatation of the bronchi
walked toward the bubble-shaped peripheral dam.
Bronchiectasis often occurs after a lung infection caused by viruses, mycoplasma and tuberculosis all
processes related to inflammation and tissue damage to ¬, also on other conditions that cause
pulmonary inflammation without his ¬ infection, such as ammonia inhalation, gastro esophageal reflux
and pulmonary hypnosis can cause bronchiectasis . Failure of lung defense mechanisms causes chronic
lung damage.
Mukocilier clearance is a mechanism that most efficient in removing respirable particles including
bacteria, aided by local immunoglobulin, especially IgA and phagocytes, especially macrophages.
Sometimes mechanical ¬ me this is not strong enough to carry out their duties eg if inhaled bacteria are
quite a lot.
At this time experiencing pulmonary inflammatory processes and plasma proteins including
immunoglobulin and complement enter into the tissues and secretions. Besides circulating phagocytes
(neutrophils monocytes dean gathered to enhance phagocytosis of bacteria. There is also a disorder that
causes lung defense mechanisms persistent bacterial infections such as the immotile cilia,
granulomatous hipogammaglobulinernia and chronic disease. Semarang is now known that proteolysis
enzymes released by phagocytes that gather and direct cause tissue damage that finally happened
bronchiectasis. This enzyme is derived from the neutrophil elastase (NE).
The role of NE in the pathogenesis of bronchiectasis is evidenced by the occurrence of bronchiectasis in
patients with alpha 1 antitrypsin deficiency. This protein is the most powerful natural inhibitor to NE and
in the event of deficiency it could lead to the NE that is released from neutrophils remains, active and
www.bronchiectasisprognosis.com

4. cause tissue damage even though the infection is mild. When found, bronchiectasis is usually
accompanied by impaired clearance and will increase the disruption mukocilier other defense
mechanisms. Because of that subject would be vulnerable to persistent and recurrent infections and
potentially to further lung damage due to accumulation of phagocytes. These two components namely
the decrease in clearance and persistent infection will lead to bronchiectasis.
Condition associated with bronchiectasis
1. Bronchial obstruction:
Bronchiectasis pascaobstruction can occur in patients with end bronchial tumors, bronkolitiasis and
inflammatory disorders such as tuberculosis and foreign body aspiration. Can also occur in patients with
medial lobe syndrome.
2. Infection:
Bronchiectasis can be derived from necrotic lung infections untreated Rosenstein et al. first give
attention to bronchiectasis after bronkopulmoner necrosis caused by Klebsiella, Staphylococcal, other
aerobic bacteria and a tuberculosis. Can also by M. nontuberkulosis, Mycoplasma pneumonia, anaerobic
pulmonary infections and complications of measles, pertussis influenza and adenovirus type 7. Carson et
al .. Found impaired acquisition of cilia in the nasal epithelium of children with viral infections in upper
respiratory tract. Most of the infected adenovirus Para influenza.With electron microscopy visible loss of
epithelial cilia progressively during episodes of infection.
3. Inflammation:
In bronchiectasis has been reported the occurrence of combustion of ammonia in the airways and after
expires stomach acid that may occur in bronchopulmonary infection that causes infiltrates on chest X-
ray picture. Although it is known that the infection is the most hoops in bronchiectasis but the effects of
acid gastric ulceration also come into play.
4. Allergic bronchopulmonaryaspergillosis:
Allergic bronchopulmonaryaspergillosis is characterized by bronchospasm, bronchiectasis and secretions
that contain aspergillums. Pathophysiology involves a hypersensitivity reaction to inhaled antigen in the
tracheobronchial branching. Bronchiectasis occurs as a result of blockage of secretions that contain Hipa
of aspergillums. The process involves an allergic reaction type I (immediate), type 3 Arthus and there
was an increase. Serum levels of IgG and IgE. Scadding believes that the discovery of the proximal
saccular bronchiectasis in the upper lobe is typical for allergic bronchopulmonaryaspergillosis, but this
does not occur in all cases and occurred also in patients with bronchiectasis by other reasons.
5. Immune Deficiency:
www.bronchiectasisprognosis.com

5. Bronchiectasis and other chronic diseases as well as frequent relapses sinopulmoner infection usually
occurs in patients with congenital or acquired immune deficiency. Abnormal B lymphocytes are often
associated with bronchiectasis. Hipogammaglobulinemia congenital or acquired is characterized by a
decrease. Or loss of circulating IgG in some patients with bronchiectasis.
6. Alpha 1 antitrypsin deficiency:
Although this condition is often associated with emphysema, but Laurel and Ericson in 1963 found the
alpha I antitrypsin deficiency in two of three patients with bronchiectasis, but pathogen precisely
remains unclear. Alpha I antitrypsin to inhibit ¬ proteolysis enzymes that can crush lung possibility is that
the protease inhibitory lawyer ¬ protect the lung during infection or other inflammatory conditions and
lung parenchyma and the airways become more susceptible to damage if the substance is lacking.
7. Primary Cilia dyskinesia:
Site total inverses, bronchiectasis and nasal polyps or recurrent sinusitis is often found in Kartagener’s
syndrome.
8. Cystic Fibrosis:
Cystic Fibrosis is characterized by impaired chloride transport disorder resulting turnover chloride into
the cell. There is accumulation of chloride inside the cells so that cells become dry and secretions
become thick and even petrified. These circumstances cause chronic irritation and resulting in recurrent
infections.
Clinical Manifestation Bronchiectasis
Not all patients with bronchiectasis provide complaints and symptoms. Bronchiectasis is known as dry
bronchiectasis. Which is usually located in the upper lobe? The most common complaint is chronic
productive cough. Morning cough, especially in patients with a lot of sputum, cough will occur
throughout the day. Sputum nature always varies in each case. Sputum sometimes white and
sometimes colored yellow in patients with severe infections sputum number could reach 400 500 cc /
day. Coughing of blood occurs in 50 70% of cases bronchiectasis. Rupture of bronchial arteries can cause
a massive coughing up blood. Ulceration of the bronchial wall can cause coughing up blood.
www.bronchiectasisprognosis.com

6. Bronchiectasis patients often complain of recurrent fever. Another common complaint was chest pain
and shortness of breath.
On physical examination abnormalities were found hanging from the area, as well as the degree of
airway obstruction that occur. Clubbing is often found in people with bronchiectasis old. Sometimes not
found physical abnormalities. Lung disorder that is often encountered is wet crackles. Other disorders
that can also be found are clada movement disorders. Abnormalities in cardiac percussion and shifting
boundaries.
Radiological bronchiectasis
In plain radiographic bronchiectasis often give a normal picture. Ogilvie get 6 of 68 case series have
normal radiology finding. CXR in bronchiectasis provides an illustration:
- Bronkovaskuler increases
- Atelectasis
- Lung collapse
- Cystic with or without air fluid level
When the plain chest X-ray picture is not clear tomogram examination can be done.
Bronkografi more accurate examination to determine the type and extent of the bronchiectasis.
According to Simon, although bronkografi seems harmless, should not be done without a
specific purpose, such as bronkografi only to determine the diagnosis is clear and visible on
plain photo tomogram.
The main indications to perform bronkografi:
1. for the radiological diagnosis
- strengthen the diagnosis of bronchiectasis, when clinical suspicion of bronchiectasis whereas normal
chest radiograph and tomogram normal or abnormal but no sufficient characteristics to
establish the diagnosis of bronchiectasis
- In the case of blood cough cases that cannot be explained by the cause
- Strengthen information about the nature of lesions that appear at regular chest X-ray picture and the
tomogram.
www.bronchiectasisprognosis.com

7. 2. To know the exact anatomic location, size and segmental distribution of the bronchiectasis. This will
be done when considering surgery or postural drainage is more appropriate.
Bronkografi should be done if the patient is stable, and already done a good bronchial hygiene and it is
important for bronchiectasis prognosis. It is important to avoid mistakes in the assessment. A lot of
secretions or blood in the lumen of the bronchi may provide an incomplete picture of the state of the
bronchial wall. In congestive heart failure and in patients with poor lung function hopefully examination
is not done.
Other Examination of bronchiectasis
Sputum: Sputum patients with infections, often times if left in place will form a third layer of the upper
layer of clear serous middle layer and lower layer consisting of turbid pus and cellular debris.
Microscopically would seem fibers elastic fibers and fibers of muscle fibers as a result of the destruction
of the bronchial wall due to inflammation.
For bacteriological examination materials should be taken with aspirations transracial sputum.
Performed the outward appearance inspection grams, culture and resistance testing.
EXAMINATION OF BLOOD
Blood tests are sometimes within normal limits. Anemia is caused by the Harmonic course of the
disease. Leukocytosis occurs when there is active infection with suppuration.
Diagnosis of bronchiectasis
Diagnosis is often already be established from the history of recurrent cough, recurring fever, coughing
up blood that accompanied the picture with or without cystic air fluid level on regular chest X-ray.
Bronkografi examination to determine a definitive diagnosis.
MANAGEMENT bronchiectasis
Management of patients with bronchiectasis is very important for bronchiectasis prognosis, basically
consists of four things:
1. Provision of medicines
2. Physiotherapy
3. Surgery
4. Prevention efforts.
www.bronchiectasisprognosis.com

8. Provision of medicines
1. Antibiotic
Antibiotics are meant to control the infection that occurs and it is important for bronchiectasis
prognosis. In patients with ambulatory patients who are given antibiotics in case of changes in the
nature of the mucous sputum becomes purulent sputum and increasing the amount of:
Antibiotics must be in accordance with the results of resistance testing. In a state of acute exacerbation
of a broad-spectrum antibiotics are given Robert and Ingold in their research have
That amoxicillin 2 g / day gives better results compared with ampicillin 4 g / day.
This is because the absorption of amoxicillin into the bronchial secretions better than ampicillin.
2. Bronchodilators
Bronchodilator drugs may be given medication in patients with bronchiectasis who gives a picture of
chronic bronchitis and airway obstruction and it is important for bronchiectasis prognosis.
Bronchodilators are useful to improve the clearance mukocilier, smooth muscle relaxation and reduce
edema mucosa. Benefits of bronchodilators in patients with bronchiectasis by using salbutamol been
examined by Nojrodi et al .. There VEP1 increase of 16% after administration of inhaled salbutamol.
3. Mucolytic and expectorant
Mucolytic drug is a drug that can thin the secretions in the airways by reducing or eliminating the
threads and mukoproteinmucopolysaccharide sputum and it is important for bronchiectasis prognosis.
The use of medicinal drugs in patients with bronchiectasis mucolytic particularly useful to say on the
state of a substance that increases the toxicity of substances like peroxide on acrolein toxicity.
Expectorant drug is a drug that can stimulate the secretion of phlegm from the airways. Mechanism of
action is to stimulate expectorant gastric mucosa and subsequent reflexively stimulate the secretion of
the airways, thereby reducing sputum viscosity and facilitate expenditure. Has become customary to use
a cough expectorant every complaint.Until now no data showing an increase in the clearance or repair
of a constant condition of the patient after administration of expectorant.According to Cott GR, very few
of the benefits of expectorant.
4. Steroids
www.bronchiectasisprognosis.com

9. Steroids should be considered if found any component of allergic aspergillums bronkopulmoner
commoners and also proved effective in bronchiectasis caused by cystic fibrosis and sometimes and it is
important for bronchiectasis prognosis.
5. Other therapies
Gamma globulin effective in patients with hipogammaglobulinemia and should be given a lifetime and it
is important for bronchiectasis prognosis. The benefits of this therapy in secondary
hipogammaglobulinemia state remain unclear, but may be useful in a failed state with antibiotic
therapy.
Immune suppression therapy is useful in circumstances of severe infections caused by increased
immunoglobulin and immune complex.
Antacids can be given to people associated with gastrointestinal reflux.
Radiotherapy is useful at least in the short term, if the occlusion of tumor is the cause of disease.
Treatment of any infection, upper respiratory symptoms sometimes can improve bronchiectasis.
Physiotherapy
Physiotherapy in patients with bronchiectasis meant to remove secretions in the airways and it is
important for bronchiectasis prognosis. With adequate physiotherapy secretions in the airways will flow
out and this can significantly improve lung function.
Physiotherapy is done is breathing exercises and postural drainage. Postural drainage is performed if
excessive sputum production and sputum retention occurred. Postural drainage is not recommended in
patients with impaired pulmonary physiology or patients with severe heart trouble. Postural drainage
positions depending on the location of the affected segment.
SURGICAL
Surgery is performed when conservative treatment is adequate with no complaints remained basically
the surgery performed on
- Recurrent infections
- recurrent coughing up blood
- massive coughing up blood
www.bronchiectasisprognosis.com

10. The operation performed depends on the location, size and lung function can be segmentektomi
Surgery patients, lobectomy or pneumonectomy and it is important for bronchiectasis prognosis.
Surgery does not guarantee the patient free from bronchiectasis. Ginsberg et al. found 85 of 221 cases
operated on their side of the bronchiectasis.
Prevention of bronchiectasis
Prevention efforts include the provision of immunization, adequate treatment in patients with
pneumonia, bronchopneumonia, pertussis and morbili and it is important for bronchiectasis prognosis.
for patients with bronchiectasis made the effort to prevent people from avoiding ingredients that can
stimulate the production of excessive secretions. Avoiding irritants away from the material, sleeping pills
and drugs that suppress cough.
Complication bronchiectasis
1. Pneumonia
Often develop recurrent exacerbations of upper respiratory tract infections. These infections often
involve abnormal bronchial area.
2. Pleuritis
Pleural pain may arise in conjunction with pneumonia usually develops from the upper respiratory tract
infection.
3. Pleural effusion or empyema
Pleural effusion or empyema is relatively rare in bronchiectasis.
4. Sinusitis
Sinusitis is a common complication of bronchiectasis and almost certainly occurs in severe cases.
5. Hemoptysis
Hemoptysis sometimes occurs in bronchiectasis, and most often is mild hemoptysis. In recurrent
hemoptysis and uncontrolled, is an indication for resection. Location of the source of bleeding is
sometimes difficult to determine.
6. Brain abscess
www.bronchiectasisprognosis.com

11. A brain abscess is a complication of chronic bronchiectasis. Once this is the worst cause of death.When
these complications are extremely rare.
7. Amyloidosis
Although amyloidosis is a very rare complication, but this possibility should still be considered. In the
event of an enlarged liver or spleen, the possibility of amyloidosis should be considered.
Bronchiectasis Prognosis
At the time of modern medicine has not been introduced, the bronchiectasis prognosis is poor, with
bronchiectasis modern treatment, medical or surgical prognosis (life expectancy) was good but this
disease cannot be cured completely.
Conclusion bronchiectasis
1. Clinical manifestations of signs and symptoms depending on severity of bronchiectasis include chronic
cough, recurrent disease, with recurrent, repetitive coughing up blood and coughing up blood
sometimes massive On examination found shortness of breath, clubbing and crackles wet.
2. The diagnosis of bronchiectasis often can be established from a history of recurrent productive
chronic cough, recurring fever, coughing up blood repeatedly with cystic image with or without water
fluid levels on plain chest X-ray or tomogram. To determine a definitive diagnosis bronkografi
examination.
3. Antibiotics are given when there is an increased amount of sputum, and no change in the nature of
the mucous sputum becomes purulent. antibiotics should be adjusted with the results of resistance
testing.
4. granting mucolytic beneficial in patients with bronchiectasis. Expectorant unclear benefits.
5. Physiotherapy greatly helps remove secretions from the airways.
6. Surgery is only done if there is recurrent infection, recurrent coughing up blood and coughing up
blood massive.
Hopefully this article on bronchiectasis prognosis of benefit to you.
www.bronchiectasisprognosis.com