توسع القصبات مع تزايد وتيرة الانتكاسات وتدهور وظائف الرئة

References

DOI: 10.1183/13993003.01126-2025

• Clinical deterioration, including increasing exacerbation frequency and/or severity, worsening of symptoms and/or rapid decline in lung function, should result in a comprehensive re-evaluation of the patients and their treatment.
• Lung resection may be considered in highly selected patients with localised disease whose symptoms are not controlled by medical treatment optimised by a bronchiectasis specialist.
• Early referral for lung transplantation is essential in patients with progressive disease despite optimal medical management.
• This may include rapidly declining FEV1 or FEV1 <30% predicted and/or arterial carbon dioxide tension (PaCO2) >50 mmHg.
• Haemoptysis: bronchial artery embolisation or surgical resection in selected cases, following multidisciplinary discussion with a thoracic surgeon experienced in bronchiectasis.
• Respiratory failure: supplemental oxygen; non-invasive ventilation; referral for lung transplantation.