Bronchiectasis In Children

What is bronchiectasis?

Bronchiectasis is a lung condition that causes your child's bronchi to permanently widen. Bronchi are larger airways which help carry air in and out of your child's lungs. Your child's lungs make mucus to trap and remove germs and irritants that he breathes. In bronchiectasis, his lungs cannot clear mucus as it would normally. This may lead to infections, inflammation, and scarring in your child's lungs and may make it difficult for him to breathe.

What increases my child's risk for bronchiectasis?

  • Chemical damage: Gastroesophageal reflux (GER) from your child's stomach or breathing in harmful fumes may damage your child's airways.

  • Immune system problems: These include conditions such as allergies, rheumatoid arthritis (RA), inflammatory bowel disease (IBS), or HIV infection. These may increase the risk of infection or cause damage to your child's airways.

  • Genetic diseases: Your child may have born with a health condition, such as cystic fibrosis, which makes it difficult to clear mucus.

  • Obstructions: Food may accidentally get stuck in your child's airways while he eats. Tumors in your child's chest may grow large and block his airway. This may lead to inflammation or infection.

  • Past lung infections: Lung infections, such as measles, whooping cough, tuberculosis, and pneumonia, can damage your child's airways.

What are the signs and symptoms of bronchiectasis?

The following signs and symptoms may appear over time:

  • A productive cough

  • Foul-smelling sputum (mucus from your child's lungs)

  • Weakness and fatigue

  • Wheezing or trouble breathing

  • Loss of appetite or weight loss

  • Clubbing of your child's fingers or toes

  • Chest pain

How is bronchiectasis diagnosed?

Your child's caregiver will examine him. He will listen to his heart and lungs. He will ask about other health conditions or medicines your child takes. Your child may need any of the following tests:

  • Sputum sample: Sputum is collected in a cup when your child coughs. The sample is sent to a lab to find out if your child has an infection.

  • Chest x-ray: This is used to look at your child's lungs and airways to check for the cause of bronchiectasis.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your child's chest and airways. Your child may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if he has ever had an allergic reaction to contrast dye.

  • Bronchoscopy: This test is done to look inside your child's airways and lungs. Caregivers will insert a bronchoscope (a tube with a light and magnifying glass on the end) into your child's mouth and down into his lungs. Your child may get medicine for pain or to help him relax during the test. Caregivers may also collect samples of sputum, fluid, or cells from your child's lungs for testing. This may help find the cause of bronchiectasis or see if your child has an infection.

  • Pulmonary function tests: Pulmonary function tests (PFTs) help caregivers learn how well your child's body uses oxygen. Your child will breathe into a mouthpiece connected to a machine. The machine measures how much air he breathes in and out over a certain amount of time. PFTs help your child's caregivers decide the best treatment for your child.

How is bronchiectasis treated?

  • Medicines:

    • Antibiotics: This medicine helps fight or prevent an infection caused by bacteria. Give this medicine to your child as directed.

    • Bronchodilators: Bronchodilators may be given to help open the air passages in your child's lungs to help him breathe easier.

    • Expectorants: These medicines will help thin your child's mucus. When mucus is thin, it may be easier for him to cough it up and spit it out. This may help your child breathe easier and may help him get better faster.

    • Steroid medicine: Inhaled steroids help decrease inflammation in your child's lungs and open his airways so he can breathe easier.

  • Oxygen: This may be given through a mask or nasal cannula to help your child breathe easier. Oxygen can also decrease the strain on your child's heart and can help prevent further problems.

  • Surgery: The part of your child's lung causing his symptoms may need to be removed. Ask for more information about surgery.

How can I help manage my child's symptoms?

Your child's caregiver may show you airway clearance techniques (ACTs) that make it easier for your child to cough up mucus. ACTs may help decrease your child's symptoms.

  • Airway oscillation: This is a device that works by vibrating your child's airways as he breathes out through it. Your child will need to breathe in until he fills his lungs, and then hold his breath for 2 to 3 seconds. He then puts the device tightly to his mouth and breathes out normally through it.

  • Chest wall oscillation: This therapy uses a vest that your child wears. It is attached to a machine that causes the vest to vibrate your child's chest.

  • Percussion: This is where you forcefully pat on your child's back with a cupped hand or soft plastic cup. It helps loosen mucus that is stuck in your child's airways. Ask your child's caregiver to show you how to do percussion on your child.

  • Positive expiratory pressure therapy (PEP): This therapy uses a device that keeps some air in your child's airways when he breathes out. This helps prevent mucus from being trapped in his small airways so he can more easily cough it up.

  • Postural drainage: This therapy is designed to help drain mucus from different areas of your child's lung. Your child's caregiver will show you how to position your child for this therapy.

What are the risks of bronchiectasis?

Your child may bleed more than expected or get an infection after lung surgery. If bronchiectasis is not treated, your child's airways may fill with mucus. It may become difficult for your child to breathe. Pressure inside the blood vessels around the lungs may increase and lead to heart failure and bleeding. These conditions may be life-threatening.

What can I do to prevent my child's bronchiectasis from getting worse?

  • Do not let anyone smoke near your child: Smoke can irritate your child's lungs and make his condition worse.

  • Keep your child away from people who are sick: This decreases your child's chance of getting sick or getting an infection.

  • Ask about vaccinations: Ask your child's caregiver if your child should get a vaccine against the flu or pneumonia. The best time to get a flu shot is in October or November. Flu shots are good for 1 year. Pneumonia shots are good for 5 to 6 years. Ask your caregiver which vaccinations are right for your child.

Where can I find more information?

  • National Heart, Lung and Blood Institute
    Health Information Center
    P.O. Box 30105
    Bethesda , MD 20824-0105
    Phone: 1- 301 - 592-8573
    Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • Your child has a fever.

  • Your child coughs more than usual or wheezes.

  • Your child's medicines do not relieve his symptoms.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care for my child?

Seek care immediately or call 911 if:

  • Your child coughs up blood.

  • Your child has sudden or more severe trouble breathing.

  • Your child is confused or feels faint.

  • Your child has severe chest pain.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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