CHRONIC BRONCHITIS

 Chronic Bronchitis : Inflammation and swelling of the lining of the airways, leading to narrowing and obstruction generally resulting in daily cough.


  • Chronic Bronchitis - Muco-ciliary escalator 

In heavy smoker ➝ Tar
↓
Ciliary damage
↓
Failure of muco - ciliary escalator
↓
Stasis of secretion
↓
infection
↓
Pus
↓
Occlusion of respiratory bronchiole
Leading to underventilation of alveoli
↓
Very severe hypoxia ⟶ Central Cyanosis (↓↓ PO2)
Increased pCO2 ➝ Narcosis , sleeping period increase , weight gain
- 'BLUE BLOATERS'


Clinical Feature :

  • Wheel chair bound patients
  • Type 2 Respiratory failure
  • Respiratory acidosis
  • Bronchorrhea
  • central cyanosis

On Examination :

  • Increased Respiratory Rate
  • Accessory muscles overactivity , subcostal recession
  • Pursed lips, Central Cyanosis(blue bloater)
  • Halitosis
  • Clubbing absent
  • Both inspiratory and expiratory Ronchi
  • Hemoptysis is absent


Work up :
  1. Spirometry
  2. Chest X ray - increased Broncho vascular markings(dirty lungs)
  3. IOC - HRCT
  4. ABG - Type 2 Respiratory failure (Respiratory acidosis)

Treatment :

- Antibiotics + Mucolytic (Ipratropium Bromide , Theophylline)

- Mainstay of treatment : Portable oxygen cylinder - Low flow oxygen with a nasal cannula
(1L/min or 16hrs/day)
It will increase dissolved oxygen - increased work capacity of patient



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