Question

At least 200 words discussion,... Is bronchiectasis restrictive, obstructive, or a combination of both? Please provide your insights, and have medical evidence of your discussion?

Answer 1

Bronchiectasis are Chronic Lung disease results from the presence of Chronic Inflammatory secretions and microbes leading to the permanent dilaton and distortion of Airway walls. Studies on the pathology of Bronchiectasis reported on the year 1930 and 1960 were accessed to significant quantities of operative and postmortem lung specimens during that time period. And may also be defined as the Irreversible Dilatation of the Bronchi.  The bronchial tubes in the lung become damaged from inflammation or other causes and the smooth muscles of the bronchial tubes are destroyed, where even the elasticity of the bronchi is often lost. Many clinicians consider this to be a form of Chronic Obstructive Pulmonary Disease [COPD] which includes Chronic Bronchitis and Emphysema. There are 3 major mechanism invloved such as 1) OBSTRUCTION that occur because of tumour, foreign body particles, impacted mucus due to poor muco-ciliary clearance, external compression, bronchial webs and atresia.2) INFECTIONS namely measles, rubella, adenovirus, d/t bordetella pertusis, mycobacterium induces Chronic inflammation. 3) CHRONIC INFLAMMATION contributes to mechanism by which obstruction leads to bronchiectasis. Inflammatory mediators have found to be elevated in the airways of patients with bronchiectasis such as the neutrophil elastase, interleukin-6 and tumour necrosis factor. Whitwell classified bronchiectasis into three different types during the study of pathology as Follicular, Saccular and Atelectatic. Among which the Follicular was the dominant form which corresponded with tubular bronchiectasis. These Follicular bronchiectasis was characterized by the presence of lymphoid follicles in the bronchial wall, in which the small airway get inflammation is caused that release of mediators namely proteases which damages the large airways causing loss of elastin and other components such as muscle and cartilage which resulyed in bronchial dilation. On progression of the disease lymphoid follicles enlarged in size and causes airflow obstruction to small airways. Broncheictasis treatment and management involves a combination of Antibiotics and Airway clearance Technique to clear mucus from lungs. COPD treatment can include the use of anti-inflammtory medications or inhalers. Recognised aetiologies include post-infection, COPD, primary ciliary dyskinesia (PCD), immune deficiencies, allergic bronchopulmonary aspergillosis (ABPA), NTM infections and other connective tissue diseases. Surgical intervention is frequently used as the goal of surgical therapy is to converse normal Pulmonary tissue and to avoid the infectious complications, depending on the patient age and Cardio Pulmonary status. This surgical management involves Segmental resection (segment of a lobe), Lobectomy (removal of the lung lobe) and Pnemonectomy (entire lung removal).  However, despite extensive testing up to 53% of patients have no identifiable cause and the diagnosis of idiopathic bronchiectasis remains common. Nursing management on bronchiectasis patients may focus on the allievating, helping on clear Pulmonary secretions and of teaching patients regarding smoking cessation and breathing exercises. Maintaining the patient hydration s/p is essential and suggest to take fluid at least three litres per day unless contraindicatted. Hence according to the studies, researches and tested it is stated that Bronchiectasis is Obstructive Lung Diseases.
Reference link of the discussion passage:

​​​​​​​ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2793069/#:~:text=The%20pathology%20studies%20by%20Whitwell,thickening%20of%20the%20bronchial%20wall.

Here is the link on medical evidence of an article that involves case study of the broncheictasis patients,  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882597/