From the Research
Bronchial breathing is a type of abnormal breath sound heard during auscultation of the lungs that indicates pathology, characterized by harsh, high-pitched sounds during both inspiration and expiration, with the expiratory phase being longer and louder than the inspiratory phase. This breathing pattern normally occurs over the trachea and main bronchi in healthy individuals, but when heard elsewhere in the lung fields, it suggests lung consolidation or compression. Bronchial breathing typically develops when air passes through patent airways surrounded by solid tissue, such as in pneumonia, pulmonary fibrosis, or lung collapse, as discussed in various studies 1, 2, 3, 4, 5. The solid tissue conducts sound better than normal air-filled alveoli, allowing the bronchial sounds to be transmitted to the chest wall. When examining a patient, bronchial breathing is best detected using the diaphragm of the stethoscope while asking the patient to breathe deeply through an open mouth. Identifying bronchial breathing is clinically important as it helps diagnose conditions requiring specific treatments, such as antibiotics for pneumonia or interventions for atelectasis, with recent studies such as 4 discussing the optimal duration of antibiotics and the usefulness of corticosteroids in the management of parapneumonic effusion and pleural infection. Some key points to consider when evaluating bronchial breathing include:
- The characteristics of the breath sound, including its pitch and duration
- The location of the breath sound, with bronchial breathing typically heard over the trachea and main bronchi
- The underlying cause of the bronchial breathing, such as pneumonia or pulmonary fibrosis
- The appropriate treatment for the underlying condition, such as antibiotics or interventions for atelectasis. It is essential to prioritize the most recent and highest quality study, such as 4, when making a definitive recommendation regarding morbidity, mortality, and quality of life outcomes.