Bronchiectasis (cont.)

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What are the complications of bronchiectasis?

Bronchiectasis decreases the ability of the lung to mobilize secretions, leading to recurrent infection, increased sputum production, and difficulty breathing.

Decreased air entry into the lung through the bronchial tubes decreases oxygen availability in the bloodstream, causing shortness of breath with activity and ultimately at rest. This decreased oxygen level over time causes constriction of the pulmonary arteries, resulting in increased pressure in these arteries, referred to as pulmonary hypertension. Overcoming these pressures forces the heart to work harder causing the right ventricle to thicken, a condition called cor pulmonale. Eventually, the right side of the heart (which pumps blood to the vessels of the lung) may fail, resulting in increased fluid accumulation in the legs or abdominal cavity.

Bronchiectasis may result in coughing up blood (hemoptysis).

Hospitalization may be required for pneumonia, massive hemoptysis, respiratory failure (when not enough oxygen is present in the bloodstream), and heart failure. Heart failure and respiratory failure are the common causes of death in patients with bronchiectasis. In some cases, due to prolonged use of antibiotics, infections with antibiotic-resistant bacteria may develop that require special antibiotics that are usually given in the hospital through an intravenous (IV) line.

What is the prognosis (outlook) for bronchiectasis?

Early recognition and adequate treatment can help control bronchiectasis and decrease symptoms. Life- long awareness of the need for treatment may allow people with bronchiectasis to minimize complications and maximize life expectancy.

The outlook depends upon the underlying reason for developing bronchiectasis. Congenital causes of bronchiectasis, like cystic fibrosis, may have a worse prognosis than acquired diseases.

Medically reviewed by James E Gerace, MD; American Board of Internal Medicine with subspecialty in Pulmonary Disease REFERENCE: Fauci, Anthony S., et al. Harrison's Principles of Internal Medicine. 17th ed. United States: McGraw-Hill Professional, 2008.

Medically Reviewed by a Doctor on 12/11/2013

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