How is bronchiectasis treated?
Bronchiectasis is treated by trying to stop the cycle of airway injury, inflammation, mucus accumulation and infection. The treatments for bronchiectasis are aimed at stopping this cycle of injury.
- Airway clearance: Airway clearance is the most important treatment for bronchiectasis. Airway clearance, also known as chest percussion therapy (CPT), helps to move mucus from the smaller airways to the larger airways so it can be cleared more easily. CPT can be done using a hand percussor, a chest vest or handheld devices (acapella or aerobika). Most people with bronchiectasis perform airway clearance one or more times per day, and your doctor may recommend that you do extra airway clearance if you are experiencing an exacerbation. The type of airway clearance recommended will depend on several factors including the cause of the bronchiectasis, your child’s age and your child’s development. Exercise is also a great form of airway clearance, so your child’s lung doctor may recommend it, if appropriate, based on your child’s development.
- Coughing: Our goal is to decrease the mucus in your child’s airways so they don’t cough all day. However, directed coughing, known as huff coughs, during airway clearance treatments can help remove mucus from the lungs. If your child’s mucus is especially thick or sticky, some children require inhaled medications to help thin their mucus to make it easier to cough up. Children with poor muscle tone may require an insufflation/exsufflation device to make their cough more effective.
- Antibiotics: Most children with bronchiectasis need antibiotics to treat a bronchiectasis exacerbation (when the child is having more cough and mucus production than normal). Some children with bronchiectasis may require daily or weekly antibiotics to treat infection or inflammation in their airway. Some children may also require inhaled antibiotics if they grow certain bacteria in their mucus.
- Anti-inflammatory medication: The best way to decrease inflammation is to stop or limit the injury to the airway. Some children with bronchiectasis benefit from inhaled steroid medication daily or inhaled or oral steroids during exacerbations. Other specific anti-inflammatory medications may be indicated based on the specific cause of bronchiectasis.
Treating the cause of airway injury is the best way to prevent bronchiectasis from developing or getting worse. Children with cystic fibrosis or primary ciliary dyskinesia are evaluated for bronchiectasis in their regular visits at our pulmonary clinic.
Why choose us for treatment of bronchiectasis?
The Breathing Institute at Children’s Colorado is nationally ranked by U.S. News & World Report as one of the best pulmonology programs in the country. Our researchers are continuously working to improve the way we measure airways and diagnose bronchiectasis. Our multidisciplinary approach to the treatment of bronchiectasis enables us to provide high-quality, specialized care for your child. We have access to a variety of pediatric subspecialists, which enables us to provide a full spectrum of care. Our specialty care includes:
- The Primary Ciliary Dyskinesia Clinic is part of a national consortium of PCD clinics.
- The multidisciplinary Aerodigestive Program is a group of experts in different disciplines who can help determine and treat the cause of chronic wet cough and bronchiectasis. They can also evaluate children with chronic aspiration and airway abnormalities including tracheomalacia, airway stenosis and esophageal atresia (with or without tracheoesophageal fistula). These pediatric experts are nationally recognized for treatment of airway problems and esophageal atresia.
- Experts from the Neuromuscular Program in the Neuroscience Institute can evaluate children with impaired cough due to low muscle tone. This program is nationally recognized for their treatment of children with low muscle tone.
- We collaborate with pediatric radiologists in our Imaging Services Department at Children’s Colorado to diagnose bronchiectasis earlier and improve chest CT scans and other imaging technology while limiting radiation exposure.
- Researchers in The Mike McMorris Cystic Fibrosis Research and Care Center are part of national clinical trials to improve the treatment of bronchiectasis in children with cystic fibrosis and they have been involved in ways to diagnose bronchiectasis in all patients earlier.