Diagnosis and Treatment of Bronchiectasis

被引:145
作者
Vendrell, Montserrat [1 ]
de Gracia, Javier [2 ]
Olveira, Casilda [3 ]
Angel Martinez, Miguel [4 ]
Giron, Rosa [5 ]
Maiz, Luis [6 ]
Canton, Rafael [7 ]
Coll, Ramon [8 ]
Escribano, Amparo [9 ]
Sole, Amparo [10 ]
机构
[1] Hosp Josep Trueta, Serv Neumol, Girona, Spain
[2] Hosp Univ Vall Hebron, Serv Neumol, Barcelona, Spain
[3] Hosp Carlos Haya, Serv Neumol, Malaga, Spain
[4] Hosp Gen Requena, Unidad Neumol, Valencia, Spain
[5] Hosp Princesa, Serv Neumol, Madrid, Spain
[6] Hosp Ramon & Cajal, Serv Neumol, E-28034 Madrid, Spain
[7] Hosp Ramon & Cajal, Microbiol Serv, E-28034 Madrid, Spain
[8] Hosp Badalona Germans Trias & Pujol, Serv Rehabil, Badalona, Spain
[9] Univ Valencia, Serv Pediat, Unidad Neumol Pediat, Hosp Clin Univ, E-46003 Valencia, Spain
[10] Hosp Univ La Fe, Unidad Fibrosis Quist Adultos & Trasplante Pulmon, Valencia, Spain
来源
ARCHIVOS DE BRONCONEUMOLOGIA | 2008年 / 44卷 / 11期
关键词
Bronchiectasis; Exacerbation; Bronchial colonization; Bronchial infection; Bronchial inflammation;
D O I
10.1016/S1579-2129(08)60117-2
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Bronchiectasis is the end result of several different diseases that share principles of management. The clinical course usually involves chronic bronchial infection and inflammation, which are associated with progression. The cause of bronchiectasis should always be investigated, particularly when it can be treated. We recommend evaluating etiology symptoms. bronchial colonization and infection, respiratory function. inflammation. structural damage, nutritional status, and quality of life in order to assess severity, and to monitor clinical course. Care should be supervised by, specialized units. at least in cases of chronic bronchial infection, recurrent exacerbations, or when there is a cause that is likely to respond to treatment. Improving symptoms and halting progression are the goals of management, which is based on treatment of the underlying cause and of acute or chronic infections and on the drainage of secretions. Complications that arise must also be treated. Antibiotic prescription is guided by how well infection is being controlled, and this is indicated by the color of sputum and a reduction in the number of exacerbations. We recommend inhaled antibiotics in cases of chronic bronchial infection that does not respond to oral antibiotics, when these cause side effects, or when the cause is Pseudomonas species or other bacteria resistant to oral antibiotics. Inhaled administration is also advisable to treat initial colonization by Pseudomonas species.
引用
收藏
页码:629 / 640
页数:12
相关论文
共 51 条
[1]   Bronchial inflammation and colonization in patients with clinically stable bronchiectasis [J].
Angrill, J ;
Agustí, C ;
De Celis, R ;
Filella, X ;
Rañó, A ;
Elena, M ;
De la Bellacasa, JP ;
Xaubet, A ;
Torres, A .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2001, 164 (09) :1628-1632
[2]  
[Anonymous], 2001, COCHRANE DB SYST REV
[3]   Multicenter randomized controlled trial of withdrawal of inhaled corticosteroids in cystic fibrosis [J].
Balfour-Lynn, Ian M. ;
Lees, Belinda ;
Hall, Pippa ;
Phillips, Gillian ;
Khan, Mohammed ;
Flather, Marcus ;
Elborn, J. Stuart .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2006, 173 (12) :1356-1362
[4]   Surgical management of bronchiectasis:: analysis and short-term results in 238 patients [J].
Balkanli, K ;
Genç, O ;
Dakak, M ;
Gürkök, S ;
Gözübüyük, A ;
Çaylak, H ;
Yücel, O .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2003, 24 (05) :699-702
[5]   Tobramycin solution for inhalation reduces sputum Pseudomonas aeruginosa density in bronchiectasis [J].
Barker, AF ;
Couch, L ;
Fiel, SB ;
Gotfried, MH ;
Ilowite, J ;
Meyer, KC ;
O'Donnell, A ;
Sahn, SA ;
Smith, LJ ;
Stewart, JO ;
Abuan, T ;
Tully, H ;
Van Dalfsen, J ;
Wells, CD ;
Quan, J .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2000, 162 (02) :481-485
[6]   Addition of inhaled tobramycin to ciprofloxacin for acute exacerbations of Pseudomonas aeruginosa infection in adult bronchiectasis [J].
Bilton, Diana ;
Henig, Noreen ;
Morrissey, Brian ;
Gotfried, Mark .
CHEST, 2006, 130 (05) :1503-1510
[7]   Evidence for physical therapies (airway clearance and physical training) in cystic fibrosis: An overview of five Cochrane systematic reviews [J].
Bradley, JM ;
Moran, FM ;
Elborn, JS .
RESPIRATORY MEDICINE, 2006, 100 (02) :191-201
[8]   Antimicrobial therapy for pulmonary pathogenic colonisation and infection by Pseudomonas aeruginosa in cystic fibrosis patients [J].
Cantón, R ;
Cobos, N ;
de Gracia, J ;
Baquero, F ;
Honorato, J ;
Gartner, S ;
Alvarez, A ;
Salcedo, A ;
Oliver, A ;
García-Quetglas, E .
CLINICAL MICROBIOLOGY AND INFECTION, 2005, 11 (09) :690-703
[9]   The effect of Pseudomonas aeruginosa on pulmonary function in patients with bronchiectasis [J].
Davies, G. ;
Wells, A. U. ;
Doffman, S. ;
Watanabe, S. ;
Wilson, R. .
EUROPEAN RESPIRATORY JOURNAL, 2006, 28 (05) :974-979
[10]  
Davies G, 2004, THORAX, V59, P540