BRONCHITIS

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BRONCHITIS: 

BRONCHITIS PRESENTED BY: A.PRIYADHARSHINI M.Sc(N), IGMCRI, PONDICHERRY.

DEFINITION:: 

DEFINITION: Bronchitis is an inflammation of the large airways that are called bronchi, which causes increased production of mucus and other changes.

TYPES:: 

TYPES: Acute bronchitis Chronic bronchitis

CAUSES:: 

CAUSES: Infectious agents such as bacteria or viruses. Physical or chemical agents--dusts, allergens, strong fumes, and those from chemical cleaning compounds, or tobacco smoke. Acute asthmatic bronchitis may happen as the result of an asthma attack, or it may be the cause of an asthma attack. In children, the most common cause of bronchitis is a virus, although it can be caused by bacteria.

CONTD..: 

CONTD.. It may also occur in children with chronic sinusitis, allergies, or those with enlarged tonsils and adenoids.

CLINICAL MANIFESTATIONS:: 

CLINICAL MANIFESTATIONS: Rhinnorhea, usually before a cough starts Malaise Chills Low grade fever Myalgia Wheezing Sore throat

CONTD..: 

CONTD.. In the earlier stages, children may experience a dry, non-productive cough which progresses later to an abundant mucus-filled cough. Younger children may have vomiting or gagging with the cough. The symptoms of bronchitis usually last seven to 14 days, but may also persist for three to four weeks.

DIAGNOSTIC EVALUATION:: 

DIAGNOSTIC EVALUATION: History collection Physical examination Chest X-ray Arterial blood gas --to analyze the amount of carbon dioxide and oxygen in the blood. Pulse oximetry --to measures the amount of oxygen in the blood. Sputum and nasal discharge cultures Pulmonary function tests

TREATMENT:: 

TREATMENT: In many cases, antibiotic is not necessary only supportive treatment is given, may include: Analgesics (for fever and discomfort) Cough suppressant Increased fluid intake

BRONCHIOLITIS: 

BRONCHIOLITIS

DEFINITION:: 

DEFINITION: Bronchiolitis is an acute viral infection of the lower respiratory tract that usually affects infants. There is inflammation bronchioles of the lung, which causes obstruction of air in the smaller airways.

CAUSES:: 

CAUSES: The most common cause is a virus, most frequently the respiratory syncytial virus (RSV). However, many other viruses have been involved, including: Parainfluenza virus Adenovirus Influenza Human metapneumovirus

RISK FACTORS OF SEVERITY:: 

RISK FACTORS OF SEVERITY: Prematurity Low birth weight Age less than 6-12 weeks Chronic pulmonary disease Hemodynamically significant cardiac disease Immunodeficiency Neurologic disease Anatomical defects of the airways

Changes in bronchial tissue:: 

Changes in bronchial tissue:

Clinical manifestations:: 

Clinical manifestations: Common cold symptoms, including: Rhinnorhea Congestion Fever Cough (the cough may become more severe as the condition progresses) Tachypnea Dyspnea wheezing, or a high-pitched sound

Contd..: 

Contd.. Decreased appetite Irritability Vomiting Low-grade fever Chest retractions

Diagnostic evaluation:: 

Diagnostic evaluation: History Collection Physical examination Chest X-rays Blood tests/blood gases Pulse oximetry Nasopharyngeal swab --for respiratory syncytial virus (RSV) and other respiratory viruses. These tests yield rapid results for presence of RSV or other viruses.

CONTD..: 

CONTD.. Nasal wash or aspirate Rapid antigen detection for RSV, parainfluenza, influenza, adenovirus (sensitivity 80-90%) Direct and indirect immunofluorescence tests Culture

Treatment:: 

Treatment: The goal of treatment is supportive of the symptoms. Antibiotics are ineffective in the treatment of bronchiolitis. Some infants, if they are having severe breathing problems, may be treated in the hospital. While in the hospital, treatment may include: Intravenous (IV) fluids if child is not taking feeds Oxygen therapy and a ventilator may be needed

Contd..: 

Contd.. Frequent suctioning for thick secretions Nebulization Increased fluid intake

CONTD..: 

CONTD.. Antipyretic for fever Do not give a child aspirin, because this medication has been linked to Reye syndrome, a disease of the brain and liver.

SUPPORTIVE TREATMENT:: 

SUPPORTIVE TREATMENT: Respiratory support and maintenance of adequate fluid intake Saline nasal drops with nasal bulb suctioning Routine deep suctioning not recommended Rest

CHEST PHYSIOTHERAPY:: 

CHEST PHYSIOTHERAPY: Not recommended Does not improve clinical status, reduce oxygen need or shorten hospitalization May increase distress and irritability

PREVENTION:: 

PREVENTION: The best way to prevent bronchiolitis is good hygiene, such as regular hand-washing. Vaccination towards respiratory syncytial virus (RSV).

THANK YOU: 

THANK YOU