BRONCHIECTASIS and PRIMARY CILIARY DYSKINESIA
The September 2011 issue of Paediatric Respiratory Reviews is devoted to non-cystic paediatric bronchiectasis (volume 12, issue 2).
BTS GUIDELINES (2010)
www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/Bronchiectasis/non-CF-Bronchiectasis-guideline.pdf
Angrill J, Agusti C, de Celis R (2002) Bacterial colonization in patients with bronchiectasis. Thorax, 57, 15-19.
thorax.bmjjournals.com/cgi/content/full/57/1/15?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Angrill+J&andorexactfulltext=and&searchid=1121537321503_1039&stored_search=&FIRSTINDEX=0&sortspec=relevance&volume=57&firstpage=15&resourcetype=1&journalcode=thoraxjnl
periodic sputum culture needed to identify bugs, which colonise distal airways of 60% of patients
Barker AF (2000) Tobramycin solution for inhalation reduces sputum pseudomonas aeruginosa density in bronchiectasis. Am J Respir Crit Care Med, 62, 481-485
ajrccm.atsjournals.org/cgi/content/full/162/2/481
inhaled tobramycin reduces sputum P. aeruginosa density
Barker AF (2002) Bronchiectasis. New Eng J Med, 346, 1383-93
comprehensive information
Benhamou D, Muir JF, Radpaud C (1997) Long-term efficiency of home nasal mask ventilation in patients with diffuse bronchiectasis and severe chronic respiratory failure. Chest, 112, 1259-66
www.chestjournal.org/cgi/reprint/112/5/1259?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Benhamou+D&andorexactfulltext=and&searchid=1121540953305_3840&stored_search=&FIRSTINDEX=0&sortspec=relevance&resourcetype=1&journalcode=chest
NIV has shown reduced hospitalizations and improved functional status in diffuse disease
Bradley J, Moran F (2006) Pulmonary rehabilitation improves exercise tolerance in patients with bronchiectasis. Austr J Physiother, 52, 65.
commentary on article describing improved exercise tolerance in people with bronchiectasis
Bush A, Cole P, Hariri M (1998) Primary ciliary dyskinesia: diagnosis and standards of care. Eur Resp J, 12, 982-8
erj.ersjournals.com/cgi/content/abstract/12/4/982?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Bush+A&andorexactfulltext=and&searchid=1121541384825_558&stored_search=&FIRSTINDEX=0&sortspec=relevance&volume=12&firstpage=982&resourcetype=1&journalcode=erj
Cowan MJ, Gladwin MT, Shelhamer JH (2001) Disorders of ciliary motility. Am J Med Sci, 321, 3-10
Daviskas E (1999) Inhalation of dry powder mannitol improves clearance of mucus in patients with bronchiectasis. Am J Respir Crit Care Med, 159, 1843-8
ajrccm.atsjournals.org/cgi/content/full/159/6/1843?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Daviskas+E+&searchid=1121542701290_2369&stored_search=&FIRSTINDEX=0&volume=159&firstpage=1843&journalcode=ajrccm
dry powder mannitol decreases sputum volume
Dentice R (2009) Airway clearance physiotherapy improves quality of life in people with bronchiectasis. Austr J Physiotherapy, 55, 4, 285
proquest.umi.com/pqdweb?index=4&did=1936835881&SrchMode=3&sid=1&Fmt=6&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1269187944&clientId=64672&aid=2
Acapella b.d. improves quality of life and exercise capacity
Dhillon SS (2000) Lady Windermere syndrome: middle lobe bronchiectasis and mycobacterium avium complex infection due to voluntary cough suppression. Clin Infectious Dis, 30, 3, 572-575
cough suppression should not be used for social reasons
Eaton T, Young P, Zeng I, et al (2007) A randomized evaluation of the acute efficacy, acceptability and tolerability of flutter and active cycle of breathing with and without postural drainage in non-cystic fibrosis bronchiectasis. Chron Respir Dis, 4, 2330
crd.sagepub.com/content/4/1/23.abstract?ijkey=18cc79bd2061f7685b648226fab353b3264eedfe&keytype2=tf_ipsecsha
ACB has shown superiority to the Flutter or postural drainage
Edwards EA, Narang I, Li A, et al (2004) HRCT lung abnormalities are not a surrogate for exercise limitation in bronchiectasis. Eur Respir J, 24, 538 - 44
erj.ersjournals.com/cgi/content/abstract/24/4/538
high resolution computed tomography is not related to exercise capacity
Feng W, Deng WW (1998) Short-term efficacy of RC-Cornet in bronchiectasis. Chest, 114, 320
the Cornet decreases sputum viscosity
Goeminne P (2010) Non-cystic fibrosis bronchiectasis: diagnosis and management in 21st century. Postgrad Med J, 86, 493-501
pmj.bmj.com/content/86/1018/493.full
patients need regular screening for infection
inhaled mannitol may reduce the tenacity of mucus
Jones A, Rowe BH (2000) Bronchopulmonary hygiene physical therapy in bronchiectasis and COPD. Heart Lung, 29, 125-9
www.heartandlung.org/article/PIIS0147956300900086/abstract
systematic review but research on chest clearance for bronchiectasis is limited
Kellet F, Robert NM (2011) Nebulised 7% hypertonic saline improves lung function and quality of life in bronchiectasis. Respir Med, 105, 12, 1831-5
King PT (2009) The pathophysiology of bronchiectasis. Int J Chron Obstruct Pulmon Dis, 4, 411-9
www.ncbi.nlm.nih.gov/pubmed/20037680?dopt=Abstract
King PT, Daviskas E (2010) Pathogenesis and diagnosis of bronchiectasis. Breathe, 6, 342-51
www.ers-education.org/pages/default.aspx?id=2041
short and sweet, with pretty pictures.
Lavery K, O'Neill B, Elborn JS, Reilly J, Bradley JM (2007) Self-management in bronchiectasis: the patients' perspective. Eur Respir J, 29, 541-7
erj.ersjournals.com/cgi/content/full/29/3/541
reported benefits of physiotherapy include reduced shortness of breath, increased exercise capacity and better quality of life
Lee AL (2010) The effects of pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis. BMC Pulm Med, 10, 5, doi:10.1186/1471-2466-10-5
www.biomedcentral.com/1471-2466/10/5
Martinez-Garcia MA, Perpina-Tordera M, Roman-Sanchez P (2005) Quality of life determinants in patients with clinically stable bronchiectasis. Chest, 128, 73945
chestjournal.chestpubs.org/content/128/2/739.full
sputum and breathlessness are the main symptoms affecting quality of life
Maziθres J (2003) Limited operation for severe multisegmental bilateral bronchiectasis.
Ann Thorac Surg; 75, 382-387
limited surgery may be indicated in non-localized bilateral bronchiectasis with cystic and functionless areas
Meeks M (2000) Primary ciliary dyskinesia. Ped Pulmonol, 29, 307-16
www3.interscience.wiley.com/cgi-bin/abstract/71001853/ABSTRACT
Murray MP, Pentland JL, Hill AT (2009) A randomised crossover trial of chest physiotherapy in non-cystic fibrosis bronchiectasis. Eur Respir J, 34,1086-109
3 months of twice daily oscillatory positive expiratory pressure increases sputum clearance, exercise capacity and SGRQ score
Murray MP, Pentland JL, Turnbull K (2009) Sputum colour: a useful clinical tool in non-cystic fibrosis bronchiectasis. Eur Respir J, 34, 361-4
erj.ersjournals.com/cgi/content/abstract/34/2/361
patients interpretation of sputum colour is reliable
Newall C, Stockley RA, Hill SL (2005) Exercise training and inspiratory muscle training in patients with bronchiectasis. Thorax, 60, 9438
thorax.bmj.com/cgi/content/full/60/11/943
pulmonary rehabilitation improves exercise tolerance, and inspiratory muscle training may extend the training effect
OCallaghan C (2007) Diagnosing primary ciliary dyskinesia. Thorax, 62, 656-7
O'Donnell AE (2008) Bronchiectasis. Chest, 134, 4, 815-23
chestjournal.chestpubs.org/content/134/4/815.full
pathology, diagnosis and treatment
ODonnell AE (2011) Bronchiectasis in patients with COPD: a distinct COPD phenotype?
Chest, 140, 5 1107-1108
O'Leary CJ, Wilson CB, Hansell DM (2002) Relationship between psychological well-being and lung health status in patients with bronchiectasis. Respir Med, 96, 68692
www.ncbi.nlm.nih.gov/pubmed/12243314?dopt=Abstract
34% of patients had elevated scores for anxiety and/or depression, with anxiety being the most common
ONeill B, Bradley JM, McArdle (2002) The current physiotherapy management of patients with bronchiectasis. Int J Clin Pract, 56, 1, 34-5
www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11831830&dopt=Abstract
Ong HK, Lee AL, Hill CJ, Holland AE, Denehy L (2011) Effects of pulmonary rehabilitation in bronchiectasis. Chr Respir Dis, 8, 1, 21-31
retrospective study supporting pulmonary rehabilitation for bronchiectasis patients
Patel AS, Watkin G, Willig B et al (2011) Improvement in health status following cough-suppression physiotherapy for patients with chronic cough. Chron Respir Dis, 8, 253-8
crd.sagepub.com/content/8/4/253.abstract?etoc
control of unnecessary coughing by education, breathing retraining and vocal hygiene
Patterson JE, Bradley JM, Hewitt O (2005) Airway clearance in bronchiectasis:
a randomized crossover trial of active cycle of breathing techniques versus Acapella. Respiration, 72, 239242. DOI: 10.1159/000085363
ACBT and the Acapella are equally effective, but patients often prefer the Acapella.
Phillips GE (1998) Airway response of children with primary ciliary dyskinesia in exercise and β2 agonist challenge. Eur Resp J, 11, 1389-91
exercise is more beneficial than drugs in aiding bronchodilation before physiotherapy
Rea H, McAuley S, Donnell O et al (2004) Home based humidification therapy for patients with COPD and bronchiectasis. Eur Respir J, 24: Suppl. 48, 31s
www.ersnet.org/ers/lr/browse/media.aspx?id_dossier=14546&id_fiche=117613
COPD & bronchiectasis pts find home humidification eases their cough and sputum production
Rea H, McAuley S, Jayaram L (2010) The clinical utility of long-term humidification therapy in chronic airway disease. Respir Med, 104, 525-33
patients on long-term humidification had fewer exacerbations, higher QoL scores and improved lung function than those without.
Silverman D (2003) Current management of bronchiectasis Heart Lung, 32, 59-64
review of pathogenesis, diagnosis and treatment limited information on physiotherapy and it doesnt mention breathing techniques!
Smith VM, Shoemark A, Nisbet M (2010) When to think of bronchiectasis and the investigations to perform. Clinical Pulm Med, 17, 1, 7-13
comprehensive report on causes, diagnosis and management.
Steinfort CL, Smith MJ, Harrison NK (1987) Reactive arthritis in bronchiectasis. Am J Resp Dis, 135, A42
RA associated with bronchiectasis shows improvement with antibiotic treatment for the bronchiectasis
Syed N (2009) Active Cycles of Breathing Technique (ACBT) versus conventional chest physical therapy on airway clearance in bronchiectasis a crossover trial. Advances in Physiotherapy, 11, 4, 193-8
both techniques equally effective, but patients tend to prefer ACBT
Tomkinson JL, Bruton A (2009) The 6-minute walk test for patients with bronchiectasis. ACPRC Journal, 41, 16-21
people with bronchiectasis show same reduction in exercise tolerance as COPD
Wilson CB, Jones PW, O'Leary CJ, Cole PJ, Wilson R (1997) Validation of the St. George's Respiratory Questionnaire in bronchiectasis. Am J Respir Crit Care Med, 156, 2, 1, 536-41
ajrccm.atsjournals.org/cgi/content/abstract/156/2/536
the SGRQ is a valid measure of health for people with bronchiectasis
ACBT = active cycle of breathing
ACPRC = Association of Chartered Physiotherapists in Respiratory Care
BTS = British Thoracic Society
NIV = non-invasive ventilation
SGRQ = St George's Respiratory Questionnaire (scores symptoms, activity, social & psychological function)
SOB = shortness of breath