Bronchiectasis

By: J. de la Cruz

​Aim:

 To highlight how the features of COPD and Bronchiectasis align and its  perioperative risks. 

Background:

 Bronchiectasis occurs when the airways in your lungs become permanently widened and damaged, often from repeated infections or inflammation. This leads to a buildup of thick mucus, trapping bacteria and causing chronic cough, frequent chest infections,  breathlessness and reflux. 

Some develop dysphagia or silent aspiration- where food /fluid enter the lungs without obvious chocking or coughing.

Key causes of bronchiectasis are cystic fibrosis, primary cilia dyskenesia, immunodeficiency and chronic chest infection. 

​Relevance 

 It's highly relevant today because it's no longer just an adult issue—studies have documented new pediatric cases unrelated to cystic fibrosis,  but with e-cigarette use as the prime suspect after at least a year of vaping. These cases highlight how modern habits can trigger this cycle of destruction early in life.​

​Bronchiectasis often overlaps with chronic obstructive pulmonary disease (COPD), especially in smokers, where tobacco damage inflames airways and promotes bacterial overgrowth. Data shows up to 30-50% of bronchiectasis patients have COPD features, worsening lung function decline—measured by FEV1 drops of 50-100mL/year in severe cases.

​Credible sources like Medscape, NCBI StatPearls, and Lung Foundation Australia back these facts with clinical data from imaging studies and patient registries.

​Perioperative Relevance

In surgery, bronchiectasis patients face heightened risks like postoperative pneumonia (up to 20% higher incidence) due to poor secretion clearance and infection susceptibility. Airway management becomes tricky with excess mucus and collapsible bronchi.

Bronchiectasis  example scenarios

A vaper with undiagnosed bronchiectasis undergoes appendectomy. Under anesthesia, mucus plugs their airways, leading to ventilation issues and further post operative pulmonary complication that required  a prolonged ICU stay.

Could early screening change this outcome?

References:

​Choi, J. S., & Lee, S. H. (2020). Impact of bronchiectasis on postoperative pulmonary complications following extra-pulmonary surgery in patients with airflow limitation. Tuberculosis and Respiratory Diseases, 83(2), 131–140. https://journal.chestnet.org/article/S0012-3692(20)35503-3/fulltext

Laska IF. Prevalence of bronchiectasis: a narrative review. Therapeutic Advances in Respiratory Disease. 2025;19. https://journals.sagepub.com/doi/full/10.1177/17534666251390073

Lung Foundation Australia. (2025). Bronchiectasis in Australia: Epidemiology and clinical management. https://lungfoundation.com.au/lung-diseases/bronchiectasis/support-and-resources/

DISCLAIMER:

The information presented here is provided for general educational and informational purposes only. It does not constitute medical advice and is not a clinical protocol. Readers must always refer to their institutional policies and clinical guidelines and consult with qualified healthcare professionals for individual patient care. The author and this site disclaim any liability for adverse outcomes that may result from the use or application of the information provided.