Obstructive bronchitis in children
Bronchitis is a respiratory disease that can have dangerous complications. Parents have many questions about the treatment of this disease: in which cases antibiotics are used and whether it is possible to cure the child with the help of inhalations and warming procedures. The condition of the baby may deteriorate sharply, it all depends on the form of the disease and age. Therefore, home treatment should always be coordinated with the doctor. To speed recovery, it is necessary to maintain optimum humidity and temperature in the room.
- What is bronchitis. Types of disease
- The causes of the disease
- Symptoms of bronchitis of various types
- Types of acute bronchitis
- Symptoms of simple bronchitis
- Symptoms of obstructive bronchitis
- Signs of bronchiolitis
- The course of bronchitis in children of different ages
- Diagnosis of bronchitis
- Bronchitis treatment
- Medicines prescribed for children with bronchitis
- The use of folk methods for bronchitis
What is bronchitis. Types of disease
So called inflammation of the bronchial mucosa. The disease has an infectious and allergic nature. Often, the inflammatory process appears on the background of colds and flu. Most often, infectious bronchitis children fall ill in the cold season, when the body's immune defense weakens.
The infection enters the child’s body from outside by inhalation of contaminated air. It is also possible to activate one’s own conditionally pathogenic microflora, which is promoted by overcooling of the body and a decrease in immunity.
Depending on the cause of occurrence, the following types of bronchitis are distinguished:
- Bacterial. Its pathogens are bacteria such as streptococci, staphylococci, pneumococci, hemophilic and pertussis, bacilli, chlamydia, and mycoplasmas.
- Viral. Occurs due to penetration into the bronchi of influenza viruses, as well as adenoviruses.
- Allergic. It occurs when the bronchi are irritated by chemicals, dust or pollen of plants, particles of animal hair.
Infectious species are contagious. When a patient sneezes or coughs, the infection spreads around 10 meters.
When breastfeeding a child has passive immunity, that is, with mother's milk, he receives protective antibodies to infections. Therefore, babies under the age of 1 year suffer from bronchitis only in cases where they have abnormalities in the development of the respiratory system, they were born premature, or the body is weakened by other diseases.
The development of infection in the bronchi occurs when the mucus formed in them as a result of irritation and inflammation of the mucous membrane dries out, blocking the respiratory passages. In this case, the ventilation of these organs is disturbed.
The causes of the disease
The causes of children with bronchitis are:
- penetration of viruses and bacteria into the bronchi with air, while in contact with a sick person,
- infection in the respiratory tract when licking toys and other items that the baby pulls into his mouth,
- infection with parasites, infection in the bronchi through the blood,
- congenital malformations of the respiratory system, leading to stagnation of sputum, the occurrence of chronic inflammatory processes,
- staying in a smoky room or inhalation of gasoline vapors, solvents, or other chemicals,
- contact with respiratory tract irritating particles (plant pollen, poplar fluff, wool) or contact with substances that have a strong odor (detergent, cosmetics).
If the treatment of bronchitis in children is not carried out in a timely manner or has turned out to be ineffective, then the disease becomes acute from chronic to chronic. At the same time it lasts for years, with periodic relapses. Most often, recurrent bronchitis occurs in children 4-7 years old. The disease is repeated 3-4 times a year after a cold, for about 2 years. There are no attacks of bronchospasm.
The likelihood of a complicated disease increases when the child has inflammation of the adenoids or chronic tonsillitis. The factors contributing to the occurrence of bronchitis in an infant are early weaning, inadequate sanitary conditions, the presence of smokers in the home.
Symptoms of bronchitis of various types
The device of the respiratory system in children has its own characteristics. Their respiratory passages are narrower, which makes it possible for them to quickly overlap in case of mucosal edema. Congenital malformations of the lungs or bronchi are more pronounced in nursing babies. After 1-1.5 years, deviations often disappear.
Immunity in children is in the developmental stage, their susceptibility to infections is increased. The respiratory muscles are weaker, due to which ventilation of the respiratory organs is worse than in adults. In addition, the volume of the lungs in children is smaller, which contributes to the accelerated spread of pathogens.
In children, the body thermoregulation is not well developed. They overheat faster, they easily get through.
Note: Especially quickly spasm and swelling of the bronchi (obstruction) develops in infants. The resulting lack of oxygen is life threatening.
Types of acute bronchitis
The following types of acute illness exist:
- Simple bronchitis. The manifestations are the easiest. Symptoms of lack of air does not exist.
- Obstructive bronchitis. Severe and dangerous condition in which the occurrence of respiratory failure.
- Bronchiolitis. There is inflammation of the bronchioles (bronchial tubes with a diameter of 1 mm, located in the transition to the lungs). This leads to blockage of pulmonary vessels, the occurrence of heart disease.
Bronchitis of any type begins with the appearance of cold symptoms, which then acquire the characteristic features of the inflammatory process.
Symptoms of simple bronchitis
Against the background of a cold, the child has general weakness, headache, and a strong dry cough for up to 7 days. Drying of mucus leads to the appearance of a husk in the bronchi. If the inflammation also struck the larynx, then a barking cough appears. The temperature rises to 37 ° -38 ° (depending on the severity of the disease). Gradually dry cough goes into wet. Gurgling wheezes appear. If sputum discharge occurs normally, the child’s condition improves significantly. The disease in this form can last for 1-3 weeks. The severity of the manifestations depends on the age of the baby, his physical development, and general health.
If the disease is started, then the child has complications such as bronchiolitis and pneumonia. Sometimes a disease that occurs in a viral form is not entirely normal. After the virus dies (after about a week), the child gets better, but then his condition worsens dramatically: the temperature rises, cough increases, headache. This suggests that a bacterial virus has joined the viral infection, urgent treatment with antibiotics is required.
The infection process can be either unilateral or bilateral. One of the signs of the disease is redness of the eyes due to inflammation of the mucous membrane (conjunctivitis).
Symptoms of obstructive bronchitis
Symptoms of obstruction most often appear in children younger than 3-4 years. They usually occur with a viral or allergic form of the disease. The main signs of obstructive bronchitis are noisy, hoarse breathing with an extended exhalation, paroxysmal cough, ending with vomiting, intercostal muscle contraction during inhalation, swelling of the chest.
With this form of the disease, the child's body temperature does not increase. Obstructive bronchitis can occur suddenly after the baby has played with a pet (for example, at a party) or has breathed paint during the repair.
Symptoms of obstruction sometimes appear around the 4th day of illness of influenza or acute respiratory infections. Characteristic are bouts of dry cough, not bringing relief. In the lungs, wheezing is heard.
Up to 4 years, relapses of the disease are possible, then the attacks most often stop.
Note: Obstructive bronchitis differs from bronchial asthma in that the symptoms of respiratory failure develop slowly, while in asthma the child begins to suffocate suddenly.
Frequently repeated obstructive process of any origin can turn into bronchial asthma.
Signs of bronchiolitis
The main sign of inflammation of the bronchioles is shortness of breath. Initially, it occurs in the child, if he is actively moving, but over time appears in a state of rest. During inhalation, you can hear a characteristic hoarse. When listening, the doctor hears rattles in the lower part of the bronchi.
As a rule, with bronchiolitis, the temperature rises to 38 ° -39 °. It is harder for the child to exhale than inhale. The chest and shoulders are raised. The face swells, a blue appears. Continuing cough with scanty sputum does not relieve, causing chest pains. Manifestations of this condition are also dry mouth, rare urination, heart palpitations.
The course of bronchitis in children of different ages
Bronchitis after a cold in a child is a frequent occurrence. Sometimes it flows easily, without increasing the temperature and is manifested only by coughing. In complicated cases, the temperature is high, bronchial spasms and choking occur.
The disease usually begins with a dry cough. Gradually in the bronchi accumulates sputum, which becomes mucopurulent. There are wheezing, they can be considered signs of the transition of the disease in the stage of recovery. At this point, it is important to facilitate the removal of sputum out, cleaning the bronchi from the infection. Older children are easier to do, since they already understand that they need to cough and spit out sputum.
A small child does not always manage to do this on his own. Parents can help him, for example, turning it on another flank. At the same time, sputum moves along the walls of the bronchi, causing their irritation and the occurrence of cough.
In infants because of the difficulties with the discharge of mucus from the bronchi and its stagnation, the main symptoms are attacks of strong cough with shortness of breath. At the age of 2-6 months, the disease usually occurs in the form of bronchiolitis.
Usually, recovery from uncomplicated bronchitis occurs in 7-8 days. If bronchitis is complicated by obstruction, then it can manifest itself within a few weeks, turning into pneumonia.
Diagnosis of bronchitis
By the nature of the cough and the type of discharge of sputum, the doctor determines what type of bronchitis occurs in a child. White phlegm is characteristic of viral inflammation, and a greenish-yellow hue appears in her with bacterial inflammation of the bronchi. In allergic bronchitis, lumps of clear mucus are cleared.
During examination and listening to the chest, the presence of such symptoms of bronchitis in children as hoarse breathing, difficulty in exhalation, swelling of the chest, muscle contraction in the intercostal space is determined.
Using a general blood test, the number of leukocytes is determined, the presence of an inflammatory process is established.
When dangerous complications (severe coughing, accompanied by fever for more than 3 days), an x-ray of the lungs is done. This equipment is used with a reduced dose of radioactive radiation. Pneumotachometry is performed. With the help of a special device, the airway patency during inhalation and exhalation is investigated.
If there is evidence of an infectious disease, sputum analysis is done to determine the type of pathogen. To diagnose bronchiolitis in infants, a histological examination of sputum for the presence of characteristic viruses that can live in the bronchi and lungs, the so-called respiratory syncytial infection, is performed. An important sign of inflammation of the bronchi in an infant is cyanosis (cyanosis of the skin and mucous membranes), which results from cardiac and pulmonary insufficiency.
For diagnosis, the presence of characteristic wheezing and shortness of breath, as well as the frequency and strength of the heartbeat is important.
A strong cough can also occur with other diseases such as pneumonia, laryngitis, and tuberculosis. It can be caused by a congenital pathology of the functioning of the respiratory system, a foreign body entering the trachea. Diagnosis allows you to confirm the presence of bronchitis, prescribe the correct treatment.
First of all, parents should remember that in no case is unacceptable to self-medicate. As pediatrician E.Komarovsky stresses, a small child with bronchitis can be injured not only by the uncontrolled use of medications, but also by the incorrect use of home procedures.
Hospitalization is carried out in cases where acute bronchitis occurs in a complicated form (in the presence of shortness of breath, high temperature, difficulty in eating and drinking). At home, when treating simple bronchitis, the child should be in bed if he has a high temperature. As soon as it is normalized, the child needs to walk in the fresh air.
It is often necessary to drink warm tea, compote (fluid consumption should be increased by 1.5 times compared to normal). This contributes to the dilution of sputum and removing it from the bronchi. For drinking, you can prepare herbal teas (lime, mint). It is useful to drink alkaline mineral water, which will help reduce the viscosity of sputum. The infant is applied to the breast as often as possible, additionally watered with water.
Thermal procedures (inhalations, mustard plasters, foot baths, chest rubbing) can be performed only in the absence of elevated body temperature.
Medicines prescribed for children with bronchitis
Antiviral drugs such as arbidol, anaferon, influenza, interferon, in acute bronchitis, the doctor prescribes, taking into account the age and weight of the child.
Antibiotics with bronchitis have an effective effect only in the case when the disease is bacterial in nature. They are prescribed when thick sputum is colored yellow-green, with a high fever, difficulty breathing, symptoms of intoxication (nausea, severe headache, weakness, sleep disturbance). The presence of a bacterial process can be said if the symptoms of the disease do not subside within 10 days after the start of antiviral treatment. Antibiotics are necessary if the child has bronchiolitis and there is a threat of his going to pneumonia. Typically, children are assigned azithromycin, zinnat, suprax, sumamed.
Cough drops. The following types of drugs are used:
- expectorants (pertussin, licorice root extract, decoctions of some herbs),
- phlegm diluents such as bromhexine, lasolvan, libexin.
A warning: Babies under 2 years old should not be given expectorants. Their reception will strengthen the coughing fit. Liquefied sputum can get into the respiratory system and into the lungs, leading to even more serious complications.
Antipyretics. Panadol (paracetamol), nurofen (ibuprofen), ibuklin in the form of tablets, suspensions, candles - in forms suitable for children of any age are used.
Antihistamines (zyrtec - for children older than 6 months, Erius - from 1 year, claritin - from 2 years). They are used in the treatment of allergic bronchitis in children.
Preparations for inhalation. Used for obstructive acute bronchitis. Procedures are performed using a special inhaler. Apply such means as salbutamol, atrovent.
As an additional procedure, a chest massage, therapeutic breathing exercises, physiotherapy treatment (ultraviolet radiation, electrophoresis) are prescribed. Procedures are not carried out in the period of acute illness.
The use of folk methods for bronchitis
Traditional medicines based on natural ingredients help to alleviate the condition of the child with bronchitis, carry out prophylactic treatment to prevent relapses, strengthen the immune system. Such means, after consultation with a physician, are taken as an adjunct to drug treatment.
Note: The well-known Moscow physician, the chief pulmonologist of Russia, Professor L. M. Roshal, strongly recommends using the “monastery collection” consisting of 16 herbs (sage, string, wormwood and others) for chronic bronchitis. Herbal remedies, mustard, honey and other medicinal components used in traditional medicine, cause allergies in many people. Therefore, they can not be used by everyone.
As an expectorant can be used broth coltsfoot, well soothes a cough with simple bronchitis decoction of Hypericum, which has a bactericidal and anti-inflammatory effect. A well-known cough medicine for bronchitis, pneumonia is baked radish with honey, oatmeal broth. Soda inhalations also help.
The effective home treatment methods include warming and distracting procedures (foot baths, mustard plasters, jars, warming compresses on the right side of the chest are used).
The most important measure for the prevention of bronchitis is the timely treatment of colds, rhinitis, infectious diseases of the throat and upper respiratory tract.The child must be tempered, accustomed to physical education, he should spend a lot of time in the fresh air. It is necessary to add vitamins to food all year round.
It is important for parents to make sure that the apartment is always clean, cool, and sufficiently humid air.
Obstructive bronchitis in children
Bronchitis in children are the most common diseases of the respiratory tract. In infants, bronchial inflammation often occurs with broncho-obstructive syndrome due to mucosal edema, increased bronchial secretion and bronchospasm. In the first three years of life, about 20% of children suffer from obstructive bronchitis, half of them have bronchoobstructive episodes later, at least 2-3 times.
Children who repeatedly suffer from acute and obstructive bronchitis constitute a risk group for the development of chronic bronchopulmonary pathology (chronic bronchitis, bronchiolitis obliterans, bronchial asthma, bronchiectasis, pulmonary emphysema). In this regard, the issues of interpretation of etiology and pathogenesis, clinical course, differential diagnosis and modern therapeutic treatment are priorities for pediatrics and pediatric pulmonology.
Causes of obstructive bronchitis in children
In the etiology of obstructive bronchitis in children, respiratory syncytial virus, type 3 parainfluenza virus, enteroviruses, influenza viruses, adeno-and rhinoviruses play a primary role. Confirmation of the leading value of viral pathogens is the fact that in most cases, the manifestation of obstructive bronchitis in a child is preceded by ARVI.
With repeated episodes of obstructive bronchitis in children in a washout from the bronchi, DNA of persistent infections is often detected - chlamydia, mycoplasma, herpes viruses, cytomegalovirus. Often, bronchitis with obstructive syndrome in children is provoked by a mold fungus that multiplies intensively on the walls of rooms with high humidity. It is rather difficult to estimate the etiological significance of the bacterial flora, since many of its representatives act as conditionally pathogenic components of the normal microflora of the respiratory tract.
An important role in the development of obstructive bronchitis in children is played by the allergic factor - increased individual sensitivity to food, drugs, house dust, animal hair, plant pollen. That is why obstructive bronchitis in children is often accompanied by allergic conjunctivitis, allergic rhinitis, atopic dermatitis.
Recurrent episodes of obstructive bronchitis in children are promoted by worm infestation, the presence of foci of chronic infection (sinusitis, tonsillitis, caries, etc.), active or passive smoking, inhalation of smoke, living in ecologically unfavorable regions, etc.
Pathogenesis of obstructive bronchitis in children
The pathogenesis of obstructive bronchitis in children is complicated. The invasion of a viral agent is accompanied by inflammatory infiltration of the bronchial mucosa by plasma cells, monocytes, neutrophils and macrophages, eosinophils. Isolation of inflammatory mediators (histamine, prostaglandins, etc.) and cytokines leads to swelling of the bronchial wall, reduction of the smooth muscles of the bronchi and the development of bronchospasm.
Due to edema and inflammation, the number of goblet cells that actively produce bronchial secretions (hypercrinia) increases. Hyperproduction and increased viscosity of mucus (discrin) cause dysfunction of the ciliary epithelium and the occurrence of mucociliary insufficiency (mucostasis). Due to coughing disorders, airway obstruction develops with bronchial secretions. Against this background, conditions are created for the further reproduction of pathogens that support the pathogenetic mechanisms of obstructive bronchitis in children.
Some researchers in bronchial obstruction see not only a disturbance of the process of external respiration, but also a kind of adaptive reactions that, in conditions of defeat of the ciliary epithelium, protect the pulmonary parenchyma from the penetration of pathogens from the upper respiratory tract. Indeed, unlike simple bronchitis, inflammation with an obstructive component is much less likely to be complicated by pneumonia in children.
The terms “asthmatic bronchitis” and “spastic bronchitis” are sometimes used to refer to obstructive bronchitis in children, but they are narrower and do not reflect the full pathogenetic mechanisms of the disease.
The course of obstructive bronchitis in children can be acute, recurrent and chronic or continuously recurrent (with bronchopulmonary dysplasia, bronchiolitis circulating, etc.). The severity of bronchial obstruction is as follows: mild (I), moderate (II), severe (III) degree of obstructive bronchitis in children.
Diagnosis of obstructive bronchitis in children
Clinical laboratory and instrumental examination of children with obstructive bronchitis is carried out by a pediatrician and pediatric pulmonologist, according to the testimony of the child, consultations are given to a children's allergist-immunologist, children's otolaryngologist and other specialists.
During auscultation, an extended exhalation is heard, different-sized wet and diffuse dry rales from two sides, with percussion above the lungs a boxed shade is determined.
Radiographs of the chest organs show signs of hyperventilation: an increase in the transparency of the lung tissue, a horizontal arrangement of the ribs, and a low standing of the diaphragm dome. In general, a blood test can reveal leukopenia, lymphocytosis, a slight increase in ESR, eosinophilia. In the study of blood gas is found moderate hypoxemia. If necessary, an additional immunological, serological, biochemical blood test, DNA determination of the main respiratory pathogens in the blood by PCR, and allergy tests are carried out. Microscopic examination of sputum, sputum bacterial culture for microflora, and nasopharyngeal washings can contribute to the detection of pathogens.
For obstructive bronchitis in children, the study of respiratory volumes (FER), including with medicinal samples, is necessary. In order to visually assess the condition of the bronchial mucosa, to conduct bronchoalveolar lavage, cytological and bacteriological examination of the washing water for children with obstructive bronchitis, bronchoscopy is performed.
Repeated episodes of obstructive bronchitis require differential diagnosis with bronchial asthma in children.
Treatment of obstructive bronchitis in children
Therapy of obstructive bronchitis in young children is carried out in the hospital, older children should be hospitalized with severe disease. General recommendations include adherence to the half-bed and the hypoallergenic (mainly dairy-vegetable) diet, abundant drinking (teas, decoctions, fruit drinks, alkaline mineral water). Air moistening, regular wet cleaning and airing of the ward where children with obstructive bronchitis are treated are important regime points.
In severe bronchial obstruction, oxygen therapy, hot foot baths, canned massage, removal of mucus from the upper respiratory tract by an electric suction pump are actively used. To relieve obstruction, it is advisable to use adrenergic inhalation (salbutamol, terbutaline, fenoterol) through a nebulizer or spacer. With the ineffectiveness of bronchodilators treatment of obstructive bronchitis in children is complemented by corticosteroids.
To liquefy sputum shows the use of drugs with mucolytic and expectorant effects, medicinal and alkaline inhalation. For obstructive bronchitis, antispasmodic and antiallergic drugs are prescribed for children. Antibacterial therapy is carried out only in the case of the accession of a secondary infection.
In order to ensure adequate drainage of the bronchial tree, children with obstructive bronchitis are shown breathing exercises, vibration massage, postural drainage.
Prognosis and prevention of obstructive bronchitis in children
About 30-50% of children are prone to recurrent obstructive bronchitis within one year. Risk factors for recurrence of bronchial obstruction are frequent colds, allergies, and foci of chronic infection. In most children, obstruction episodes cease at preschool age. Bronchial asthma develops in a quarter of children who have had recurrent obstructive bronchitis.
The prevention of obstructive bronchitis in children includes the prevention of viral infections, including vaccination, the provision of a hypoallergenic environment, hardening, recovery in climatic resorts. After suffering obstructive bronchitis, children are under observation at a pediatrician, possibly a pediatric pulmonologist and an allergist.
What causes the development of the disease?
Let's first consider the word "obstructive". This name comes from the word obstruction, which means squeezing, constriction or spasm. The concept of "bronchitis" is derived from the word bronchi, which means the name of the lung in the human body.
To sum up: obstructive bronchitis is a narrowing of the bronchi or a spasm, as a result of which the accumulated mucus cannot go out and thus makes breathing difficult.
The causes of obstructive bronchitis in children include
- allergic inflammation of the bronchi - due to the allergic reaction of the child (dust, pollen, animal hair, etc.),
- viral infections
- hypothermia or overheating,
- passive smoking - besides the fact that, in general, inhalation of tobacco smoke leads to a decrease in immunity, smoke also provokes excessive secretion of mucus, which can become bronchial obstruction,
- polluted environment,
- frequent crying, during which the natural functions of breathing are disturbed,
- birth injuries and health in the first 2 years of a child’s life,
- high humidity leads to the formation of fungus indoors, which provokes bronchial obstruction,
It is necessary to take measures immediately after the diagnosis. How to treat obstructive bronchitis in children will depend on the severity of symptoms, as well as the age of the child and his well-being.
The first signs of bronchitis are runny nose and dry cough, worse at night. A sick child feels weakness, pain behind the sternum, usually they are very restless, capricious, there is increased nervous irritability.
- Signs of difficulty expiratory breathing appear, its frequency and expiratory duration increase, it is noisy and is accompanied by a whistle that is heard from a distance.
- Sometimes the chest of the child visually increases in size.
- Pallor of the skin appears.
- Cough at first unproductive and infrequent.
- Body temperature is low or normal.
- In the later stages of the disease there are moist rales.
- X-ray shows signs of pulmonary distention.
In older children, acute obstructive bronchitis is sometimes accompanied by sore throat or cervical lymphadenitis, it has a protracted course.
First of all, the prevention of obstructive bronchitis in children is to strengthen the immune system: maintaining breastfeeding for at least one year, more walks in the fresh air, a varied and healthy diet, taking vitamins, hardening.
In addition, it is very important to timely and correctly treat colds, preventing the development of complications. Self-treatment is the first enemy of health. Although the consequences may not be immediately apparent. That misleads parents about the harm of their actions.
Stages of treatment
Acute obstructive bronchitis in children is a serious pathology that does not go away for a long time without treatment or is complicated by pneumonia, the development of respiratory failure and metabolic disorders in body tissues.
There are several situations where the presence of obstructive bronchitis in children requires urgent treatment in a hospital:
- The presence of obstruction in infants.
- If on the background of the disease symptoms such as very high fever, general drowsiness and lethargy, nausea and loss of appetite develop.
- The appearance of signs of insufficiency in breathing, such as acrocyanosis and severe shortness of breath.
It is impossible to refuse hospitalization and treatment of obstructive bronchitis in a child with the above symptoms in a hospital setting, since under the guise of normal bronchitis can hide dangerous acute pneumonia.
The goal of therapy for this disease is to eliminate the causes that caused it, relieve bronchial obstruction, improve the functioning of the respiratory organs, and symptomatic treatment depending on the manifestations. First of all, measures are taken to clear the bronchi from mucus, and bronchodilator and anti-inflammatory measures are prescribed.
Effective treatment is based on the provision of sputum discharge. For such purposes are prescribed mucoregulatory agents. They are aimed at diluting the viscous sputum and its early discharge. Medications are popular:
Ambroxol is very effective. Often it is prescribed in the form of inhalation through a nebulizer. The course of treatment with the above remedies lasts 7-10 days.
After such treatment, the cough passes from paroxysmal, painful to wet. The phlegm is less viscous, but does not move well. At this stage, the mucoregulators are replaced with expectorant drugs.
Preference is given to herbal medicines:
Anti-cough codeine-containing drugs are not shown and can be recommended (only by a doctor) for an obsessive paroxysmal dry cough with mandatory monitoring of the child’s condition and treatment correction.
Massage and breathing exercises
Very useful massage for sputum discharge. The baby needs to lightly tap the edge of the palm on the back. The older guys are told to take a breath and a slow, smooth exhalation, on which they perform tapping.
Recommended for children special breathing exercises. Such exercises stimulates the body to get rid of sputum. Babies can be recommended to inflate a ball or blow out a candle.
Bronchitis in a child under one year - symptoms and treatment.
Breastfed babies who do not have contact with sick children and adults should not have any respiratory problems. However, if the child was born premature, has congenital malformations of the respiratory organs and other diseases, and there are also preschool children in the family attending kindergartens and often sick - the development of bronchitis in a child under one year is possible for the following reasons:
- narrower than the adult, bronchi, drier and more vulnerable mucosa of the respiratory tract
- congenital malformations
- after a viral or bacterial infection
- individual sensitivity to chemical and physical irritants - allergic to anything.
The most basic symptoms of developing bronchitis are severe dry cough, paroxysmal, followed by difficulty breathing, shortness of breath. Gradually, the cough becomes wet, but mucus, sputum during bronchitis in a child under one year of age makes it difficult to breathe, and the normal functioning of the lungs is disturbed, since the airways during infancy are narrow. Bronchitis in children under one year old or even 3-4 years old is most often of the following types:
- Acute bronchitis is simple
- Obstructive bronchitis
On acute and obstructive bronchitis, we will discuss in more detail below. Now consider the most common in children under one year. bronchiolitis.
Bronchitis in children under one year - bronchiolitis
This bronchitis affects both small bronchi and bronchioles, often develops on the background of acute respiratory viral infections, influenza viruses, followed by the multiplication of pneumococci (and so forth streptococci). In case of inhalation of icy air or sharp concentrations of various gases, bronchiolitis can develop as an independent disease. The danger of such bronchitis is pronounced broncho-obstructive syndrome with the development of sometimes even acute respiratory failure:
- It is characterized by a dry cough with attacks, severe dyspnea of mixed or expiratory form with syndromes of nasal wing inflation, with the participation of auxiliary muscles, contraction of the intercostal spaces of the chest, pale skin, cyanosis.
- The child has dry mouth, no tears when crying.
- The child eats and drinks less than usual, respectively, and his urination is more rare.
- Increased body temperature, but unlike pneumonia, it is less pronounced (see whether you need to churn the temperature).
- Dyspnea up to 60-80 breaths per minute, with a grunting breath, shallow.
- On both sides, diffuse moist ringing fine bubble and crepitus rales are heard.
- Symptoms of intoxication with bronchiolitis in children are not pronounced.
- On the x-ray is determined by the sharp transparency of the lung tissue, the diversity of the pattern, the horizontal position of the ribs, the absence of infiltrative changes in the lungs.
- Если сначала был простой бронхит, то присоединение бронхиолита через некоторое время проявляется резким ухудшением общего состояния ребенка, кашель становится более мучительным и интенсивным, со скудной мокротой.
- Дети обычно очень беспокойны, капризны, возбуждены.
- Анализ крови может быть незначительно изменен, возможен небольшой лейкоцитоз и повышение СОЭ.
- Обычно бронхиолит у детей до года имеет длительное течение до 1-1,5 месяцев.
- The causes of acute bronchiolitis in children are akin to the causes of obstructive bronchitis in children older than 2–4 years of age. The local immune system of the respiratory tract in children under 2 years of age is weak, protection against viruses is insufficient, so they easily penetrate deep into the bronchioles and small bronchi.
Treatment of bronchiolitis in children
At home, cure bronchiolitis can not. When bronchiolitis occurs in an infant, hospitalization is usually indicated so that the child is under medical supervision. In the hospital, pediatricians, pulmonologists will establish an accurate diagnosis and prescribe the appropriate treatment. What should mom do before the ambulance arrives?
You can only relieve cold symptoms - create optimally comfortable air in the room, turn on a humidifier, an air purifier.
If there is no high temperature in a child, it is possible to ease breathing with the help of warming up creams and ointments, spread the legs and calves with them. Only with this you need to be careful if the child did not have any allergic manifestations before, then it helps well if the child is allergic, warming ointments should be excluded.
To make the cough softer, you can do steam inhalation, over a boiling pot with a weak saline solution, hold the baby in her arms. Or sit him down at the table and cover him with a towel over a cup with a hot healing solution.
Try to get the baby to drink more to avoid dehydration, if the baby refuses breast or a mixture, give the baby just plain water.
In the hospital, to remove the signs of respiratory failure, the child is inhaled with bronchodilators and given oxygen to breathe. Also, at the discretion of the doctor, an antibiotic is selected - Sumamed, Makropen, Augumentin, Amoxiclav. It is possible to use various drugs with interferon. Be sure to prescribe antihistamines to relieve swelling at the site of inflammation and possible allergic reactions to treatment. If symptoms of dehydration are observed, then the necessary rehydration therapy is carried out.
Acute bronchitis in children - symptoms
Bronchitis in children is the most common type of respiratory tract disease. Acute bronchitis is considered to be an acute inflammation of the bronchial mucosa without symptoms of inflammation of the lung tissue. Simple bronchitis in children in 20% of an independent bacterial disease, 80% - either in the program of viruses (Coxsackie virus, adenovirus, influenza, parainfluenza) or as a bacterial complication after these viral infections.
The clinical symptoms of bronchitis in children are as follows:
First, the child has a general weakness, malaise, headache, lack of appetite, then there is a dry cough or cough with sputum, the intensity of which is rapidly increasing, while listening to, dry diffuse or variegated wet rales are determined. Sometimes there can be a barking cough in a child, whose treatment is slightly different.
In the first 2 days, the temperature rises to 38 ° C, but with a light form, the temperature can be 37-37.2.
After 6–7 days, a dry cough turns into a wet one, sputum discharge facilitates the child’s condition and is a good sign that the body is coping with infection and a virus.
On average, the duration of acute bronchitis in children is 7-21 days, but the nature of the disease, the severity of the inflammatory process depend on the age of the child, the strength of his immune system, the presence of concomitant chronic and systemic diseases. With inadequate or untimely treatment, acute bronchitis can lead to the addition of bronchiolitis, pneumonia.
Sometimes after the flu, the child's condition improves for a while, and then a sharp deterioration, a rise in temperature, an increase in cough — this is due to a weakening of the immune system in fighting the virus and the accession of a bacterial infection, in which case an antibiotic is indicated.
With mycoplasmal or adenoviral acute bronchitis in children, symptoms of intoxication, such as high fever, headaches, chills, lack of appetite, can be about a week. Usually acute bronchitis is bilateral, however, with mycoplasmal bronchitis, it is most often unilateral, sometimes combined with conjunctivitis.
Acute bronchitis in children - treatment
Most often, the duration of acute bronchitis in children, whose treatment is correct and is carried out on time, should not be more than 14 days, but in infants the cough can last for up to a month, as well as in older children with atypical mycoplasma bronchitis. If suddenly a child’s bronchitis is delayed, a number of diseases should be excluded:
- food aspiration
- cystic fibrosis
- foreign body in bronchi
- tuberculosis infection
A pediatrician prescribes a full range of treatment. In addition to the implementation of all the recommendations of the doctor, the child should be provided with special nutrition and quality care. It is desirable to create an optimum humidity and cleanliness in the room; for this, it is convenient to use a humidifier and an air purifier, often ventilate the room and conduct daily wet cleaning in the room where the child is located. And:
Provide abundant intake of fluids in the form of heat. To soften the cough helps warm milk with butter or mineral water Borjomi, you can replace with honey.
When fever, temperature only above 38C should be taken antipyretics - paracetamol in syrup.
Antibiotics for bronchitis in children, if recommended by the doctor, should be given strictly by the hour. If antibiotics should be taken 3 times a day, this does not mean that you should drink for breakfast, lunch and dinner, which means that they should be taken 24/3 = 8, every 8 hours, if 1 time per day , then give it only at the same time, for example at 9 am. 11 rules - how to take antibiotics.
If the child coughs dry, he may be given antitussive medications as prescribed by the doctor, and when he becomes wet, he can switch to expectorant drugs. When dry coughing means can be combined (Sinekod). If the cough is wet, then expectorants are shown - Mukaltin, Bromhexin, Gadelix, Alteyn syrup, Infusion of the herb of thermopsis or its dry extract, Bronhikum, Evkabal, Prospan, chest charges.
Inhalation with bronchitis in children, whose symptoms are very pronounced, well help inhalation with ordinary baking soda, which is called above the hot pan, inhalation of sodium bicarbonate using a nebulizer, inhaler.
For small children and infants who do not know how to cough themselves, doctors advise to turn the child more often from one side to another. At the same time, sputum moves downward, irritating the walls of the bronchi, this leads to a reflex cough.
For older children, banks, mustard plasters, hot foot baths, they still help, and if the child has strong immunity, such procedures will help to avoid taking antibiotics. The baby’s feet can already float after 1 year, and rub them with warming agents such as turpentine ointments, Barsukor, Pulmax Baby, etc., but only if there is no high temperature, you should warm the feet after rubbing and wrap the baby. However, in the case of allergic bronchitis in a child, neither mustard plasters, nor warming ointments can be used, since the composition of ointments and mustard can worsen the condition of the child.
With bronchitis in children, compresses of warm oil help to treat. Warm up the sunflower oil to 40C and wet them with gauze, folded several times. This compress should be applied only on the right side and back of the baby, put a plastic bag and a layer of cotton wool on top, bandage the child around several times. Put on warm clothes, it is necessary to do such procedure for the night if there is no temperature at the child.
The old folk method - radish juice with honey, cabbage juice, turnip juice - any of these juices should be given 1 teaspoon 4 times a day. You can also give lingonberry juice, mixing it with honey in a ratio of 3/1, a tablespoon 3 times a day.
In the first week, the chest massage helps well; older children would do well to perform breathing exercises.
Physiotherapy for bronchitis
In children, these procedures are prescribed and carried out only at the discretion of the doctor, these are physiotherapeutic methods that contribute to the fastest recovery, since they have anti-inflammatory effect, however, they cannot be performed more often 2 times a year:
- Ultraviolet irradiation of the chest
- Mud, paraffin applications on the chest and between the shoulder blades
- Induction on the same areas
- Calcium Electrophoresis
- Solux on chest
- Aeronization of the respiratory tract with ionization solutions of chamomile, antibiotics.
With obstructive bronchitis in children up to a year or 2 years old, treatment should be carried out in a hospital under the supervision of a pediatrician, in other cases at the discretion of the doctor and parents. Treatment is best done in the hospital if:
- In addition to obstruction in a child, symptoms of intoxication - loss of appetite, high fever, nausea, and general weakness.
- Severe signs of respiratory failure. This is shortness of breath, when the respiratory rate increases by 10% of the age norm, it is better to keep counting at night, rather than during games or crying. In babies up to 6 months, the respiratory rate should not be more than 60 per minute, 6-12 months - 50 breaths, 1-5 years, 40 breaths. Acrocyanosis is a sign of respiratory failure, manifested by cyanosis of the nasolabial triangle, nails, that is, the body suffers from oxygen deficiency.
- Not infrequently, obstructive bronchitis in children masks pneumonia, so if the doctor suspects pneumonia from hospitalization can not be denied.
Bronchiolitics expand the bronchi, so they are intended to relieve obstruction. Today in the market of the pharmaceutical industry they are presented in various forms:
- In the form of syrups (Salmeterol, Clenbuterol, Ascoril), which is convenient to use for young children, their disadvantage is the development of tremor and heartbeat.
- In the form of solutions for inhalation (see. Berodual for inhalation) - this is the most convenient way for young children, diluting the medicinal solution with physical solution, they inhale 2-3 times a day, after improvement it is possible to use only for the night. Frequency and dosage, as well as the course of treatment is determined only by a pediatrician.
- Inhalers - aerosols can be used only for older children (Berodual, Salbutamol).
- Such tablet forms of bronchodilators such as theophylline (Teopek, Eufillin) are not indicated for the treatment of children with obstructive bronchitis, they have more pronounced side effects, more toxic than local inhalation forms.
To facilitate the discharge of sputum, parents can themselves massage the neck area, chest, and back of their child. Especially strong massage should be done for the back muscles along the spine. Useful for obstructive bronchitis in children is a postural massage - that is, beating the back of the baby in the morning, you should hang the child upside down from the bed (put a pillow under the tummy) and tap the palms in the boat for 10-15 minutes. For older children, during a massage, ask the child to take a deep breath, and on exhalation perform tapping. Additional exercises such as ballooning, blowing out candles, or breathing exercises (Strelnikova) are also useful.
When antibiotics are shown
Treatment with bronchial obstruction with antibiotics is not indicated, only if the child has a high temperature for more than 4 days, or there is a second temperature jump to 39 ° C 4-5 days after the onset of the disease, accompanied by severe intoxication, severe cough, and if the child is adequately treated becomes apathetic, lethargic, refuses to eat, he has weakness, nausea, headaches and even vomiting. In such cases, the use of antibiotics is justified. They are prescribed only by a pediatrician on the basis of the clinical picture, the presence of purulent sputum (indicating bacterial bronchitis), inflammatory changes in the blood test, and also for other signs of bacterial bronchitis or pneumonia (wheezing, radiological signs).
Most doctors recommend taking antiviral drugs for SARS and flu, Genferon, Viferon for candles, as well as drops of Gripferon, Interferon, Orvirem (rimantadine) syrups, and after three years of age, tablets, such as Kagocel and Arbidol, Tsitovir 3. But it is worth remembering that if there is any autoimmune disease in the family history (with close relatives) (Sjogren's syndrome, rheumatoid arthritis, systemic lupus erythematosus, diffuse toxic goiter, vitiligo, multiple sclerosis, ne chronic anemia, insulin-dependent diabetes mellitus, myasthenia gravis, uveitis, Addison's disease, primary biliary cirrhosis, autoimmune hepatitis, scleroderma) cannot take immunostimulants (Kagocel, Tsitovir, Amiksin), a child of a child of a child of a child of a child of a child of a child of a child of a child of a child. See details on antiviral drugs for ARVI).
What not to do
In obstructive bronchitis in children - treatment by rubbing and spreading the body of the child with various warming ointments (Dr. Mom ointment, ointments with medicinal plants, essential oils), the use of mustard plaster is unacceptable because they cause an even greater allergic reaction and bronchospasm, especially in children under 3 years old. Also, it is absolutely impossible to conduct inhalation with bronchitis with various medicinal herbs and essential oils. Only the use of such folk remedies is possible - heat compresses with potatoes, salt, buckwheat.
Hypoallergenic diet and heavy drinking
Any natural drinks - mineral water with milk, tea, dogrose broth, should be drunk as often as possible. The diet should be hypoallergenic, but at the same time maximally vitaminized, full of protein and fat. Exclude from the child’s diet anything that may cause an allergic reaction:
- citrus, red and orange fruits
- purchased spices, sweets, cheese dairy, yoghurts, soda, sausages and sausages - everything that contains dyes, flavors, preservatives and flavor enhancers
- honey and other bee products
- fish grown on fish farms, broiler chickens, as they are stuffed with hormones and antibiotics, which causes allergies.
When caring for a child should be daily ventilate, moisturize the room where the child is. Hot in the apartment should not be, it is better that there was cool, fresh, clean air. After recovery, the child should be put on a dispensary account with an allergist.
Causes of obstructive bronchitis in children
Doctors explain this disease as follows: bronchial obstruction is a sharp spasm of the bronchi, which occurs as a result of the appearance of infection or other negative factors. The dangerous infections that trigger the onset of this disease include adenoviruses, rhinoviruses, and mycoplasma. But in the development of bronchial obstruction syndrome, non-infectious causes are also of great importance.
One of the most common causes of obstructive bronchitis is allergy, which is a trigger for the occurrence of other diseases, and obstructive bronchitis occupies a special place among them.
There are many different factors that cause allergic reactions. In a large number of allergens are part of the purchase of sweets, beverages, convenience foods and canned products.
This disease very often provokes a mold fungus that usually develops on the walls of a wet room. It is imperative that it be removed and prevented from re-distribution with the help of special sealants and solutions that are used in construction.
Passive smoking also leads to obstructive bronchitis. Parents of young children should understand that passive smoking negatively affects the body of young family members. Therefore, in the same room with your children should not smoke. If your baby has wheezing and shortness of breath, immediately consult a doctor.
The cause of the disease can be ordinary household dust in the house, which can irritate the respiratory tract of a sick child and cause severe irritation.
Special attention should be paid to children who have recently experienced sinusitis (inflammation of the sinuses from bacteria and viruses). Obstructive bronchitis is also at risk for children who have a curved nasal septum.
Diagnosis of the disease
Obstructive bronchitis in children is very difficult to diagnose at home, but it can be done by a qualified pediatrician.
In the initial stages, this form of bronchitis develops as acute respiratory infections and acute respiratory viral infections, and often has signs of viral damage or the common cold.
Initially, the baby has pain in the throat, a mild cough and a runny nose, and body temperature can gradually increase. Obstructive form of bronchitis can occur without increasing the temperature of the body.
After that, the cough becomes paroxysmal, very debilitating and dry, with the result that viscous mucus is secreted. Кашель также может быть влажным, но при этом мокрота не отделяется.Even without a phonendoscope, breathing difficulties can be noted, because of which the bronchi become swollen and their function is impaired.
At the initial stages of the disease, the treating pediatrician can easily diagnose, so you can stop the development of this disease with a timely visit to a specialist.
As a result of the neglected disease, the child has difficulty breathing, coughing occurs without sputum separation and can be quite painful.
When diagnosing all of the above symptoms should consult a pediatrician.
Symptoms of the disease in children
As a rule, the first time a child gets obstructive bronchitis at the age of 2-3 years. The first symptoms of obstructive bronchitis in children are very similar to the manifestations of acute respiratory viral infections: babies suffer from general malaise, sore throat, rhinitis, fever. Younger children often have diarrhea, nausea, vomiting.
As the disease progresses, manifestations of bronchial obstruction increase. At first it is difficult for the child to exhale air, then after a few days there are difficulties with inhalation. The expiratory duration and breathing rate gradually increase, whistling and noise appear, which can be heard even from a distance.
Often, the child appears against the general pallor of the skin blueness around the mouth, the wings of the nose swell.
Another frequent symptom of obstructive bronchitis in children is an unproductive dry cough with very viscous, scanty, difficult to separate sputum. Especially cough annoys kids at night.
In older children, symptoms of obstructive bronchitis are often associated with manifestations of sore throat or cervical lymphadenitis. In some cases, the disease takes a protracted nature with the addition of secondary bacterial infections.
In children of the first 6 months of life, especially premature and weakened ones, acute bronchiolitis sometimes develops - a very severe form of bronchial obstruction. This disease is characterized by the development of respiratory failure, which can cause serious health problems and even death.
A protracted course of obstructive bronchitis in children can occur if they have other pathologies, for example, anemia, asthenia (psychophysiological depletion), chronic ENT diseases, rickets (calcium deficiency in a child).
Diagnosis and treatment of obstructive bronchitis in children
Diagnosis and treatment of this disease is carried out by a pediatrician or pediatric pulmonologist. In some cases, the child is sent for consultation to a children's otolaryngologist, a children's allergist-immunologist.
The doctor examines the child, prescribes a general and biochemical blood tests, an x-ray of the chest organs. If necessary, the child is staged with allergy tests, sputum, nasopharyngeal swabs.
Treatment of obstructive bronchitis in children 2-3 years old is carried out in a children's hospital.
The goal of therapy for this disease is to eliminate the causes that caused it, relieve bronchial obstruction, improve the functioning of the respiratory organs, and symptomatic treatment depending on the manifestations. First of all, measures are taken to clear the bronchial mucus from the mucus, and bronchodilator and anti-inflammatory measures are prescribed.
In severe cases of the disease, oxygen therapy with a mask is used, artificial respiration is carried out in the intensive care unit.
In the treatment of obstructive bronchitis in children, the use of inhalers-nebulizers with special therapeutic solutions is effective. With their help, you can successfully dilute sputum in the bronchi, reduce swelling, improve respiratory function.
In addition, this procedure is painless, easy and, as a rule, the children like it. With the help of inhalation bronchodilator drugs, mucolytic agents are delivered to the bronchi.
Such a procedure can quickly arrest the attack of acute obstructive bronchitis.
If a child suffers from a painful dry cough, he is prescribed mucolytic drugs, such as Ambrobene, Ambroxol, Lasolvan.
As a treatment for the expansion of the bronchi in children, as a rule, use short-acting theophyllines (Eufillin), β-2-agonists (Berodual, Salbutamol), anticholinergics.
Anti-inflammatory treatment of obstructive bronchitis in children includes the use of drugs based on fenspiride (Erispal). In severe cases, the doctor may prescribe glucocorticoids in the form of inhalers or injections.
If a disease develops due to an allergic reaction of the body, the doctor prescribes antihistamine therapy to the child. Nowadays, as a rule, second-generation drugs are used, which have significantly fewer side effects. For babies after 6 months, Zyrtec is usually prescribed, after two years - Erius or Claritin, for children over 3-5 years old - Telfast.
As a rule, antibacterial drugs are not used in the treatment of bronchial obstruction. Their use is justified in the case of the accession of a secondary bacterial infection.
Great importance in the treatment of obstructive bronchitis in children is given a special hypoallergenic sparing diet. In addition, it is necessary to create favorable living conditions for the child: to regularly humidify the air and ventilate the room.
Symptoms and treatment of obstructive bronchitis in children
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Bronchitis is a well-known disease of the respiratory tract, which often affects children of preschool age.
Bronchitis involves inflammation in the bronchi, inherent in the presence of infections, bacteria, allergic or physico-chemical provocateurs.
Obstructive bronchitis in children is a disease characterized by obstruction and progression of respiratory failure. Obstructive bronchitis is of two types: acute and recurrent. Both types have different effects and complications.
The recurrent type of the disease is associated with repeated ingestion of the provocateur and is more characteristic of young children. One of the root causes of obstruction in this type of obstructive bronchitis is food ingress into the respiratory tract.
Pharmaceutical drugs for the treatment of obstructive bronchitis in children
For obstructive bronchitis symptoms, hospitalization is recommended for a child under two years of age. Treatment must take place in the hospital under the clear guidance of a specialist.
If a child does not have intoxication symptoms and clear signs of respiratory failure, then by decision of the parents and a specialist, hospitalization may not be carried out.
However, with the symptoms of pneumonia, you definitely need to go to the hospital, because in babies, pneumonia is very often similar to obstructive bronchitis.
For the successful treatment of a child with obstructive bronchitis and the eradication of all its symptoms, the following drugs are prescribed:
Bronchodilator drugs are prescribed to eliminate the symptom of bronchial obstruction. Modern pharmacology produces them in the form of syrups (Salmeterol, Ascoril), solutions for inhalation (Berodual), aerosols for inhalation (Salbutamol, Berodual) and tablets (Teopek, Eufillin).
IMPORTANT! Bronchodilators in the form of tablets do not recommend treating babies with a diagnosis of obstructive bronchitis, because they have a number of side effects and are more toxic.
Such tools are used to reduce the likelihood of bronchospasm. You can take them inhalation, in pill form or intravenously. This is the well-known No-spa, Drotaverine and Papaverine.
For the rapid elimination of sputum from the bronchi, various mucolytic drugs are prescribed:
- Ambroxol based medications. They should not be used for more than 10 days. The most effective way to use them is inhalation.
- In the transition from cough to wet, expectorant drugs are used for children (Bronhikum, BronhoSan, Gedelix, etc.). They need to take no more than 10 days.
- Doctors often prescribe Erespal, which relieves obstruction, reduces the amount of secretion, and at the same time is an anti-inflammatory medication. However, it is contraindicated in children up to 2 years.
- Codeine drugs are prescribed by experts with caution. Sinekod, Libexin and Bronholitin are most commonly used.
Survey: What antitussive medication is often prescribed by your pediatrician?
Lasolvan 11%, 1 vote
1 vote - 11% of all
Erespal 11%, 1 vote
1 vote - 11% of all
Sinekod 11%, 1 vote
1 vote - 11% of all
Antihistamine medications are prescribed for a child with allergic symptoms. Erius in the form of syrup can be taken from the first year of life, and Claritin and Zyrtek from 6 months. From 2 years it is better to resort to the use of Tsetrin, Zodak or Parlazina.
Most doctors tend to use such antiviral drugs as Genferon or Viferon in the form of suppositories, Grippferon or Interferon in the form of drops, Orvirem in the form of syrup, and after three years Kagocel and Arbidol in the form of tablets.
IMPORTANT! When autoimmune diseases in the family history can not take immunostimulants (Kagocel or Amiksin). Their reception can lead to the early manifestation of an autoimmune disease.
Antibiotics treat bronchial obstruction only in extreme cases, when the child has a temperature above average for more than 4 days, intoxication is pronounced or, if properly treated, the child does not want to eat and becomes apathetic. Only a doctor should prescribe such drugs, based on the clinical picture, characteristics of sputum, laboratory tests and if bacterial bronchitis is suspected.
In addition, when treating obstructive bronchitis in children, a draining massage, physiotherapy and a special diet are always relevant. In some cases, use hormone therapy.
Folk medicines and treatment of obstructive bronchitis in children
Medicine does not exclude folk medicinal methods of treatment of bronchitis in children. However, parents must clearly distinguish the dangerous signs of obstructive bronchitis from the standard course of the disease. Among the well-known and approved medicinal methods for eliminating the symptoms of the disease are the use of propolis, compresses with honey and inhalations with medicinal herbs.
Recipe with propolis. Freeze, and then rub the propolis. Melt 100 g of butter, add grated propolis and stir until smooth. The resulting substance, let the child before the meal in the amount of 10 g. It is recommended to drink this medicinal substance with warm milk.
For a compress with honey, take in the same proportions flour, honey and mustard. Mix the ingredients thoroughly, form a lozenge, attach it to the upper chest area and fix with a warm bandage.
For inhalation procedures with medicinal plants for obstructive bronchitis use herbs such as thyme, oregano, sage and chamomile.
In the decoction of herbs, you can add a little propolis or honey.
Treatment of children by folk methods should be agreed by parents with a doctor. The specialist in this case should exclude the occurrence of allergies to any components used.
Therapy of obstructive bronchitis should definitely be comprehensive. In addition to traditional methods and pharmaceutical drugs, doctors prescribe breathing exercises, which will help accelerate the excretion of sputum and relieve shortness of breath. Parents can themselves help the child with the exercises, but the first procedure should be carried out together with a specialist.
What is dangerous obstructive bronchitis in children?
Obstructive bronchitis in children is more severe than in adults. This is due to the structure of the bronchial tree.
Children suffer pneumonia very hard with high fever and frequent complications in the form of:
- septic conditions
In children, the immune system is still imperfect, because the infectious agent often penetrates the bloodstream and spreads throughout the body.
In addition, obstructive bronchitis in children is dangerous because adequate ventilation of the lungs is disturbed. It is difficult for a child to breathe, less air enters the lungs, and a larger volume remains inside the alveoli.
Nerve cells begin to experience oxygen starvation. The child becomes too agitated, then, on the contrary, sluggish and apathetic. With prolonged obstructive bronchitis or frequent relapses, the child may begin to lag behind in psychomotor development. This is especially dangerous in the first years of life, when babies are actively developing and growing.
General information about bronchitis
For pediatricians, patients with bronchitis are part of everyday work. Infections of the respiratory system are most common in children. Almost all babies and younger students get bronchitis more than once a year. Usually, when a kindergarten starts, there is a sharp accumulation of pathogens, and many parents have a feeling that their child is constantly sick.
Obstructive bronchitis in children is much more common in winter than in summer, as everyone knows from personal experience. Cold outside air and dry heated indoor air increases the vulnerability of the bronchial mucosa to pathogens.
Whether the clinical course of bronchitis is uncomplicated or due to bronchial obstruction is partly due to the genetic predisposition of the child. Depending on the family history of bronchial asthma and allergies, the risk can be increased many times.
The bronchi transmit air from the trachea (respiratory tube) to the lungs. When these pathways become inflamed, mucus production increases. This condition is called bronchitis.
Bronchitis is associated with bronchial obstruction. The risk of obstruction depends on the lumen of the inflamed bronchus: the smaller the lumen, the more likely clinically significant bronchial obstruction. This condition is called obstructive bronchitis.
Broncho-obstructive signs can be caused by the following pathophysiological changes.
- The smooth muscles of the bronchus contract, which leads to acute shortness of breath.
- The mucous membrane of the respiratory epithelium swells due to inflammation, which narrows the bronchial lumen.
- Increased mucus production also clogs the lumen.
In addition, due to inflammation in the respiratory epithelium, the function of cilia decreases, and mucus cannot be transported adequately. Auscultation of the lung shows wheezing.
In 90% of cases, acute obstructive bronchitis in children occurs due to viruses, and the remaining 10% is caused by bacterial infections. A child may have chronic bronchitis with obstruction if he has bouts of acute bronchitis that remain undiagnosed and untreated. Other causes of chronic bronchitis with obstruction include a child living in a region with persistent industrial pollution and passive inhalation of cigarette smoke.
Viral infections that are responsible for the development of obstructive bronchitis include:
- Coxsackie virus,
- respiratory syncytial virus,
- herpes simplex virus,
- human bocavirus.
A child may develop a secondary bacterial infection, leading to bronchitis with obstruction. However, it is rare in children who do not have immunodeficiency or cystic fibrosis.
In a child, a bacterial infection develops due to the following bacteria:
- hemophilus bacillus,
- moraccella cataraly,
Other causes of bronchitis with obstruction in children:
- fungal infection
- chronic aspiration
- gastroesophageal reflux,
Is obstructive bronchitis contagious?
Most children with obstructive bronchitis are contagious if the cause is an infectious agent, such as a virus or a bacterium. The contagious period for bacteria and viruses usually lasts as long as the patient has symptoms, although some viruses will be contagious a few days before the onset of symptoms. Contagious viruses that cause bronchitis with obstruction are listed in the causes section.
Contagiousness disappears when symptoms subside. But bronchitis caused by exposure to pollutants, cigarette smoke or other environmental substances is not contagious.
Shortness of breath and wheezing
Shortness of breath gradually increases with the severity of the disease. As a rule, children with obstructive bronchitis with activity can not breathe normally and begin to cough. Dyspnea at rest usually indicates that COPD (chronic obstructive pulmonary disease) or emphysema has developed. A loud whistling sound is heard as you exhale, but in severe cases it can be heard when inhaling. This is caused by inflammation of the bronchi and narrowing of the respiratory tract.
- Sensation of rattling in the chest.
- Moderate fever.
- Runny nose
- Bad sleep due to cough.
- Constriction and pain in the chest.
- Чувство щекотания в задней части горла, что приводит к болезненности при глотании.
- Общее чувство недомогания.
Obstructive bronchitis in children up to one year is manifested by blue tips of the ears and nose, nails and lips.
The above symptoms are especially dangerous for children under one year, since the body is not yet strong, the immunity is not formed. This causes rapid progression of bronchitis with obstruction.
What and how to treat obstructive bronchitis in children
In general, bronchitis can be treated symptomatically, because in most cases it is caused by a viral infection, from which there is no specific treatment.
To achieve this, the doctor will prescribe a combination of drugs that open up the bronchial airways and soften the mucus to make it easier to cough up. Recommended bed rest.
The most effective way to control cough and sputum production in patients with chronic obstructive bronchitis is to prevent environmental irritants, especially cigarette smoke.
Treatment of obstructive bronchitis in children includes taking a number of drugs.
Bronchitis with obstruction makes it difficult for the child to breathe due to the narrowing of the respiratory tract. Therefore, the doctor will prescribe bronchodilators.
They expand the inflamed airways and reduce swelling. This allows the child to breathe more freely, without wheezing, pain or discomfort.
Albuterol and Metaproterenol relaxes the smooth muscles of the bronchi, having little effect on the contractility of the heart.
Theophylline and Ipratropium is used to control symptoms such as chronic cough, shortness of breath, bronchospasm in stable patients with chronic obstructive bronchitis.
Corticosteroids are the most powerful anti-inflammatory drugs. Inhalation forms are active locally, almost do not penetrate into the systemic circulation. In children who are stable in chronic bronchitis with obstruction, treatment with a long-acting bronchodilator in combination with an inhaled form of corticosteroid can help alleviate chronic cough.
Beclomethasone causes a direct relaxation of smooth muscles and can reduce the activity and the number of inflammatory cells, which reduces the hyper-reactivity of the respiratory tract.
Fluticasone has extremely strong vasoconstrictor and anti-inflammatory activity.
Budesonide reduces inflammation in the respiratory tract by inhibiting multiple types of inflammatory cells and reducing the production of mediators that are involved in an asthmatic reaction.
Mucolytic drugs cause dilution of bronchial mucus (sputum) to facilitate its coughing. Acetylcysteine, Bromhexin and Ambroxol are most known among mucolytics.
- Acetylcysteine has anti-inflammatory effect.
- Bromhexine activates enzymes that break down mucus molecules and stimulate glandular cells to increase mucus production, reducing its viscosity.
- Ambroxol is the result of the breakdown of bromhexine. In addition to its effects, it stimulates the production of surfactant (a substance lining the inside of the alveoli of the lungs). It helps the lungs to absorb and absorb oxygen.
Some herbal substances, such as ivy, also belong to mucolytic agents. As a rule, the therapeutic value of all these so-called cough syrups should not be overestimated. It is much more important for children to drink and inhale enough.
Antibiotics for obstructive bronchitis in children are prescribed in the case of a bacterial infection. The choice of an appropriate antibiotic depends on the age of the child, because there is a predominant pathogenic group in different age groups.
After antibiotic tracing, antibiotic therapy can be determined according to the sensitivity and resistance of bacteria. Bacterial spectra also differ between non-hospital and nosocomial infections. Sometimes it is impossible to distinguish between viral and bacterial infections, since the clinical picture and blood parameters can be very similar. In this situation, the child will be treated with an antibiotic, although this is just a viral infection with a high fever.
Amoxicillin and Clavulanate (Augmentin)
This is a semisynthetic antibiotic with a wide spectrum of bactericidal activity, covering both gram-negative and gram-positive microorganisms. It works by stopping the growth of bacteria.
This is a good alternative antibiotic for children with allergies or intolerance to the category of macrolides. It is usually well tolerated and provides good coverage of most infectious pathogens, but it is ineffective against Mycoplasma and Legionella species. The half-life of an oral dose is 1-1.3 hours. It penetrates well into tissues, but does not pass the blood-brain barrier, which makes it useless in the fight against neuroinfection.
Tetracycline acts on gram-positive and gram-negative organisms, as well as on mycoplasma, chlamydial infections.
In certain cases, tetracycline is used if penicillin or another antibiotic cannot be used in the treatment of severe infections such as clostridia, listeria, and others.
It is less effective than Erythromycin.
Tetracycline works best if taken on an empty stomach one hour before or 2 hours after a meal. Take each dose with a full glass of water (240 milliliters). Do not lie down 10 minutes after taking this medication. For this reason, do not take the dose right before bedtime.
Children under 8 years of age should not take tetracycline. Tetracycline may cause persistent tooth discoloration and may also affect the growth of the child.
This drug belongs to the class of drugs known as cephalosporins antibiotics.
It is prescribed for exacerbation of chronic bronchitis, which is caused by sensitive strains of S pyogenes.
Cefditoren works best if taken with food.
This drug is not recommended for longer use (several months) due to the increased risk of side effects.
Used to treat a specific type of pneumonia (Pneumonia pneumonia) in immunocompromised patients. This drug is a combination of 2 antibiotics: sulfamethoxazole and trimethoprim. Like tetracycline, it has activity against whooping cough, but does not affect mycoplasma infections.
Do not give this medication to a child under 2 months old.
It is a broad-spectrum synthetic bacteriostatic antibiotic in the tetracycline class.
Doxycycline should be used in children under 8 years of age only in cases of severe or life-threatening conditions. This medicine may cause persistent yellowing or discoloration of teeth in children.
Antibiotics work best if the amount of the drug in the body is kept constant. Therefore, taking antibacterial drugs should be at the same time every day.
Analgesics / Antipyretic
Analgesics and antipyretics are often useful for alleviating the apathy, malaise and fever associated with the disease.
- Ibuprofen Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAIDs). It reduces the production of substances that cause inflammation and pain in the body. Ibuprofen is used to lower the temperature and treat inflammation or pain.
- Paracetamol. Paracetamol is an analgesic and antipyretic agent. Children under 12 should not take more than 5 doses in 24 hours. Use in the dosage only the recommended amount of milligrams for the age and weight of the child.
Saline nasal drops are used to moisturize and clean the nasal mucosa. Vasoconstrictor nasal drops should be given if the Eustachian tube swells in response to an infection of the upper respiratory tract to ensure ventilation of the middle ear. These drops should not be given for more than 7 days, otherwise they can lead to irreversible damage to the mucous membrane.
In case of severe bronchial obstruction with spasms of the bronchial muscles, edema of the bronchial mucosa and the formation of viscous secretions, ventilation in the respiratory tract and diffusion in the alveoli may be disrupted. This causes partial or systemic oxygen deficiency. If the pulse oximetry test detects that blood oxygen saturation is too low, additional oxygen is needed.
This therapy is carried out to provide the body with additional oxygen, so that the tissues and cells through the blood received enough of it.
Normally, oxygen is supplied through the nasal cannula. If young children do not tolerate nasal cannulas, a mask can be used, especially during sleep.
Treatment of chronic bronchitis helps to minimize all symptoms, but you must realize that the symptoms will never disappear. They will continue to return, and your child will need regular and long-term treatment.
Chronic Obstructive Pulmonary Disease
Chronic obstructive bronchitis in children can turn into chronic obstructive pulmonary disease (COPD). This disease reduces the ability of the lungs to function optimally and causes difficulty in breathing. It also makes the child more susceptible to other lung infections.
COPD is a progressive disease, and the symptoms worsen over time. Because the lungs suffer irreversible damage, treatment and lifestyle changes are the only way to slow the progression of the disease and allow the child to lead an active life.
Children's obstructive bronchitis can range from mild to severe with symptoms of respiratory failure. Do not ignore the cough that a child has, take him to a doctor. The last thing you want is a worsening of the infection and leading to complications such as pneumonia and COPD. With early diagnosis and proper treatment, bronchitis should not cause concern.