BRONCHITIS

BRONCHITISACUTE BRONCHITISDEFINITIONAcute bronchitis is defined as the inflammation of the bronchi and it is usually occurs in the trachea. It is also called Bracheo Bronchitis.ETIOLOGICAL FACTORSPATHOPHYSIOLOGY

CLINICAL MANIFESTATIONSDIAGNOSTIC FEATURESHistory Collection Regarding any history of chronic lung diseases and their occupational pattern.Physical Examination On palpation and percussion the patient is having tenderness over sternum and increased in their respiratory rate. On auscultation crackles sound can be heard and having mild to high grade fever.Sputum Culture To find out the presence of bacterial or viral invasion and its colonization.Chest X-Ray - It reveals there is normal in its findings.MEDICAL MANAGEMENTMainly focus on symptomatic and supportive management only.Increases the fluid intake such as hot water to 2-3 L / Day to loosen the secretions.Administration of mild analgesics and Antipyretics to reduce the temperature and pain along with Aspirin, Acetaminophen, Ibuprofen every 4-6 hours.Codeine or Dextromethorphan may be administered to maintain a good sleeping pattern.MEDICAL MANAGEMENTBroncho-Active substances such as inhaled Beta2-Agonist is used for patient with wheezing and other respiratory discomfort.If the patient is diagnosed with bacterial infections, antibiotics are prescribed.Amantadine / Kimantadine may be given early for the patients affected with influenza A viruses to minimize their symptoms at early stage.The patient should avoid the exposure of respiratory irritant substances.CHRONIC BRONCHITISDEFINITIONChronic Bronchitis is defined as the presence of a productive cough that lasts 3 year for 2 consecutive years.ETIOLOGICAL FACTORSPATHOPHYSIOLOGYCLINICAL MANIFESTATIONSChronic productive coughEarly morning coughIncreasingly dyspneaUsing accessory muscles to breathCyanosisIncreased pulmonary vascular resistanceHypoxemiaOverweight from edema (Cor Pulmonale)Skin appears duskyDIAGNOSTIC FEATURESHistory Collection Regarding family history of any disease, occupational pattern and environmental exposure.Physical Examination On Inspection Skin appears dusky, cyanosis and dyspnea.Chest X-Ray It reveals enlarged heart. In Cor Pulmonale chest film shows increased Broncho-Vascular markings.Pulmonary Function Test There will be a decreased PTT from 25-75%.Arterial Blood Gas (ABG) Analysis PaO2 is less than 50 mm Hg and PaCo2 is more than 50 mm Hg.Sputum Culture In order to detect the presence of bacterial and viral colonization.

MEDICAL MANAGEMENTAvoid the repeated exposure to respiratory irritants.Administration of Bronchodilators to relieve bronchospasm and reduce airway obstruction by removing bronchial secretions.In case of severe bronchospasm administration of IV fluids to restore the hydration level.Oral fluid is given to loosen the secretions and it can be removed by coughing.Corticosteroids may be administered along with bronchodilators for an effective treatment.MEDICAL MANAGEMENTAntibiotic therapy can be used for the chronic and recurrent respiratory tract infection.Based on culture and sensitivity results antimicrobial therapy should be started.Patients should be immunized against common viral agents such as influenza and pneumonia.Improve the alveolar ventilation by postural drainage and chest percussion after treatments. So that O2 is distributed throughout the lungs.COMPLICATIONS