Chronic Cough/Bronchiectasis – Pediatrics: Difference between revisions
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'''Pathophysiology:''' Recurrent pneumonia and lower respiratory tract infections cause airway damage that leads to "ectasia" and lossof elasticity of bronchi. Loss of muco-ciliary function leads to difficulty clearing secretions. | |||
<br/>'''Risk Factors:''' | |||
*low birth weight | |||
*Prematurity | |||
*Early recurrent respiratory infections | |||
*Previous injury | |||
*Enironmental effects (lack of piped water, household crowding, woodstove in the house) | |||
'''Demographics:''' Alaska YK Delta: 1 in 63 children, Central Australia: 1 in 68, U.S.: 1 in 250,000. low income. | |||
<br/>'''Signs/Symptoms:''' Chronic wet cough | |||
<br/>'''Diagnosis:''' Progression of disease from protracted bronchitis to chronic suppurative lung disease (3 episodes at least 3 months each) and CT scan confirmed Bronchiectasis | |||
<br/>'''Management:''' | |||
*Reduce infection-inflammation: treat early and exacerbations 'aggressively' with antibiotics, airway hygiene clearance, vaccinations | |||
*Improve other factors contibuting: attention to nutrition, detect complications, pllutants | |||
*Systemic care: regular review, multi-discplinary care, education, enhance self care and management | |||
'''Critical Times for Affected Patients:''' during exacerbations, if untreated can lead to early COPD and death | |||
<br/>'''Resources:''' | |||
* [[media:Bronchiectasis.pdf|Bronchiectasis: Prevention and Management 2016]] (Powerpoint Presentation by Rosalyn Singleton, MD) | |||
* Singleton RJ et al. [https://onlinelibrary.wiley.com/doi/abs/10.1002/ppul.22763 Indigenous children from three countries with non-cystic fibrosis chronic suppurative lung disease/bronchiectasis]. ''Pediatr Pulmonol'' 2014. | |||
* Redding et al. [https://www.sciencedirect.com/science/article/pii/S0012369215510817?via%3Dihub Respiratory Exacerbations in Indigenous Children From Two Countries With Non-Cystic Fibrosis Chronic Suppurative Lung Disease/Bronchiectasis]. CHEST 2014:146;762-4 | |||
* Healthy Homes Study | |||
* [[media:Bronchiectasis_peds.pdf|YKHC Clinical Guideline for Bronchiectasis]] | |||
[[:category:YKHC Guidelines]] | [[:category:YKHC Guidelines]] | ||
<br/>[[Practicing Medicine in Bush Alaska—Some ABCs|Common/Unique Medical Diagnoses]] |
Revision as of 10:41, 24 September 2020
Pathophysiology: Recurrent pneumonia and lower respiratory tract infections cause airway damage that leads to "ectasia" and lossof elasticity of bronchi. Loss of muco-ciliary function leads to difficulty clearing secretions.
Risk Factors:
- low birth weight
- Prematurity
- Early recurrent respiratory infections
- Previous injury
- Enironmental effects (lack of piped water, household crowding, woodstove in the house)
Demographics: Alaska YK Delta: 1 in 63 children, Central Australia: 1 in 68, U.S.: 1 in 250,000. low income.
Signs/Symptoms: Chronic wet cough
Diagnosis: Progression of disease from protracted bronchitis to chronic suppurative lung disease (3 episodes at least 3 months each) and CT scan confirmed Bronchiectasis
Management:
- Reduce infection-inflammation: treat early and exacerbations 'aggressively' with antibiotics, airway hygiene clearance, vaccinations
- Improve other factors contibuting: attention to nutrition, detect complications, pllutants
- Systemic care: regular review, multi-discplinary care, education, enhance self care and management
Critical Times for Affected Patients: during exacerbations, if untreated can lead to early COPD and death
Resources:
- Bronchiectasis: Prevention and Management 2016 (Powerpoint Presentation by Rosalyn Singleton, MD)
- Singleton RJ et al. Indigenous children from three countries with non-cystic fibrosis chronic suppurative lung disease/bronchiectasis. Pediatr Pulmonol 2014.
- Redding et al. Respiratory Exacerbations in Indigenous Children From Two Countries With Non-Cystic Fibrosis Chronic Suppurative Lung Disease/Bronchiectasis. CHEST 2014:146;762-4
- Healthy Homes Study
- YKHC Clinical Guideline for Bronchiectasis