Search This Blog

Diagnostic Examination in Patients with Bronchiectasis


Diagnostic Examination in Patients with Bronchiectasis
Bronchiectasis is a permanent abnormal dilation of one or more branches of a large bronchus (Barbara, 1998).

Classification

Based on bronchography and bronchiectasis pathology can be divided into three, namely:
  • Cylindrical bronchiectasis
  • Fusiform bronchiectasis
  • Cystic or saccular bronchiectasis.
Etiology
  • Infection
  • Heriditer abnormalities or congenital abnormalities
  • Mechanical factors that facilitate the onset of infection
  • Patients often have a history of pneumonia as a complication of measles, whooping cough, or other infectious diseases in childhood.

Diagnostic Examination in Patients with Bronchiectasis

1. Examination of sputum
Sputum examination include; sputum volume, sputum color, cells and bacteria in the sputum. When there is an infection sputum volume will increase and become purulent and contains more leukocytes and bacteria. Sputum culture can produce the normal flora of the nasopharynx, streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aereus, Klebsiella, aerobacter, Proteus, Pseudomonas aeruginosa. If found foul-smelling sputum showed anaerobic infection.

2. Examination of peripheral blood.
Usually found in the normal range. Sometimes found any leukocytosis showed suppuration active and anemia showed that chronic infection.

3. Examination of urine
Found within normal limits, sometimes found any significant proteinuria caused by amyloidosis, however serum immunoglobulins are usually within normal limits, can sometimes increase or decrease.

4. Examination of ECG
Regular ECG within normal limits except in advanced cases existing cor pulmonary complications or signs of cardiac stimulation. Spirometry in mild cases may be normal, but in severe cases there is an abnormality of obstruction by a decrease in expiratory volume 1 minute or decrease in vital capacity, usually accompanied by respiratory insufficiency which can lead to:
  • Ventilation and perfusion imbalance.
  • Increase the pressure difference alveoli-arterial PO2.
  • Hypoxemia.
  • Hypercapnia.
5. Additional examination to determine the predisposing factors examined:
  • Immunological examination.
  • Examination of spermatozoa.
  • Bronchial biopsies and nasal mucosa (bronchopulmonary repeated).
6. PA and Lateral chest radiograph
Lung markings are usually found to be more rugged and boundaries become blurred markings, clustered, sometimes there is a wasp nest picture and description of the boundaries of cystic and fluid air surface. Most of the left lung lobe, because it has a smaller diameter and located right crosses mediastinum, lingual segment of the left upper lobe and medial lobes of the right lung.

7. Examination of bronchography
Bronchography not routinely done, but if there is any indication of where to evaluate the patient to be operated on, ie patients with pneumonia are limited to somewhere and repetitive who showed no clinical improvement after receiving conservative treatment or patients with massive hemoptysis.
Bronchography done after a steady state, after the administration of antibiotics and postural drainage is adequate so that the net bronchial secretions.

Ineffective Airway Clearance related to Bronchiectasis

Related Articles: