MODUL MADYA RESPIROLOGI

BRONKIEKTASIS

Pembimbing :
Prof.Dr.M.Sidhartani Zain, Msc, SpA(K)
Dr. Dwi Wastoro Dadiyanto, SpA(K)
Dr.MS.Anam, Msi.Med, SpA

Rr. Kartika Dwi Septieningtyas

 DEFINISI
Penyakit kronis progresif yang ditandai
dengan adanya dilatasi (ektasis) dan
distorsi (penebalan) bronkus yang
bersifat patologis, persisten atau
irreversible.

Chang AB, Bell SC, Byrnes CA, Grimwood K, Holmes PW, King PT, et al. Chronic suppurative lung disease and
bronchiectasis in children and adult in Australia and New Zealand and the Australian Lung Foundation.
MJA. 2010;193:256-65
 Klasifikasi berdasarkan Lynee Reyd

Wurzel D & Chang A. An Update on Pediatric Bronchiectasis. Expert Review

of Respiratory Medicine.2017.
P BRONKIEKTASIS
A Traction
theory
KONGENITAL
T Fibrosis kistik, Kertagener
Syndrome, William Campbell
KELAINAN DIDAPAT

O syndrome, Mounier-Kuhn Syndrome

Infeksi Obstruksi Saluran
G
Infection
theory Nafas
Hilangnya Mekanisme Pertahanan

E
(reflek batuk/bersin) Atelektasis
Destruksi
dinding bronkus Penyerapan udara

N Inhalasi Bahan-bahan
(jaringan otot
dan elastic)
di parenkim paru

Atelectasis

E
Korosif dan Aspirasi theory
Cairan Lambung tekanan intrapleura
Kerusakan
S
lebih negatif dari
bronkus tekanan atmosfir
yang
I menetap
Bronkus dilatasi
S
 The pressure of
secretion theory

Kemampuan bronkus Penumpukan

untuk konstriksi sekret, infeksi
berkurang dan sekunder dan
ekspirasi menghilang terjadi arkulus

Bronkiektasis

Wurzel D & Chang A. An Update on Pediatric Bronchiectasis. Expert Review of

Respiratory Medicine.2017.
King PT. The pathophysiology of bronchiectasis. International Journal of Chronic Obstructive Pulmonary Disease.
2009;4:411-419.
 Etiologi

Brower KS, Del Vecchio MT, Aronoff SC. The etiologies of non-CF bronchiectasis in childhood: a systematic review of 989
subjects. BMC Pediatrics. 2014;14:4.
 Diagnosis
ANAMNESIS PEMERIKSAAN FISIK

Batuk 96% Crackles 82%

Sesak napas 81 % Ronki kasar 44%
Sputum produktif 66% Wheezing 21%
Demam 63% Perkusi pekak
Hemoptisis 16% Jari tabuh 3751%
Failure to thrive 10%

Kumar A, Lodha R, Kumar P, Kabra SK. Non-cystic fibrosis bronchiectasis in children: Clinical profile, etiology
and outcome. Indian Pediatr . 2015; 52: 35
Thoracic society of Australia and New Zealand. Clinical practice guideline chronic suppurtive lung disease and
bronchiectasis. 2014.
 Patogen

Eastham KM, Fall AJ, Mitchell L. The need to redefine non-cystic fibrosis
bronchiectasis in childhood. Thorax. 2004;59:324-327.
 DIAGNOSIS
Laboratorium
sweat chloride test; IgE,
hitung eosinofil,
presipitan, serologi
Asergilus; darah rutin
lengkap, kultur sputum,
serologi HIV, antinuclear
antibody atau rhematoid
factor
Bronkografi
Rontgen Paru
CT Scan Paru

Miliron B, Henry T, Veeraraghavan S, Little B. Bronchiectasis

: Mechanisms Imaging Clue of Associated Common and
Uncomon Disease. RSNA. 2015
 TATALAKSANA
1. Mengatasi obstruksi saluran respiratorik (chest
physiotherapy, postural drainage)
2. Mengatasi infeksi
Antiinflamasi
Kortikosteroid inhalasi
Bronkodilator
Hiperreaktivitas bronkhial
Operasi
Gagal terapi medikamentosa atau antibiotika, infeksi saluran napas berulang,, produksi
sputum persisten, hemoptoe profus,, batuk kronik dan abses paru persisten.
Terlokalisir, resectable, fungsi residual paru adekuat

Thoracic society of Australia and New Zealand. Clinical practice guideline chronic suppurtive lung disease and bronchiectasis. 2014.
Rademacher J, Welte T. Bronchiectasis Diagnosis and Treatment. Deutsches rzteblatt International. 2011;108(48):809-815 .
 TERIMA KASIH