Chronic bronchitis: classification

There is no generally accepted classification of chronic bronchitis. In practical medical activities, it is advisable to use the following.

The most widespread classification of chronic bronchitis NR Paleyeva, VA Ilchenko, LN Tsarkova (1990, 1991). The classification is based on the following principles: determining the nature of the inflammatory process, the presence or absence of bronchial obstruction and complications.

1. The nature of the inflammatory process in the bronchi.
   1. Simple (catarrhal) bronchitis.
   2. Purulent bronchitis with discharge of purulent sputum.
   3. Muco-purulent bronchitis with discharge of mucopurulent sputum.
   4. Special forms:
      1. Hemorrhagic bronchitis with discharge of sputum with an admixture of blood.
      2. Fibrinous bronchitis - with the separation of a very viscous sputum, rich in fibrin, in the form of casts of small bronchi.
2. The presence or absence of bronchial obstruction syndrome.
   1. Non-obstructive bronchitis.
   2. Obstructive bronchitis.
3. The level of damage to the bronchial tree.
   1. With primary lesion of large bronchi (proximal).
   2. With the predominant lesion of small bronchi and bronchioles (distal - "disease of small airways").
4. Flow.
   1. Latent.
   2. With rare exacerbations.
   3. With frequent exacerbations.
   4. Continuously recurring.
5. Phase.
   1. Exacerbation.
   2. Remission.
6. Complications.
   1. Emphysema of the lungs.
   2. Hemoplegia.
   3. Respiratory failure.
      1. Sharp.
      2. Chronic.
      3. Acute on a background of chronic.
   4. Secondary pulmonary hypertension:
      1. Transitional stage.
      2. Stable stage without circulatory failure.
      3. Stable stage with circulatory failure.

[1], [2], [3], [4], [5]

Severity of chronic respiratory failure

• I degree - obstructive ventilation disorders without arterial hypoxemia;
• II degree - moderate arterial hypoxemia (PaO2 from 79 to 55 mm Hg);
• III degree - severe arterial hypoxemia (PaO2 below 55 mm Hg) or hypercapnia (PaCO2 above 45 mm Hg).

A. N. Kokosov and N.V. Η. Kanaev (1980) identified two variants of chronic non-obstructive bronchitis:

1. functionally stable with predominant lesion of the central bronchi;
2. functionally unstable, in which, along with the damage to the major bronchi, there is a syndrome of moderate obstruction of the peripheral bronchi (a kind of preclinical stage of chronic obstructive bronchitis) in connection with the development of bronchospasm.

Classification of chronic bronchitis

1. On etiology - bacterial, viral, mycoplasmal, from the effects of chemical and physical factors, dust.
2. By the nature of the inflammatory process:
   • catarrhal;
   • purulent;
   • catarrhal-purulent;
   • fibrinous;
   • hemorrhagic.
3. On functional changes:
   • non-obstructive;
   • obstructive.
4. With the flow:
   • the phase of remission;
   • exacerbation phase.
5. For complications:
   • respiratory (pulmonary) insufficiency;
   • emphysema of the lungs;
   • chronic pulmonary heart (compensated, decompensated);
   • development of bronchiectasis.

[6], [7],