Chronic Bronchitis

Highmark Health, Allegheny Health Network and Johns Hopkins Medicine Expand Collaboration

Chronic Bronchitis | Johns Hopkins Medicine

PITTSBURGH, Jan. 16, 2020 /PRNewswire/ — Highmark Health, Allegheny Health Network (AHN) and Johns Hopkins Medicine today announced an expanded collaboration between the organizations that will focus on gynecologic care and maternal fetal medicine, chronic obstructive pulmonary disease (COPD) and lung transplantation.

The collaboration between AHN's Women and Children Institute, led by Allan Klapper, MD, and the Johns Hopkins Department of Gynecology & Obstetrics will create one of the largest coordinated women's gynecologic and obstetrical health research programs in the United States, providing AHN patients with streamlined access to hundreds of clinical trials, second opinions and specialized treatments for rare and complex conditions.

Collaborative gynecologic and obstetrical women's health research between the organizations will also provide a unique opportunity to combine data from tens of thousands of patient interactions, including deliveries, gynecologic surgeries and ambulatory visits, to further study common conditions and improve practice standards.

“We are creating a community of collaborators in women's health who are operationally integrated and programmatically focused on raising standards of excellence in patient care, research and education to benefit women of all ages and stages of life,” said Andrew J. Satin, MD, Director, Johns Hopkins Department of Gynecology and Obstetrics.

Expectant women being cared for by AHN will also have streamlined access to the Johns Hopkins Center for Fetal Therapy, a world-renowned program for diagnosing and treating rare and complex fetal conditions in the womb.

The team at Johns Hopkins uses innovative fetoscopic surgical techniques – accessing the fetus through a small incision – to treat potentially life-threatening complications of pregnancy, including congenital diaphragmatic hernia, spina bifida, complicated monochorionic twins, and bladder obstruction.

 AHN specialists in obstetrics, maternal-fetal medicine, neonatology and pediatrics will work with the Johns Hopkins team to meet the comprehensive health needs of such patients.

The enhanced collaboration between AHN and Johns Hopkins Medicine builds on the success of the two organizations' five-year cancer relationship, which has provided cancer patients in the greater Pittsburgh region with more seamless access to second opinions and clinical trials testing new therapies at Hopkins.  The relationship also enables clinicians at both institutions to share knowledge and consult on patient care.  

“As we have demonstrated over the past several years through our important work together in cancer, collaboration among leading institutions truly is essential to health care innovation and improving quality of care for the patients and communities we serve,” said Cynthia Hundorfean, AHN President and CEO.  “We look forward to the tremendous value this model will now also have for both patients and caregivers in our women and infants and pulmonary medicine programs.”

The pulmonology collaboration between AHN and Johns Hopkins will be research-focused, with the two institutions conducting joint research on precision medicine approaches for chronic obstructive pulmonary disease (COPD). The disease affects about three million patients in the United States each year, with an estimated 12 million additional cases that are undiagnosed.  

Utilizing the Johns Hopkins Precision Medicine Analytics Platform, AHN and Johns Hopkins will study new approaches for treatment of COPD, to identify the most effective treatments and ultimately reduce hospitalization rates associated with the disease.  Anil Singh, MD, Chair of Pulmonology at AHN, will lead the implementation of the partnership at AHN.

AHN patients with advanced lung disease will also have streamlined access to the Johns Hopkins lung transplant program, a pioneering leader in lung transplantation for nearly 25 years.

 According to the Scientific Registry of Transplant Recipients, a federally funded organization that provides advanced statistical analyses related to organ allocation and transplantation, 98 percent of Johns Hopkins' lung transplant patients are alive with a functioning transplanted lung one year post-surgery, compared to 89 percent nationwide. Johns Hopkins' median time from waitlist to transplant is 2.8 months, compared to a national average of 3.1 months.

AHN patients choosing Johns Hopkins for their lung transplant will be guided through every step of the process by a personal patient navigator.

 Pre and post-lung transplant care programs aligned with the Johns Hopkins' transplant team have been established at AHN's Allegheny General Hospital, providing patients with convenient local access to care needed prior to and after surgery.

   Additionally, Highmark insured patients requiring lung transplant will have specific in-network benefits to better accommodate them and their families while being cared for at Johns Hopkins.   

About the Allegheny Health Network:

Allegheny Health Network (AHN.ORG), part of Highmark Health, is an integrated healthcare delivery system serving the Western Pennsylvania region.

  The Network is comprised of nine hospitals, including its flagship academic medical center Allegheny General Hospital, Allegheny Valley Hospital, Canonsburg Hospital, Forbes Hospital, Grove City Hospital, Jefferson Hospital, Saint Vincent Hospital, Westfield Memorial Hospital and West Penn Hospital; employed physician organizations, a research institute, health + wellness pavilions, home and community-based health services and a group purchasing organization.   The Network employs approximately 21,000 people, and has more than 2,500 physicians on its medical staff.   The Network also serves as a clinical campus for Temple University School of Medicine, Drexel University College of Medicine and the Lake Erie College of Osteopathic Medicine.

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SOURCE Allegheny Health Network



Chronic Bronchitis | Johns Hopkins Medicine

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Bronchitis is an inflammation of the main air passages (bronchi) to the lungs. Coughing often brings up yellow or greenish mucus. There are two main types of bronchitis: acute and chronic.

Acute bronchitis, often caused by the same viruses that cause colds, usually starts as a sore throat, runny nose or sinus infection, then spreads to your airways. It can cause a lingering dry cough, but it usually goes away on its own.

In chronic bronchitis, a type of chronic obstructive pulmonary disease (COPD), the inflamed bronchi produce a lot of mucus, leading to cough and difficulty getting air in and the lungs. 


Symptoms of acute bronchitis include: 

  • Cough 
  • Shortness of breath 
  • Wheezing 
  • “Rattle” sensation in chest 
  • General ill feeling, or malaise 
  • Slight fever 
  • Tickle feeling in back of throat that leads to soreness 
  • Chest pain, soreness, and tightness in the chest 
  • Poor sleep 
  • Chills (uncommon) 

Symptoms of chronic bronchitis include: 

  • Cough that produces mucus (sputum), which may be blood streaked 
  • Shortness of breath aggravated by exertion or mild activity 
  • Frequent respiratory infections that worsen symptoms 
  • Wheezing 
  • Fatigue 
  • Headaches 


Tests to diagnose acute and chronic bronchitis include: 

Treatment for Acute Bronchitis

  • Antibiotics usually aren't helpful because acute bronchitis is almost always caused by a virus, which will not respond to antibiotics. Antibiotics are usually only needed if your doctor diagnoses you with whooping cough or pneumonia. 
  • Medications called bronchodilators are used to open tight air passages in the lungs. Your doctor may prescribe this type of medicine if you are wheezing. 
  • Decongestants may also help relieve symptoms of bronchitis. Medications that loosen mucus can also be prescribed, but how well they work remains uncertain. 
  • Your doctor will tell you to drink more fluids to help thin mucus in the lungs, rest and soothe your airways by increasing humidity in the air with a cool mist humidifier. 

Symptoms will usually go away within seven to 14 days if you don't have chronic pulmonary disease. However, in some people it may take much longer for the cough to go away. 

Treatment for Chronic Bronchitis

There is no cure for chronic bronchitis. Treatments to relieve symptoms and prevent complications include: 

  • Inhaled medications that dilate (widen) the airways and decrease inflammation may help reduce symptoms such as wheezing.
  • Antibiotics to fight infections
  • Corticosteroids may occasionally be used during flare-ups of wheezing or in people with severe bronchitis that does not respond to other treatments. 
  • Oxygen therapy may be needed in severe cases. 

Treatment will help symptoms, but chronic bronchitis is a long-term condition that keeps coming back or never goes away completely. 


Good handwashing is one of the best ways to avoid getting viruses and other respiratory infections. 

  • Since flu viruses have been shown to be a major cause of bronchitis, getting a flu shot may also help prevent acute bronchitis. 
  • Limit exposure to cold, damp environments.


Chronic Bronchitis

Chronic Bronchitis | Johns Hopkins Medicine

Bronchitis is inflammation of the breathing tubes. These are the airways calledbronchi. This inflammation causes too much mucus production and other changes. There aredifferent types of bronchitis. But the most common are acute and chronic.

Chronic bronchitis is long-term inflammation of the bronchi. It is common amongsmokers. People with chronic bronchitis tend to get lung infections more easily. Theyalso have episodes of acute bronchitis, when symptoms are worse.

To be classified as chronic bronchitis:

  • You must have a cough and mucus most days for at least 3 months a year, for 2 years in a row.
  • Other causes of symptoms, such as tuberculosis or other lung diseases, must be ruled out.

People with chronic bronchitis have chronic obstructive pulmonary disease (COPD). Thisis a large group of lung diseases that includes chronic bronchitis. These diseases canblock air flow in the lungs and cause breathing problems. The 2 most common conditionsof COPD are chronic bronchitis and emphysema.

What causes chronic bronchitis?

Chronic bronchitis is not caused by a virus or bacteria. Most experts agree that themain cause of chronic bronchitis is cigarette smoking. Air pollution and your workenvironment may also play a role. This is especially true if you also smoke.

Bronchitis symptoms often happen with other lung diseases, such as:

  • Asthma
  • Pulmonary emphysema
  • Scarring of the lungs (pulmonary fibrosis)
  • Sinusitis
  • Tuberculosis
  • Upper respiratory infections

What are the symptoms of chronic bronchitis?

Below are the most common symptoms of chronic bronchitis. But each person may have slightly different symptoms.

Symptoms may include:

  • Cough, often called smoker’s cough
  • Coughing up mucus (expectoration)
  • Wheezing
  • Chest discomfort

People with chronic bronchitis often have a cough and make mucus for many years beforethey have shortness of breath.

Chronic bronchitis may cause:

  • Disability
  • Frequent and severe infections that affect your airways
  • Narrowing and plugging of your breathing tubes (bronchi)
  • Trouble breathing

Other symptoms may include:

  • Bluish fingernails, lips, and skin because of lower oxygen levels
  • Wheezing and crackling sounds with breathing
  • Swollen feet
  • Heart failure

Thesymptoms of chronic bronchitis may look other lung conditions or health problems.See your healthcare provider for a diagnosis.

How is chronic bronchitis diagnosed?

Yourhealthcare provider will take a complete health history and do a physical exam. He orshe may order the following tests:

These tests help to measure the lungs’ ability to move air in and your lungs.The tests are often done with special machines that you breathe into. They mayinclude:

Spirometry. This test uses a spirometer device to see how well your lungsare working. It is one of the simplest, most common pulmonary function tests. It maybe used for any or all of these reasons:

  • To find out how well your lungs take in, hold, and move air
  • To keep watch on a lung disease
  • To see how well treatment is working
  • To find out how serious your lung disease is
  • To find out if your lung disease is restrictive or obstructive. Restrictive means less air will get into your lungs. Obstructive means less air will get your lungs.

Peakflow monitor. This test measures the fastest speed you can blow air your lungs. Inflammation and mucus in the large airways in the lungs narrow theairways. This slows the speed of air leaving the lungs. It can be measured with apeak flow monitor. This measurement is very important in telling how well yourdisease is being controlled.

This blood test is used to check the amount of oxygen and carbon dioxide in your blood. It also measures the acidity of your blood.

An oximeter is a small machine that measures the amount of oxygen in your blood. To get this measurement, a small sensor is taped or clipped onto a finger or toe. When the machine is on, a small red light can be seen in the sensor. The sensor is painless, and the red light does not get hot.

This test makes pictures of your internal tissues, bones, and organs, including the lungs.

This imaging test uses a combination of X-rays and computer technology to makeimages of the body. A CT scan shows detailed images of any part of the body,including the bones, muscles, fat, and organs. CT scans are more detailed thangeneral X-rays.

How is chronic bronchitis treated?

Treatment for chronic bronchitis is aimed at treating the causes and symptoms. It mayinclude:

  • Quitting smoking
  • Staying away from secondhand smoke and other lung irritants
  • Taking medicines by mouth (oral) to open airways and help clear away mucus
  • Taking inhaled medicines, such as bronchodilators and steroids
  • Getting oxygen from portable containers
  • Having lung reduction surgery to take out damaged areas of the lung
  • Getting a lung transplant, in rare cases
  • Humidifying the air
  • Pulmonary rehab to help you learn how to live with your breathing problems and stay active

Key points about chronic bronchitis

  • Bronchitis is inflammation of the breathing tubes (bronchi). There are several types of bronchitis, but the most common are acute and chronic.
  • Chronic bronchitis is often part of chronic obstructive pulmonary disease (COPD). This is a group of lung diseases that cause airflow blockage and breathing problems.
  • The most important cause of chronic bronchitis is cigarette smoking. Air pollution and your work environment may also play a role.
  • This condition causes a cough that’s often called smoker’s cough. It also causes you to cough up mucus, wheeze, and have chest discomfort. These may get worse over time and lead to severe breathing problems.
  • Tests that help measure how well your lungs are working are used to diagnose chronic bronchitis. Blood, breathing, and imaging tests may also be used to see how severe the problem is and watch it over time.
  • The goal of treatment is to live more comfortably by controlling symptoms. A key part of treatment is to quit smoking.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your healthcare provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your healthcare provider if you have questions.


Johns Hopkins study suggests medical errors are third-leading cause of death in U.S

Chronic Bronchitis | Johns Hopkins Medicine

Analyzing medical death rate data over an eight-year period, Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error in the U.S.

Their figure, published May 3 in The BMJ, surpasses the U.S.

Centers for Disease Control and Prevention's third leading cause of death—respiratory disease, which kills close to 150,000 people per year.

The Johns Hopkins team says the CDC's way of collecting national health statistics fails to classify medical errors separately on the death certificate. The researchers are advocating for updated criteria for classifying deaths on death certificates.

“Incidence rates for deaths directly attributable to medical care gone awry haven't been recognized in any standardized method for collecting national statistics,” says Martin Makary, professor of surgery at the Johns Hopkins University School of Medicine and an authority on health reform. “The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used.”

In 1949, Makary says, the U.S. adopted an international form that used International Classification of Diseases billing codes to tally causes of death.

“At that time, it was under-recognized that diagnostic errors, medical mistakes, and the absence of safety nets could result in someone's death,” says Makary, “and because of that, medical errors were unintentionally excluded from national health statistics.”

In their study, the researchers examined four separate studies that analyzed medical death rate data from 2000 to 2008. Then, using hospital admission rates from 2013, they extrapolated that a total of 35,416,020 hospitalizations, 251,454 deaths stemmed from a medical error, which the researchers say now translates to 9.5 percent of all deaths each year in the U.S.

According to the CDC, in 2013, 611,105 people died of heart disease, 584,881 died of cancer, and 149,205 died of chronic respiratory disease—the top three causes of death in the U.S. The newly calculated figure for medical errors puts this cause of death behind cancer but ahead of respiratory disease.

“Top-ranked causes of death as reported by the CDC inform our country's research funding and public health priorities,” Makary says. “Right now, cancer and heart disease get a ton of attention, but since medical errors don't appear on the list, the problem doesn't get the funding and attention it deserves.”

The researchers caution that most medical errors aren't due to inherently bad doctors, and that reporting these errors shouldn't be addressed by punishment or legal action.

Rather, they say, most errors represent systemic problems, including poorly coordinated care, fragmented insurance networks, the absence or underuse of safety nets, and other protocols, in addition to unwarranted variation in physician practice patterns that lack accountability.

“Unwarranted variation is endemic in health care,” Makary says. “Developing consensus protocols that streamline the delivery of medicine and reduce variability can improve quality and lower costs in health care. More research on preventing medical errors from occurring is needed to address the problem.”

Posted in Health

patient safety, marty makary


How Lupus Affects the Lungs

Chronic Bronchitis | Johns Hopkins Medicine

About 50% of people with SLE will experience lung involvement during the course of their disease. Five main lung problems occur in lupus: pleuritis, acute lupus pneumonitis, chronic (fibrotic) lupus pneumonitis, pulmonary hypertension, and “shrinking lung” syndrome.

Pleuritis (Pleurisy)

Pleuritis, also known as pleurisy, is characterized by inflammation of the pleura, the two-layered membrane surrounding the lungs. If fluid forms and escapes the membrane, the condition is referred to as pleural effusion.

Since inflammation of the pleura puts pressure on the lungs, people with pleuritis often experience pain when taking deep breaths. A pleural effusion is detectable on an x-ray, and pleurisy or a pleural effusion can be treated with NSAIDs or steroid medications.

Antimalarials Plaquenil may also be effective in preventing or fending off the condition.

Acute Lupus Pneumonitis

Acute lupus pneumonitis is a serious condition that affects anywhere from 1-10% of lupus patients. The condition is characterized by chest pain, shortness of breath, and a dry cough that may bring up blood.

Acute lupus pneumonitis requires immediate treatment with high dose steroids and possibly immunosuppressive medications. Yet, even with successful treatment, some people develop lung scarring.

Thus, it is very important that you speak with your physician if you experience any unfamiliar lung pains or symptoms.

Chronic (Fibrotic) Lupus Pneumonitis

As the name suggests, chronic lupus pneumonitis is the creeping cousin of acute lupus pneumonitis. Whereas the acute form comes on quickly, chronic lupus pneumonitis accumulates subtly over years. Some people with chronic lupus pneumonitis may have had acute lupus pneumonitis as some point during their lives, while others have not.

Often the disease takes so long to develop that people do not realize or complain of the initial symptoms. While current inflammation can be treated with steroid medications, any scarring that occurs over time is permanent. Thus, it is very important that you remember to tell your doctor about any chest, lung, or breathing pain during regular visits.

If caught early, chronic lupus pneumonitis can be treated.

Pulmonary Hypertension

In order for the organs in your body to work, they must receive oxygen. The right side of your heart is responsible for pumping blood from your veins back to your lungs to receive oxygen; the oxygenated blood then returns to the left side of the heart, where it is pumped to the rest of the body for use.

Pulmonary hypertension is a unique form of hypertension (high blood pressure) in which the blood vessel that carries blood from the heart to the lungs thickens, reducing the amount of blood that can move through it in a given amount of time. In order to counter this resistance, your heart must pump harder and faster.

When the heart fails to keep up, the rest of the body suffers by receiving less and less oxygen (a condition called hypoxia).

Pulmonary hypertension occurs in about 10% of people with lupus. On rare occasions pulmonary hypertension responds to corticosteroids and immunosuppressive treatment. However, if it is not reversible (meaning, if it is not due to active lupus), then your doctor can discuss with you one of the FDA-approved medications for pulmonary hypertension.

“Shrinking Lung” Syndrome

“Shrinking lung” syndrome is another rare lupus complication. People with the condition feel a sense of breathlessness and reduced chest expansion. Some people with shrinking lung syndrome improve with corticosteroid or immunosuppressive therapy.


  • D’Cruz, D, Khamashta, MA, Hughes, G. Pulmonary Manifestations of Systemic Lupus Erythematosus. In: Wallace, DJ, Hahn, BH, eds. Dubois’ Lupus Erythematosus. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2007:678-699.
  • Medsger, Thomas A. “Pulmonary Manifestations.” The Clinical Management of Systemic Lupus Erythematosus. Ed. Peter H. Schur. 2nd ed. Philadelphia: Lippincott-Raven, 1996. 87-94.
  • “Pulmonary hypertension.” American Heart Association. 1 July 2009. .
  • Wallace, Daniel J. “Pants and Pulses: The Lungs and Heart.” The Lupus Book: A Guide for Patients and Their Families. 1st ed. New York: Oxford University Press, 1995. 81-98.


Bronchitis: Symptoms, Causes, Diagnosis, and Treatment

Chronic Bronchitis | Johns Hopkins Medicine

Bronchitis is inflammation and irritation of the bronchial tubes, which are the airways in your lungs. If you have bronchitis, thick mucus may form in your airways, possibly making it difficult to breathe.

Acute bronchitis is caused by a viral respiratory infection, and it may be contagious. However, it usually resolves on its own within days or weeks. Chronic bronchitis, on the other hand, is a lung disease, not an infection, and is not contagious.

Verywell / Emily Roberts

The symptoms of acute bronchitis and chronic bronchitis are similar. Acute bronchitis begins during or shortly after a cold, while chronic bronchitis develops over months or years, often due to smoking.

Acute bronchitis is a short-term problem that can develop when you have a respiratory infection. Normally, acute bronchitis develops soon after initial symptoms of a respiratory infection, which can include a sore throat, a stuffy or a runny nose, headaches, fevers, and fatigue. 

Acute bronchitis can last for weeks, and often resolves on its own.

Symptoms of acute bronchitis include:

  • Frequent coughing
  • Coughing up watery or thick mucus, often described as sputum, which is saliva mixed with mucus
  • Wheezing when you breathe
  • Aching of your chest muscles from persistent coughing

Chronic bronchitis is a long-term condition that is characterized by recurrent, often daily, symptoms that last for months at a time. Chronic bronchitis is primarily caused by cigarette smoking, second-hand smoke, air pollution, and environmental chemicals. 

Symptoms of chronic bronchitis include:

  • A long-term cough
  • Coughing up mucus
  • Coughing up blood
  • Breathing that takes effort
  • Frequent clearing of your throat
  • Pain throughout the chest, which is usually worse with breathing
  • Shortness of breath which is worse with activity, but may be present at rest
  • Your cough can be exacerbated by cold weather, dampness, and things that irritate the lungs, such as fumes or smoke

There are a number of known causes of bronchitis. Usually, if you are diagnosed with bronchitis, your medical team can identify the cause.

Acute and chronic bronchitis have different triggers, and both are due to an inflammatory reaction in the bronchi, which is accompanied by an overproduction of mucus.

The inflammation and mucus cause obstruction of the bronchi, which results in the coughing, shortness of breath and wheezing that is characteristic of bronchitis. 

The most common causes of acute bronchitis are brief episodes that trigger inflammation of the bronchi and typically resolve fairly well within a few weeks. Viral infections are the most common causes of acute bronchitis, though other infections can lead to as well. Inhalation of chemicals can also trigger acute bronchitis as can fungal or parasitic infections (rarely). 

Chronic bronchitis is usually caused by recurrent toxin exposure over a long period of time, which results in an inflammatory response. The most common cause of chronic bronchitis is smoking. Some people develop chronic bronchitis as the result of occupational exposure to environmental pollution, which can occur in an indoor or an outdoor setting, or contact with industrial chemicals. 

A diagnosis of bronchitis is your medical history, environmental and occupational exposure, and smoking history. Diagnostic tests can help support the diagnosis of bronchitis and can rule out other causes of your cough.

Before an appointment with your doctor, you can use our Doctor Discussion Guide below to read up on common terms and questions that may come up during that conversation.

Get our printable guide for your next doctor's appointment to help you ask the right questions.

If you have a persistent, productive cough lasting for a few weeks, you may have acute bronchitis. If you have had recurrent episodes of daily coughing persisting for at least three months at a time for two years in a row, you might have chronic bronchitis.

Several diagnostic tests can help in the diagnosis of bronchitis. You will probably not need all of these, but your doctor will determine which tests are required the certainty of your diagnosis and whether your breathing is impaired. 

  • Chest X-ray: This test may identify other problems, such as pneumonia.
  • Complete blood count: A blood count can show signs of infection.
  • Sputum culture: A sputum culture can grow bacteria or other organisms that may require antibiotics or other medical treatment
  • Pulmonary function tests (PFTs): If you have chronic bronchitis, your lung function may not be optimal. If you have acute bronchitis, it is unly that you would have abnormal PFTs. This test requires your cooperation as you breathe into a device that measures your respiratory abilities, but it is not an invasive test. PFTs can help your doctors determine the degree of impact bronchitis has had on your lung function, which can help direct your treatment. 
  • Pulse oximetry: This is a quick test which uses a small electronic device placed on your finger. A pulse oximetry test is a screening test that can measure the concentration of oxygen in your blood. This test would only be abnormal if you have severe lung disease. 
  • Arterial blood gas test: This is a blood test in which blood is taken from your artery, not your vein, which is where you normally have your blood drawn for a complete blood count. An arterial blood gas may be slightly more uncomfortable than getting blood drawn from your vein. Normally, your arterial blood will be obtained from an artery in your wrist. This test provides a more accurate analysis of your oxygen concentration, which is a better reflection of your pulmonary function than a pulse oximetry test. 

The main goals in the treatment of bronchitis are to keep the airways clear of inflammation and mucus so they can function properly.

Avoiding things that can exacerbate bronchitis, such as fumes or lung infections, can prevent further disability. 

Treatment methods include:

Avoiding smoke from cigarettes and cigars is important if you have bronchitis, as smoke can exacerbate the symptoms of acute bronchitis, and it can make chronic bronchitis worse. Secondhand smoke is also an irritant. 

Smoking causes the airways in the lungs to become constricted (narrowed) and paralyzes the cilia, which help the lungs remove irritating particles.

Talk with your doctor if you want to quit smoking, but aren't sure where to start. Many options are available for those who wish to quit smoking but haven't been successful doing so on their own, including stop smoking aids, support groups, and counseling. 

Chronic and acute bronchitis have very similar symptoms, but they are different diseases. Acute bronchitis is reversible and occurs due to an infection. Chronic bronchitis is an irreversible disease that occurs due to recurrent inflammation of the bronchi, usually due to smoking. 

If you have acute bronchitis, you do not need to worry about the long-term health of your lungs. If you have chronic bronchitis, however, you do need to make some lifestyle changes to optimize your breathing and respiratory abilities. Chronic bronchitis is not an uncommon condition, and there are many effective methods of treatment that can help you as you live with the illness.