Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand

被引:103
作者
Chang, Anne B. [1 ,2 ,3 ]
Bell, Scott C. [4 ,5 ]
Byrnes, Cass A. [6 ,7 ]
Grimwood, Keith [1 ,2 ,5 ]
Holmes, Peter W. [8 ]
King, Paul T. [8 ,9 ]
Kolbe, John [10 ,11 ]
Landau, Louis I. [12 ]
Maguire, Graeme P. [13 ]
McDonald, Malcolm I. [14 ]
Reid, David W. [15 ]
Thien, Francis C. [16 ]
Torzillo, Paul J. [17 ]
机构
[1] Royal Childrens Hosp, Queensland Paediat Infect Dis Lab, Brisbane, Qld, Australia
[2] Queensland Childrens Med Res Inst, Brisbane, Qld, Australia
[3] Charles Darwin Univ, Menzies Sch Hlth Res, Resp Program, Child Hlth Div, Darwin, NT 0909, Australia
[4] Prince Charles Hosp, Brisbane, Qld 4032, Australia
[5] Univ Queensland, Sch Med, Brisbane, Qld, Australia
[6] Starship Childrens Hosp, Auckland, New Zealand
[7] Univ Auckland, Dept Paediat, Auckland, New Zealand
[8] Monash Med Ctr, Dept Resp & Sleep Med, Melbourne, Vic, Australia
[9] Monash Med Ctr, Dept Med, Melbourne, Vic, Australia
[10] Auckland City Hosp, Resp Serv, Auckland, New Zealand
[11] Univ Auckland, Dept Med, Auckland, New Zealand
[12] Hlth Dept Western Australia, Perth, WA, Australia
[13] James Cook Univ, Sch Med & Dent, Cairns, Qld, Australia
[14] Remote Hlth, Dept Hlth & Families, Darwin, NT, Australia
[15] Univ Tasmania, Royal Hobart Hosp, Hobart, Tas, Australia
[16] Monash Univ, Box Hill Hosp, Melbourne, Vic 3004, Australia
[17] Univ Sydney, Royal Prince Alfred Hosp, Nganampa Hlth Council Alice Springs, Sydney, NSW 2006, Australia
基金
英国医学研究理事会;
关键词
HIGH-RESOLUTION CT; CYSTIC FIBROSIS BRONCHIECTASIS; NON-CF BRONCHIECTASIS; PHYSICAL-THERAPY; HEALTH-STATUS; MYCOBACTERIA; MANAGEMENT; CHILDHOOD; ETIOLOGY; RISKS;
D O I
10.5694/j.1326-5377.2010.tb03949.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Consensus recommendations for managing chronic suppurative lung disease (CSLD) and bronchiectasis, based on systematic reviews, were developed for Australian and New Zealand children and adults during a multidisciplinary workshop The diagnosis of bronchiectasis requires a high-resolution computed tomography scan of the chest People with symptoms of bronchiectasis, but non-diagnostic scans, have CSLD, which may progress to radiological bronchiectasis CSLD/bronchiectasis is suspected when chronic wet cough persists beyond 8 weeks Initial assessment requires specialist expertise Specialist referral is also required for children who have either two or more episodes of chronic (>4 weeks) wet cough per, year that respond to antibiotics, or chest radiographic abnormalities persisting for at least 6 weeks after appropriate therapy Intensive treatment seeks to improve symptom control, reduce frequency of acute pulmonary exacerbations, preserve lung function, and maintain a good quality of life Antibiotic selection for acute infective episodes is based on results of lower airway culture, local antibiotic susceptibility patterns, clinical severity and patient tolerance Patients whose condition does not respond promptly or adequately to oral antibiotics are hospitalised for more intensive treatments, including intravenous antibiotics Ongoing treatment requires regular and coordinated primary health care and specialist review, including monitoring for complications and comorbidities Chest physiotherapy and regular exercise should be encouraged, nutrition optimised, environmental pollutants (including tobacco smoke) avoided, and vaccines administered according to national immunisation schedules Individualised long-term use of oral or nebulised antibiotics, corticosteroids, bronchodilators and mucoactive agents may provide a benefit, but are not recommended routinely
引用
收藏
页码:356 / 365
页数:10
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