Paediatric and adult bronchiectasis: Monitoring, cross-infection, role of multidisciplinary teams and self-management plans

Vidya Navaratnam, Douglas L. Forrester, Kah Peng Eg, Anne B. Chang

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Bronchiectasis is a chronic lung disease associated with structurally abnormal bronchi, clinically manifested by a persistent wet/productive cough, airway infections and recurrent exacerbations. Early identification and treatment of acute exacerbations is an integral part of monitoring and annual review, in both adults and children, to minimize further damage due to infection and inflammation. Common modalities used to monitor disease progression include clinical signs and symptoms, frequency of exacerbations and/or number of hospital admissions, lung function (forced expiratory volume in 1 s (FEV1)% predicted), imaging (radiological severity of disease) and sputum microbiology (chronic infection with Pseudomonas aeruginosa). There is good evidence that these monitoring tools can be used to accurately assess severity of disease and predict prognosis in terms of mortality and future hospitalization. Other tools that are currently used in research settings such as health-related quality of life (QoL) questionnaires, magnetic resonance imaging and lung clearance index can be burdensome and require additional expertise or resource, which limits their use in clinical practice. Studies have demonstrated that cross-infection, especially with P. aeruginosa between patients with bronchiectasis is possible but infrequent. This should not limit participation of patients in group activities such as pulmonary rehabilitation, and simple infection control measures should be carried out to limit the risk of cross-transmission. A multidisciplinary approach to care which includes respiratory physicians, chest physiotherapists, nurse specialists and other allied health professionals are vital in providing holistic care. Patient education and personalized self-management plans are also important despite limited evidence it improves QoL or frequency of exacerbations.

Original languageEnglish
Pages (from-to)115-126
Number of pages12
JournalRespirology
Volume24
Issue number2
Early online date30 Nov 2018
DOIs
Publication statusPublished - Feb 2019

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Bronchiectasis
Self Care
Cross Infection
Pediatrics
Lung
Pseudomonas aeruginosa
Infection
Quality of Life
Patient Participation
Allied Health Personnel
Physical Therapists
Forced Expiratory Volume
Patient Education
Bronchi
Infection Control
Microbiology
Sputum
Cough
Lung Diseases
Signs and Symptoms

Cite this

Navaratnam, Vidya ; Forrester, Douglas L. ; Eg, Kah Peng ; Chang, Anne B. / Paediatric and adult bronchiectasis : Monitoring, cross-infection, role of multidisciplinary teams and self-management plans. In: Respirology. 2019 ; Vol. 24, No. 2. pp. 115-126.
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Paediatric and adult bronchiectasis : Monitoring, cross-infection, role of multidisciplinary teams and self-management plans. / Navaratnam, Vidya; Forrester, Douglas L.; Eg, Kah Peng; Chang, Anne B.

In: Respirology, Vol. 24, No. 2, 02.2019, p. 115-126.

Research output: Contribution to journalArticleResearchpeer-review

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