Total Care of the Chronic Bronchitis Patient

An Evaluation of Twenty Years' Experience

¹ Department of Thoracic and Cardiovascular Surgery, University of Tennessee Memorial Research Center and Hospital, and the Thoracic Surgical Services, Fort Sanders Presbyterian Hospital and the East Tennessee Tuberculosis Hospital

1. Chronic bronchitis, the most prevalent chest disease, is an indolent, highly resistant condition frequently ignored or ineffectually treated.

2. Bronchitis can be a primary disease entity or a secondary problem in many other chest diseases.

3. A vigorous concerted attack on bronchitis can produce an excellent result quickly.

4. Bronchoscopy evacuates secretion, produces adequate productive cough, and prepares the bronchial tree for effective inhalation therapy.

5. The use of a psychotropic drug, diazepam, producing amnesia, greatly facilitates bronchoscopy and increases patient acceptance of the procedure.

6. Bronchoscopically aspirated secretions provide more valid bacteriologic data than sputum specimens.

7. Intensive post-bronchoscopy treatment with inhalations, including aerosol antibiotics, expectorants, bronchodilators, and mucolytic agents, brings about rapid improvement.

8. Smoking, the most common etiologic factor, must be stopped totally and permanently.

9. Sensitivity studies of the total bronchial flora can be obtained rapidly by available methods, and provide the best guide for antibiotic therapy.

10. The treatment regimen presented has been highly effective in almost 14,000 cases of bronchitis over a 20-year period.