Obstructive bronchitis in a child can. Obstructive bronchitis in children: symptoms and treatment

Bronchitis in children most often occurs as a complication against the background of SARS, flu or severe colds, hypothermia. Provoking factors for the development of bronchitis are seasonal temperature fluctuations, especially periods of rain with high humidity, so this disease usually occurs in autumn or spring.

According to the form, all bronchitis in children are divided into: Acute, Protracted and Recurrent.

For reasons of occurrence, it depends on the causative agent of inflammation and is divided into:

• Viral - influenza, adenoviruses, parainfluenza
• Bacterial - can be acute and obstructive (the causative agent is streptococcus, staphylococcus, moraxella, Haemophilus influenzae, as well as mycoplasma and chlamydia)
• Allergic, obstructive, asthmatic - arises from irritating chemical or physical factors, such as household chemicals, house dust (read about), animal hair, plant pollen, etc.

Bronchitis in a child under one year old - symptoms and treatment

For babies who are on breastfeeding and not having contact with sick children and adults, there should be no diseases respiratory tract. However, if the child was born prematurely, has congenital malformations respiratory organs and other diseases, as well as in the family there are children of preschool age who attend kindergartens and are often ill - the development of bronchitis in a child under one year old is possible for the following reasons:

• narrower than in an adult, bronchi, more dry and vulnerable mucous membranes of the respiratory tract
• existing congenital malformations
• after a viral or bacterial infection
• the presence of individual sensitivity to chemical and physical irritants - an allergy to something.

The most basic symptom of developing bronchitis is a strong dry cough, paroxysmal, accompanied by shortness of breath, shortness of breath. Gradually, the cough becomes wet, but mucus, sputum with bronchitis in a child up to a year makes it difficult to breathe, the normal functioning of the lungs is disturbed, since the airways in infancy are narrow. Bronchitis in children up to a year and even up to 3-4 years is most often of the following types:

• Acute bronchitis simple
• Obstructive bronchitis
• bronchiolitis

On acute and obstructive bronchitis, we will dwell in more detail below. And now consider the most common in children under one year old. bronchiolitis.

Bronchitis in children under one year old - bronchiolitis

This bronchitis affects both small bronchi and bronchioles, develops more often against the background of SARS, influenza viruses, followed by the reproduction of pneumococci (and other 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 a pronounced broncho-obstructive syndrome with the development of sometimes even acute respiratory failure:

• Characterized by dry cough attacks, pronounced shortness of breath of mixed or expiratory form with syndromes of swelling of the wings of the nose, with the participation of auxiliary muscles, retraction of the intercostal spaces of the chest, pallor skin, cyanosis.
• The child is observed, there are no tears when crying.
• The child eats and drinks less than usual, respectively, and his urination is more rare.
• An increase in body temperature, but unlike pneumonia, it is less pronounced (see).
• Shortness of breath up to 60-80 breaths per minute, while breathing is grunting, superficial.
• Diffuse, moist, voiced, finely bubbling and crepitant rales are heard on both sides.
• Symptoms of intoxication in bronchiolitis in children are not expressed.
• On the X-ray, a sharp transparency of the lung tissue, a variegated pattern, a horizontal standing of the ribs, and the absence of infiltrative changes in the lungs are determined.
• If at first there was a simple bronchitis, then the accession of bronchiolitis after a while is manifested by a sharp deterioration in the general condition of the child, the cough becomes more painful and intense, with scanty sputum.
• Children are usually very restless, capricious, excited.
• The blood test may be slightly changed, a slight leukocytosis and an increase in ESR are possible.
• Usually bronchiolitis in children up to a year has a long course of up to 1-1.5 months.
• The causes of acute bronchiolitis in children are similar to the causes of obstructive bronchitis in children older than a year -2-4 years. 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

There is no cure for bronchiolitis at home. If bronchiolitis occurs in an infant, hospitalization is usually indicated so that the child is under the supervision of doctors. In the hospital, pediatricians, pulmonologists will establish an accurate diagnosis and prescribe appropriate treatment. What should mom do before the ambulance arrives?

You can only alleviate the symptoms of a cold - create optimally comfortable air in the room, turn on a humidifier, air purifier.

If not high temperature in a child, you can ease breathing with the help of warming creams and ointments, spread them on legs, calves. Only with this you need to be careful if the child did not have any before. allergic manifestations, then it helps well if the child is allergic, warming ointments should be excluded.

To make the cough softer, you can do steam inhalations - over a boiling pot with a weak saline solution hold the baby in your arms. Or seat him at the table and cover with a towel over a cup of hot healing solution.

Try to get the baby to drink more to avoid dehydration, if the baby refuses breast or formula, just give the baby clean water.

In the hospital, in order to relieve signs of respiratory failure, the baby is given inhalations with bronchodilators and allowed to breathe oxygen. Also, at the discretion of the doctor, an antibiotic is selected - Sumamed, Macropen, 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 reaction for treatment. If observed, then carry out the necessary rehydration therapy.

Acute bronchitis in children - symptoms

Bronchitis is the most common type of respiratory disease in children. Acute bronchitis is considered acute inflammation bronchial mucosa without symptoms of inflammation of the lung tissue. Simple bronchitis in children in 20% is an independent bacterial disease, 80% is either in the program of viruses (Coxsackie virus, adenovirus, influenza, parainfluenza) or as a bacterial complication after these viral infections.

Clinical symptoms of bronchitis in children are as follows:

First, the child develops general weakness, malaise, headache, lack of appetite, then a dry cough or cough with sputum appears, the intensity of which is rapidly increasing, when listening, dry diffuse or various wet rales are determined. Sometimes it can be a little different.

In the first 2 days, the temperature rises to 38 C, but with mild form, temperatures can be 37-37.2.

After 6-7 days, a dry cough turns into a wet one, sputum discharge relieves the child's condition and is a good sign that the body is coping with the infection and the virus.

On average, the duration of acute bronchitis in children is 7-21 days, but the nature of the disease, the severity inflammatory process depend on the age of the child, his strength immune system, the presence of concomitant chronic and systemic diseases. With inadequate or untimely treatment, acute bronchitis can lead to complications - bronchiolitis, pneumonia.

Sometimes after the flu, for some time, the child's condition improves, and then a sharp deterioration, a rise in temperature, an increase in cough - this is due to a weakened immune system in the fight against the virus and the addition of a bacterial infection, in which case an antibiotic is indicated.

With mycoplasma or adenovirus acute bronchitis in children, symptoms of intoxication such as high fever, headaches, chills, lack of appetite may last for 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, the treatment of which is correct and carried out on time, should not be more than 14 days, however, in infants, cough can persist for up to a month, as well as in older children with atypical mycoplasmal bronchitis. If suddenly bronchitis in a child is delayed, a number of diseases should be excluded:

• food aspiration
• pneumonia
• cystic fibrosis
• foreign body in the bronchi
• tuberculosis infection

The pediatrician prescribes a full range of treatment. In addition to following all the recommendations of the doctor, you should provide the child with special nutrition and quality care. It is desirable to create optimal humidity and cleanliness in the room, for this it is convenient to use a humidifier and air purifier, often ventilate the room and carry out daily wet cleaning in the room in which the child is located. As well as:

• Plentiful drink

Provide plenty of warm fluids. To soften a cough, warm milk with butter or mineral water borjomi, can be replaced with honey.

• Heat

With fever, temperature only above 38C should be taken.

• Antibiotics

• Cough medicines

With a dry cough, a child, as prescribed by a doctor, can be given antitussive medicines, and when he becomes wet, he can switch to funds that can be combined (). If the cough is wet, then Bromhexine, Gedelix, Altai syrup, Thermopsis herb infusion or its dry extract, Bronchicum, Eucabal, Prospan, are shown.

• Inhalations

Almost always, obstructive bronchitis is associated with a virus or mycoplasmal infection, relapses of obstructive bronchitis in children most often spontaneously stop by the age of 4 years.
If bronchioles and small bronchi are affected, then this is already acute bronchiolitis.

Oobstructive bronchitis in children differs from asthma attacks in that the obstruction develops slowly, and in asthma the child suddenly begins to choke. Although the first attacks bronchial asthma children also begin during SARS. If the obstruction occurs several times a year, this is a signal that the child is at risk for developing bronchial asthma in the future.

Obstructive bronchitis in a child may be due to passive smoking, it can be distinguished by a strong cough with a whistle in the morning, while the child's condition is quite satisfactory. Obstruction in allergies occurs upon contact with an allergen, and recently it has become a very common manifestation in children prone to allergies, such bronchitis are recurrent in nature and are threatened by the development of bronchial asthma.

Allergic and obstructive bronchitis in children - treatment

Hospitalization

With obstructive bronchitis in children under one 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 a hospital if:

• In addition to obstruction, the child has symptoms of intoxication - decreased 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 count at night, and not 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 the cyanosis of the nasolabial triangle, nails, that is, the body is deficient in oxygen.
• It is not uncommon for obstructive bronchitis in children to disguise pneumonia, so if the doctor suspects pneumonia, hospitalization should not be refused.

Bronchodilators

Bronchiolytics dilate the bronchi, so they are designed to relieve obstruction. Today, they are presented in the pharmaceutical industry market in various forms:

• In the form of syrups (Salmeterol, Clenbuterol, Ascoril), which are convenient to use for young children, their disadvantage is the development and heartbeat.
• In the form of solutions for inhalation (see) - this is the most convenient way for young children, diluting the medicinal solution with saline, inhalation is carried out 2-3 times a day, after improvement it can only be used at night. The multiplicity and dosage, as well as the course of treatment, is determined only by the pediatrician.
• Aerosol inhalers can only be used for older children (Berodual, Salbutamol).
• Such tablet forms of bronchodilators as theophylline (Teopek, Eufillin) are not indicated for the treatment of children with obstructive bronchitis, they have more pronounced side effects, are more toxic than local inhaled forms.

Antispasmodics

Can be used to reduce bronchospasm. This or . They can be taken with an inhaler, orally as tablets, or intravenously in a hospital.

Cough remedies

In order to better sputum, various mucoregulatory drugs are used, they help to thin the sputum and accelerate its excretion:

• These are preparations with the active substance Ambroxol (Lazolvan, Ambrobene). These funds should not be taken for more than 10 days, it is most convenient to use them in the form of inhalations, as well as carbocysteine ​​preparations (Flyuditek, Bronhobos, Mukosol).
• After the cough has become wet, the attacks have become less intense, the sputum thins, but does not come out well, Ambroxol should be changed to, which should be given no more than 5-10 days, these include Gedelix, Bronchikum, Prospan, Bronchosan, Gerbion (see. ), Tussin, Bronchipret,.
• Codeine-containing drugs are not recommended for children to take if the child has a paroxysmal obsessive cough, as prescribed by a doctor, you can use Sinekod, Stoptusin Fito, Libeksin (with caution in childhood), Bronchicum, Broncholitin.
• Erespal - helps to relieve obstruction and reduce sputum production, and it also has anti-inflammatory activity, is used from the first days of the disease, reduces the risk of complications, is contraindicated in children under 2 years of age.

Draining massage

To facilitate the discharge of sputum, parents themselves can give their child a massage of the collar zone, chest, and back. Especially strong massage should be done for the back muscles along the spine. Postural massage is useful for obstructive bronchitis in children - that is, tapping 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 with palms folded in a boat for 10-15 minutes. For older children, when massaging, ask the child to take a deep breath, and tap on the exhale. Useful and additional exercises such as inflating balloons, blowing out candles or).

Antihistamines

Antihistamines are prescribed for children with a predisposition to allergic reactions. Allergy medicines such as Erius in syrup can be taken by children from 1 year old, from six months it is possible to use Claritin and Zirtek, from 2 years old in syrups and drops of Tsetrin, Zodak, Parlazin (see). Such 1st generation antihistamines as Suprastin and Tavegil are used less frequently today, only for drying with abundant liquid sputum.

Allergy or virus

If the obstruction is caused by an allergy or a virus, antibiotics cannot be used, and even dangerous (see). The appointment of antibiotics is possible only with a proven infectious origin of bronchitis in children.

When antibiotics are indicated

Treatment of bronchial obstruction with antibiotics is not indicated, only if the child has a high temperature for more than 4 days, or there was a second jump in temperature up to 39C 4-5 days after the onset of the disease, accompanied by severe intoxication, severe cough, if, with adequate treatment, the child suddenly 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 clinical picture, the presence of purulent sputum (indicative of bacterial bronchitis), inflammatory changes in the blood test, as well as other signs of bacterial bronchitis or pneumonia (wheezing, x-ray signs).

Antivirals

hormone therapy

Hormonal drugs such as Pulmicort are indicated only for severe or moderate obstructive bronchitis (usually with the help of a nebulizer), they quickly stop obstruction and inflammation, they are prescribed only by a doctor.

What Not to Do

With obstructive bronchitis in children - treatment by rubbing and spreading the child's body with various warming ointments (Doctor Mom ointment, ointments with medicinal plants, essential oils), the use of mustard plasters is unacceptable, because they cause an even greater allergic reaction and bronchospasm, especially in babies under 3 years old. It is also categorically impossible to carry out inhalations for bronchitis with various medicinal herbs and essential oils. It is only possible to use such folk remedies for warming up - thermal compresses with potatoes, salt, buckwheat.

Physiotherapy

Physiotherapeutic procedures in the acute period are contraindicated when the obstruction is already stopped, it is possible to carry out UHF, electrophoresis or laser.

Hypoallergenic diet and plenty of fluids

Any natural drinks - mineral water with milk, tea, the child should drink as often as possible. The diet should be hypoallergenic, but at the same time as vitaminized as possible, complete in terms of protein and fat content. Eliminate from the child's diet anything that can cause an allergic reaction:

• citrus, red and orange fruits
• purchased spices, sweets, milk curds, yogurts, carbonated drinks, 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, you should ventilate and humidify the room where the child is located daily. It should not be hot in the apartment, it is better to have cool, fresh, clean air. After recovery, the child should be registered with an allergist.

Obstructive bronchitis in a child is an instant panic for his relatives: few parents are able to maintain rational thinking and the logic of their actions, seeing how their baby literally suffocates. Therefore, alas, children with symptoms of obstructive bronchitis in most cases end up in hospitals for treatment. Meanwhile, there are real opportunities to help them without leaving home!

Obstructive bronchitis is characterized not only by a strong cough, but also by choked breathing with characteristic wheezing or whistling.

Obstructive bronchitis in children - life with obstacles

Unlike, which, as you know, is caused mainly by the activity of viruses on the bronchial mucosa, obstructive bronchitis in children is not directly related to either viruses or bacteria, it can occur without their intervention.

Moreover, obstructive bronchitis is not even a disease as such. This is a symptom. More precisely, this is a condition of the bronchi, in which there is an obstacle to the passage of air into the lungs and back. "Among the people" this state of affairs is usually referred to as "neither breathe nor exhale" ...

As obstacles for obstructive bronchitis in children are usually:

• Accumulation of sputum in the bronchi (most often against the background of SARS, but also often as an allergic reaction);
• Swelling of the bronchial wall (for example, during an allergic reaction);
• Strong spasm of the muscle tissue of the bronchi (for example, with bronchial asthma);
• An obstacle that presses on the bronchi from the outside (for example, some kind of tumor has appeared next to the bronchi, which simply squeezes the airways).
• Burning of the mucous membrane of the respiratory tract (for example, in a fire or as a result of inhaling too hot steam).

In more than 90% of cases, obstructive bronchitis in children occurs against the background of the current, although it is not directly related to the activity of viruses. But since ARVI itself is extremely conducive to an increase in mucus in the respiratory tract, it is often precisely this that becomes the very obstacle to full breathing, which gives the doctor the right to pronounce this phrase in the direction of your baby - “obstructive bronchitis”.

As a rule, obstructive syndrome against the background of ARVI happens to the baby once. But not always - there are also cases when, after each, even a minor, cold, the child has difficulty breathing. In this case, obstructive bronchitis is an indicator hypersensitivity child's respiratory system. In the lexicon of otolaryngologists, this phenomenon is referred to as “bronchial hyperreactivity” and is considered one of the manifestations of the so-called infectious-allergic bronchial asthma with exacerbations during viral infections.

Naturally, the main danger of obstructive bronchitis for children is shortness of breath and a clear lack of oxygen for the body. If you notice that the baby wheezes strongly with every breath, breathes short and fast, unsuccessfully tries to cough and is clearly suffocating - call your doctor immediately. It is almost impossible to help such a child at home, he needs emergency therapy in a hospital.

The most serious and most frequent complication after obstructive bronchitis in children (as well as in normal bronchitis) is pneumonia.

However, at less severe symptoms obstructive bronchitis (wheezing or wheezing when breathing, coughing, feeling of slight tightness in the chest, loss of appetite) it is possible to alleviate the child's condition at home.

Treatment of obstructive bronchitis in children

General rules

Since obstructive bronchitis is not an independent disease, but only a symptom against the background of another disease (for example, SARS, allergies, and others), treatment should first of all start from therapy for the underlying disease. In other words, if the obstruction occurs during a viral infection, then it is necessary to intensively treat this infection. If the child suffocates due to the manifestation of an allergy, it is urgent to carry out antihistamine therapy. Etc.

Drinking mode

However, in addition to treating the underlying disease, there are methods and ways to alleviate the manifestation of obstructive bronchitis itself. Since the vast majority of cases of obstruction in the airways are associated with the accumulation of increased amounts of mucus in them, any measures to reduce and eliminate this mucus are the first task of parents.

Drinking plenty of water is one of the most effective measures of this kind. A well-known medical fact - the density of mucus is directly related to the density of blood. This means that the thinner the child's blood becomes, the thinner the mucus in the airways becomes. And the viscosity of the blood is primarily affected by the amount of fluid in the body. As a result, we have a stable dependence: the more the child drinks liquids (any: water, tea, juices, fruit drinks, etc.), the less chance the mucus has to accumulate and dry out on the walls of the bronchi.

Drink your baby as often as possible - this is an extremely simple, but very effective technique that helps to defeat obstructive bronchitis in a child!

Obstructive bronchitis and antibiotics

In the vast majority of cases, obstructive bronchitis occurs in children on the background of SARS or as an allergic reaction. In both cases, the use of antibiotics is completely useless, since they do not fight viruses and allergens, but exclusively bacteria and microbes.

The only case that allows the use of antimicrobial agents and drugs is obstructive bronchitis, which occurs against the background of pneumonia. However, in this case, antibiotic therapy is prescribed not by parents or pharmacists, but exclusively by doctors!

Do I need medication for obstructive bronchitis in children?

As well as with bronchial congestion, their condition is determined primarily by what kind of air the child breathes. And climate control in the house helps to cope with the disease much easier, faster and more efficiently than any pharmaceutical preparations.

Recall the ideal parameters of a "healthy" climate for any respiratory ailment, including obstructive bronchitis: air temperature - no higher than 21 ° C (if the child is very difficult to breathe - reduce to 18 ° C), humidity - 60-70%. And don't freeze your kids! If you are sure that your baby is cold in such a climate, just dress him warmer. A child with obstructive bronchitis can walk around the house in felt boots and a hat, but he must breathe moist and cool air!

However, with obstructive bronchitis with pronounced insufficient breathing, doctors certainly resort to medication. The most common of these is salbutamol. This drug imposes bronchodilatory properties, and in the case of obstructive syndrome, it is used in children regardless of age. Salbutamol is used in the form of an aerosol, that is, the baby must inhale deeply the particles of the drug so that it reaches the bronchi.

Like most drugs for bronchitis, salbutamol can only be used as directed by a doctor!

However, the use of drugs in the treatment of obstructive bronchitis in children in no way cancels all other, “household” measures, which can no longer be taken care of by doctors, but by parents: plenty of fluids and cool air.

No, even the most effective, bronchodilator will help to cope with obstructive bronchitis if the child continues to breathe warm and dry air and at the same time drinks little liquid.

Obstructive bronchitis and nasal congestion

When treating obstructive bronchitis in children, it is extremely important that the child breathe freely through the nose. If he has a runny nose or stuffy nose - you need to use vasoconstrictor drops.

Percussion (tapping) massage

With obstructive bronchitis in children, dried mucus accumulates in the airways, which actually "sticks" to the walls of the bronchi. Percussion massage helps to “peel off” dried clots of mucus so that it is easier for the baby to cough it up:

• 1 Lay your baby on your lap, face down and slightly tilted (head slightly lower than legs). This slope is necessary in order to use the force of attraction - it will also contribute to the removal of sputum from the bronchi.
• 2 With your fingertips, tap your baby vigorously on the back of the shoulder blades. The movements of your fingers should be slightly "raking" and move strictly in one direction - from the lower back to the head.
• 3 Then abruptly put the child on your lap and ask him to cough.
• 4 These manipulations can be carried out in sessions, that is, 2-3 times in a row.

Attention! In no case should percussion massage be carried out while the child has a high temperature, fever. And also it is not recommended to do it for those children who cannot yet cough “on command”.

What not to do with children with obstructive bronchitis

There is a certain list of procedures that not only do not help in the treatment of obstructive bronchitis in children, but vice versa - they greatly interfere with it. So, the baby with difficulty breathing should not:

• 1 Do inhalation. Imagine what happens to a raisin if you dip it in hot water - that's right, it will steam out and turn into a full-fledged grape, having increased in size. Exactly the same thing happens with sputum clots in the bronchi,. Even with a normal cough, it is extremely difficult for children to cough up excess sputum (due to the immaturity of the respiratory muscles), and with bronchitis it is much more difficult. After inhalation, the child's condition may deteriorate sharply - he will not only wheeze and breathe heavily, but also choke on the sputum that he is not able to cough up.
• 2 Bathe in a bath. In fact, bathing in warm water is the same inhalation: warm steam penetrates the bronchi, increasing the amount of sputum in them.
• 3 Give mucolytics (expectorants). The very action of mucolytics is based on the thinning of mucus in the respiratory tract, due to which its volume increases dramatically. This is unacceptable in the case of a child with obstructive bronchitis, since it is too difficult for the baby to breathe without it.

Popular pediatrician, Dr. E. O. Komarovsky: “In case of obstructive bronchitis, the use of expectorants at home is extremely dangerous! And for children of the first two years of life, it is often deadly!”

• 4 Give immunostimulants. The use of these drugs also affects the production of mucus in the airways in the direction of its increase. And since the baby cannot cough it up, this will only aggravate the already difficult breathing of the child.
• 5 Follow pastel mode. The fact is that in the vertical position, the force of the cough push is much greater than in the supine position. So if general state a child with obstructive bronchitis allows him not to lie down - do not lay him down intentionally.

In addition, if the child's temperature does not exceed 37.5 ° C, then do not keep him "under house arrest" - go for a walk, in the fresh air, even despite his general malaise. Ventilation of the lungs with obstructive bronchitis helps children cope with the accumulation of mucus in the airways faster. In addition, with a clear lack of oxygen (due to obstruction in the airways), fresh air is extremely useful for the baby's body.

On average, with adequate treatment, obstructive bronchitis disappears in a child in 7-10 days. However, if the obstructive syndrome does not disappear, or if it makes itself felt at regular intervals, parents should consult a doctor about bronchial asthma in a baby.

Bronchitis is a respiratory disease that can have dangerous complications. Parents have many questions about the treatment of this disease: in what cases are antibiotics used and whether it is possible to cure a child with the help of inhalations and warming procedures. The condition of the baby can deteriorate dramatically, it all depends on the form of the disease and age. Therefore, home treatment should always be agreed with the doctor. To speed up recovery, it is necessary to maintain optimal humidity and temperature in the room.

Content:

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, children get sick with infectious bronchitis in the cold season, when the body's immune defenses weaken.

The infection enters the child's body from the outside by inhaling contaminated air. It is also possible to activate one's own conditionally pathogenic microflora, which is facilitated by hypothermia of the body, a decrease in immunity.

Depending on the cause of occurrence, the following types of bronchitis are distinguished:

1. Bacterial. Its pathogens are bacteria such as streptococci, staphylococci, pneumococci, Haemophilus influenzae and whooping cough, chlamydia, mycoplasma.
2. Viral. It occurs due to the penetration of influenza viruses into the bronchi, as well as adenoviruses.
3. Allergic. It occurs when the bronchial tubes are irritated. chemicals, dust or pollen of plants, particles of animal hair.

Infectious species are contagious. When the patient sneezes or coughs, the infection spreads up to 10 meters around.

When breastfeeding, the 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 deviations in the development of the respiratory system, they were born prematurely, 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 mucosa dries up, blocking the respiratory passages. In this case, the ventilation of these organs is disturbed.

Causes of the disease

The causes of bronchitis in children are:

If the treatment of bronchitis in children is not carried out in a timely manner or turned out to be ineffective, then the disease from acute form becomes chronic. Moreover, it lasts for years, with periodic relapses. Most often, recurrent bronchitis occurs in children 4-7 years old. The disease recurs 3-4 times a year after a cold, for about 2 years. There are no episodes of bronchospasm.

The likelihood of a complicated disease increases if the child has inflammation of the adenoids or chronic tonsillitis. Factors contributing to the occurrence of bronchitis in an infant are early weaning, unsuitable sanitary and living conditions, the presence of smokers in the house.

Symptoms of different types of bronchitis

The device of the respiratory system in children has its own characteristics. Their respiratory passages are narrower, due to which their rapid overlap is possible in the event of mucosal edema. Congenital malformations of the lungs or bronchi are more pronounced in infants. After 1-1.5 years, deviations often disappear.

Immunity in children is under development, their susceptibility to infections is increased. The respiratory muscles are weaker, due to which the ventilation of the respiratory organs is worse than in adults. In addition, the volume of the lungs in children is less, which contributes to the accelerated spread of pathogens.

In children, thermoregulation of the body is not sufficiently developed. They overheat faster, catch a cold easier.

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

There are the following types of acute illness:

1. Simple bronchitis. The symptoms are the mildest. There are no symptoms of shortness of breath.
2. Obstructive bronchitis. A serious and dangerous condition in which respiratory failure may occur.
3. bronchiolitis. There is inflammation of the bronchioles (bronchial tubes with a diameter of 1 mm, located in the region of transition to the lungs). This leads to blockage of the pulmonary vessels, the occurrence of heart disease.

Bronchitis of any type begins with the onset 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, severe dry cough up to 7 days. Drying of the mucus leads to the appearance of hoarseness in the bronchi. If the inflammation also affected the larynx, then a barking cough appears. There is an increase in temperature to 37 ° -38 ° (depending on the severity of the disease). Gradually, a dry cough turns into a wet one. There are gurgling wheezing. If the discharge of sputum occurs normally, then the child's condition improves significantly. The disease in this form can last for 1-3 weeks. The severity of manifestations depends on the age of the baby, his physical development, 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 does not proceed quite normally. After the virus dies (after about a week), the child gets better, but then his condition deteriorates sharply: the temperature rises, the cough and headache intensify. This suggests that a bacterial infection has joined the viral infection, and urgent antibiotic treatment 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

Signs of obstruction most often appear in children under 3-4 years of age. They usually occur with a viral or allergic form of the disease. The main signs of obstructive bronchitis are noisy hoarse breathing with prolonged expiration, paroxysmal cough ending in vomiting, retraction of the intercostal muscles during inhalation, and swelling of the chest.

With this form of the disease, the child's body temperature does not rise. Obstructive bronchitis can occur suddenly after the baby has played with a pet (for example, at a party) or inhaled paint during repairs.

Signs of obstruction sometimes appear around the 4th day of influenza or acute respiratory infections. Characteristic are bouts of dry cough, which does not bring relief. Whistling rales are heard in the lungs.

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 with asthma, the child begins to choke suddenly.

A frequently recurring obstructive process of any origin can turn into bronchial asthma.

Video: How to treat obstructive bronchitis in children

Signs of bronchiolitis

The main sign of inflammation of the bronchioles is shortness of breath. At first, it occurs in a child if he is actively moving, but over time it appears at rest. During inspiration, you can hear a characteristic hiss. When listening, the doctor hears wheezing in the lower part of the bronchi.

As a rule, with bronchiolitis, the temperature rises to 38 ° -39 °. It is more difficult for a child to exhale than to inhale. The chest and shoulders are raised. The face swells, blue appears. Persistent cough with scanty sputum gives no relief, causing chest pains. Other manifestations of this condition are dry mouth, infrequent urination, and rapid heartbeat.

The course of bronchitis in children of different ages

Bronchitis after a cold in a child is a common occurrence. Sometimes it proceeds easily, without fever and is manifested only by a cough. In complicated cases, the temperature is high, there are spasms of the bronchi and suffocation.

The disease usually begins with a dry cough. Gradually, sputum accumulates in the bronchi, which becomes mucopurulent. Wheezing appears, they can be considered signs of the transition of the disease to the stage of recovery. At this point, it is important to facilitate the removal of sputum to the outside, cleaning the bronchi from infection. This is easier for older children, as they already understand that they need to cough up and spit out sputum.

A small child is not always able to do it on his own. Parents can help him, for example, by turning him over to another barrel. In this case, sputum moves along the walls of the bronchi, causing irritation and coughing.

In infants, due to difficulties with the discharge of mucus from the bronchi and its stagnation, the main symptoms are often bouts of severe coughing 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 sputum discharge, the doctor determines what type of bronchitis occurs in a child. Sputum white color is characteristic of viral inflammation, and a greenish-yellow tint appears in it with bacterial inflammation of the bronchi. With allergic bronchitis, lumps of clear mucus are coughed up.

During examination and listening to the chest, the presence of such symptoms of bronchitis in children as hoarse breathing, difficulty exhaling, swelling of the chest, and muscle retraction in the intercostal region is determined.

By using general analysis blood, the number of leukocytes is determined, the presence of an inflammatory process is established.

At dangerous complications(severe attacks of coughing, accompanied by a high temperature for more than 3 days), an x-ray of the lungs is taken. In this case, equipment with a reduced dose of radioactive radiation is used. Pneumotachometry is performed. With the help of a special device, the patency of the respiratory tract is examined during inhalation and exhalation.

If there are signs of an infectious disease, a sputum test is done to determine the type of infectious agent. To diagnose bronchiolitis in infants, histological examination sputum for the presence of characteristic viruses that can live in the bronchi and lungs, the so-called respiratory syncytial infection. An important sign inflammation of the bronchi in an infant is cyanosis (cyanosis of the skin and mucous membranes), which appears as a result of heart and lung failure.

For the diagnosis, the presence of characteristic wheezing and shortness of breath, as well as the frequency and strength of the heartbeat, are important.

A strong cough can also occur with other diseases, such as pneumonia, laryngitis, tuberculosis. Its cause may be congenital pathology the functioning of the respiratory system, the ingress of a foreign body into the trachea. Diagnosis allows you to confirm the presence of bronchitis, prescribe the correct treatment.

Video: Dr. E. Komarovsky about the cause and treatment of bronchitis

Bronchitis treatment

First of all, parents should remember that in no case is it unacceptable to self-medicate. As pediatrician E. Komarovsky emphasizes, little child with bronchitis, not only the uncontrolled intake of medications can harm, but also the improper 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 fever. As soon as it normalizes, the child needs walks in the fresh air.

It is often necessary to drink warm tea, compote (fluid intake should be increased by 1.5 times compared to usual). This contributes to the liquefaction of sputum and its removal from the bronchi. For drinking, you can prepare herbal teas (linden, mint). It is useful to drink alkaline mineral water, which will help reduce the viscosity of sputum. infant as often as possible, apply to the chest, additionally drink water.

Thermal procedures (inhalations, mustard plasters, baths for warming the legs, rubbing the chest) can only be carried out in the absence of elevated temperature body.

Medicines prescribed for children with bronchitis

Antiviral drugs, such as arbidol, anaferon, fluferon, interferon, for acute bronchitis, the doctor prescribes, taking into account the age and weight of the child.

Antibiotics with bronchitis effective action only if the disease is bacterial in nature. They are prescribed when thick sputum is colored yellow-green, while there is a high temperature, shortness of breath, symptoms of intoxication of the body (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 needed if a child develops bronchiolitis and is at risk of developing pneumonia. Usually, children are prescribed azithromycin, zinnat, supraks, sumamed.

Cough remedies. The following types of drugs are used:

• expectorants (pertussin, licorice root extract, decoctions of some herbs);
• sputum thinners such as bromhexine, lazolvan, libexin.

Fluifort, which has proven itself in the treatment of children, is used to thin sputum for bronchitis and cough. It is produced in the form of a syrup, which is convenient to give to a child, and even babies like the pleasant taste. Main active substance as part of the syrup - carbocysteine ​​lysine salt, it helps to thin and remove sputum from the lungs. Fluifort restores the structure of the mucous membranes of the respiratory system, facilitates breathing, significantly reduces the frequency and intensity of coughing. The effect of the drug is noticeable already in the first hour after application and lasts up to 8 hours. The neutral pH of the syrup makes it completely safe.

Warning: Babies under 2 years of age should never be given expectorants. Taking them will increase the coughing fit. The liquefied sputum can enter the respiratory tract and lungs, leading to even more serious complications.

Antipyretics. Panadol (paracetamol), nurofen (ibuprofen), ibuklin are used in the form of tablets, suspensions, suppositories - in forms convenient for children of any age.

Antihistamines(Zyrtec - for children older than 6 months, Erius - from 1 year old, Claritin - from 2 years old). They are used in the treatment of allergic bronchitis in children.

Preparations for inhalation. Used for obstructive acute bronchitis. The procedures are carried out using a special inhaler. Used such means as salbutamol, atrovent.

As additional procedures, chest massage, therapeutic breathing exercises, physiotherapy (ultraviolet irradiation, electrophoresis) are prescribed. Procedures are not carried out during an exacerbation of the disease.

Video: Therapeutic cough massage

The use of folk methods for bronchitis

Folk medicines based on natural ingredients help to alleviate the condition of a child with bronchitis, preventive treatment to prevent relapse, strengthen immunity. Such funds, after agreement with the doctor, are taken as an adjunct to drug treatment.

Note: The well-known Moscow doctor, chief pulmonologist of Russia, Professor L. M. Roshal strongly recommends using the "Monastic Collection" for chronic bronchitis, composed of 16 herbs (sage, string, wormwood and others). 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, you can use a decoction of coltsfoot, it calms a cough well with simple bronchitis, a decoction of St. John's wort, which has a bactericidal and anti-inflammatory effect. A well-known cough medicine for bronchitis, pneumonia is considered to be baked radish with honey, oatmeal broth. Soda inhalations also help.

Effective home methods of treatment include warming and distracting procedures (foot baths, mustard plasters, cups, warming compresses on the right side of the chest are used).

The most important measure for the prevention of bronchitis is timely treatment colds, runny nose, infectious diseases of the throat and upper respiratory tract. The child must be tempered, accustomed to physical education, he must spend a lot of time outdoors. Vitamins must be added to the diet all year round.

It is important for parents to ensure that the apartment is always clean, cool, sufficiently humid air.

Obstructive bronchitis is a disease that occurs quite often in children. The reason for this is the physiological characteristics of the body. The already narrow lumen of the bronchi, in the event of inflammatory processes in them, can overlap almost completely. This is obstruction - "spasm", "narrowing". With early diagnosis given state responds well to treatment. Therapy is carried out using medicines and physiotherapy. Effective in the treatment of obstructive bronchitis in children and folk remedies.

What is obstructive bronchitis

Bronchitis is an inflammatory change in the bronchi, caused either by an allergic reaction, or a viral or bacterial infection, or by physicochemical factors. And the edema and spasm associated with inflammation are the main causes of obstruction.

Obstructive bronchitis in children (obstruction, obstructive syndrome) is a narrowing of the lumen of the bronchi and a violation of their patency, in the consequence of which develops respiratory failure. The condition is complicated by the production of viscous sputum and spasm.

The inflammatory process in the airways provokes swelling of the bronchial mucosa. And because of its thickening by only 1 mm, the total area of ​​the bronchial lumen in an infant can decrease by 75%, while in an adult it is only 19%.

This is what healthy bronchi and bronchi look like during an attack of bronchial obstruction

Attacks of obstruction begin, as a rule, at night. The baby has an increased cough and runny nose, the child is naughty, complains of weakness, chest pain and shortness of breath. Wheezing is clearly audible, and body temperature usually rises.

The main distinguishing feature of obstructive bronchitis is that it appears suddenly and proceeds very rapidly. In just a few minutes, the patient's condition can deteriorate to critical.

The stronger the swelling, the harder it becomes for the baby to breathe and the less oxygen enters the blood. This threatens with oxygen starvation and suffocation. Therefore, it is very important to be able to distinguish between obstructive bronchitis and ordinary bronchitis, and to come to the aid of a sick little one in time.

Obstructive bronchitis in a child - video by Dr. Komarovsky

Types of disease

Depending on the symptoms and duration of the course of the disease, obstructive bronchitis is divided into:

• acute - an attack occurs suddenly and once;
• with an asthmatic component (or simply asthmatic) - it manifests itself most often as a result of the reaction of the bronchial mucosa to an external irritant, an allergen.
• recurrent, which in young children develops again precisely against the background of a viral infection - it is not associated with exposure to non-infectious factors, for example, allergens, it is repeated more than 2-3 times a year;
• with regular repetition of attacks for 2-3 years, doctors diagnose chronic obstructive bronchitis. This also includes COPD - chronic obstructive pulmonary disease. A disease characterized by airflow limitation that is not completely reversible. They usually get sick in adulthood.

When choosing a treatment strategy, the doctor will be guided precisely by the nature of the occurrence of obstruction. And already, depending on the form of the disease, prescribe therapeutic measures.

Causes

Causes of asthmatic obstructive bronchitis in children

1. Viral infection. Most common cause obstruction development. Parainfluenza and respiratory syncytial viruses, cytomegalovirus, adenovirus, etc. can cause inflammation in the respiratory tract.
2. bacterial infection. The causative agents of inflammation in the bronchi are most often staphylococci or streptococci, pneumococci or Haemophilus influenzae, chlamydia or mycoplasma, Proteus or Klebsiella.
3. Anatomical features of the structure of the respiratory system in children. AT early age the glandular tissue of the bronchi is enlarged, and the lumen in them is much narrower than in adults.
4. Features of the structure of the diaphragm. It provides depth of inspiration. The shallow breathing of young children is due to the weakness of their diaphragm contractions.
5. Insufficient local immunity. Protective properties of mucous membranes. In babies, this type of immunity is in the formation stage.
6. Production of viscous sputum. It interferes with the passage of air through the lumen of the bronchi, swollen and spasmodic due to inflammation.
7. Aspiration. Inhalation of small objects or food. This reason is most relevant for young children. Occurs with gastroesophageal reflux, swallowing disorders and some other pathologies of the nasopharynx and esophagus, as well as when foreign bodies after extraction, foci of infection are left in the pharynx.
8. Helmite migration. You can suspect from two years.
9. Allergic reaction. Due to the reaction of the immune system to an irritant, allergic bronchitis develops and its complication is an obstructive form of the disease.
10. Malformations of the respiratory organs. Hypoplasia, aplasia, agenesis, etc.
11. Unfavorable living conditions. Non-compliance with hygiene standards, passive smoking, poor environmental background.

It should be borne in mind that the syndrome of bronchial obstruction in children most often occurs due to swelling of the bronchial mucosa and the accumulation of viscous sputum in them. And in older children, obstruction, as a rule, causes bronchospasm.

Factors that increase the risk of developing obstructive bronchitis:

• intrauterine infections;
• insufficient body weight;
• rickets;
• hereditary predisposition to allergies;
• enlarged thymus (thymus gland);
• artificial feeding or early transition to it;
• viral or colds.

Symptoms

Symptoms of bronchial obstruction usually appear 2 to 4 days after the onset of a respiratory infection.

Obstructive bronchitis precedes a number of catarrhal phenomena:

• runny nose;
• redness, pain and sore throat;
• dry and unproductive cough;
• fever, chills;
• general weakness.

The main signs of bronchial obstruction are a dry exhausting cough, noisy rapid breathing, expiratory dyspnea

The attack of obstruction begins suddenly, progresses quickly, it is characterized by the following manifestations:

1. The child shows visible anxiety. He tries to take a sitting position, relying on his hands.
2. Viscous sputum accumulates in the bronchi, which is not expectorated, but only irritates the mucous membrane and provokes a cough.
3. Breathing is noisy, wheezing, rapid (70-90 breaths per minute at a rate for children under 6 months - no more than 60, from 6 months to 1 year - no more than 50, and from 1 to 5 years - no more than 40).
4. Cough becomes frequent and strong, exhausting. It even happens that it provokes vomiting.
5. Rattling and gurgling can be heard even at a distance. But they do not have a clear localization and pass along with an attack of obstruction.
6. Expiratory shortness of breath appears - the baby can hardly exhale.
7. In the process of breathing, auxiliary muscles are involved, the space under the sternum and the intercostal spaces are drawn in.
8. Body temperature is kept at 37.5 ºС.
9. Asphyxia attacks appear and become more frequent. It looks as if the baby is constantly in a state of inhalation (to inhale, he needs to additionally strain). At the same time, the baby feels more comfortable on his stomach, hanging his head below body level.
10. Blue nails, nasolabial triangle. This is acrocyanosis - a clear sign oxygen starvation. There are signs of intoxication of the body: nausea, vomiting. You should count how many breaths per minute the child takes. If the amount exceeds the age limit by 10%, you should immediately call an ambulance.

An attack of obstruction can last up to 2-3 days, and in children with a weakened immune system with a history of rickets and other pathologies, it drags on for a longer time.

Features of the course depending on age

Due to the anatomical features of the child's body (narrow bronchial lumen), obstructive bronchitis most often affects infants and toddlers up to three years. The older the child, the less likely he is to develop this disease.

In children older than 3 years, the above signs of obstruction may be added pain between the shoulder blades and the discharge of sputum, which has a yellowish tinge. A body temperature above 38 ° C indicates complications in the course of the disease.

At an early age, obstructive bronchitis is a physiologically justified phenomenon. In children who have crossed the age limit of 3-4 years, attacks of obstruction may indicate the development chronic diseases respiratory organs, bronchial asthma.

Diagnostics

Examination and treatment of children prone to attacks of obstructive bronchitis can be carried out by a pediatrician and a pediatric pulmonologist.

To eliminate the causal dependence of the occurrence of bronchial obstruction and bronchospasm on allergens and diseases of the ear, throat, nose (sinusitis, tonsillitis, pharyngitis, etc.), a small patient is referred for a consultation with an otolaryngologist and an allergist-immunologist. After all, the tactics of treating a disease directly depends on what caused its development.

Spirometry - a method for studying volume and speed indicators of respiration in obstructive bronchitis

To make an accurate diagnosis and prescribe appropriate therapy, doctors need results:

• questioning the child and parents;
• auscultation (listening to breath sounds);
• x-ray examination of the respiratory system, which usually shows an enhanced pulmonary pattern;
• sputum culture (allows you to determine the causative agent of the inflammatory process in the respiratory tract);
• a blood test (states the fact of the occurrence of a focus of inflammation in the baby's body, shows the degree of oxygen saturation of the blood).

Also, children over 5 years of age are subjected to spirometry - the volume and speed of breathing are measured.

Treatment

Acute obstructive bronchitis without proper treatment can be complicated by pneumonia, metabolic disorders, develop into more severe forms. Therefore, at the first signs of obstruction, you should immediately consult a doctor. Only under the condition of accurate detailed diagnostics and qualified therapy, a complete recovery is possible with a guarantee of the absence of far-reaching consequences.

Bed rest is indicated during acute manifestations. As normalization respiratory function and metabolism mode can be semi-bed or free.

When is hospitalization required?

Attacks of obstructive bronchitis in a child can be stopped and treated at home, of course, after prior consultation with specialists. First of all, it concerns the chronic and asthmatic form.

But there are times when hospitalization is vital:

• Obstruction in a newborn or a child under one year old.
• Risk factors present in history (enlarged thymus, rickets, viral infections)
• Severe condition of the crumbs before the attack.
• Bronchospasm in a child happened for the first time, and parents do not know how to help him.
• Outpatient treatment for three hours did not give positive dynamics.
• The frequency of breaths is 10% higher than normal for age.
• The appearance of symptoms of respiratory failure: shortness of breath, acrocyanosis.
• The child has obvious signs of intoxication: lethargy, loss of appetite, nausea, vomiting, fever.
• The impossibility of full care for a small patient at home.

In order to avoid causing irreparable harm to the health of the child, children under 3 years old should be hospitalized at the first signs of bronchial obstruction. For recurring attacks, follow the instructions given earlier by your doctor.

First aid for an acute attack of obstruction

An acute attack of bronchial obstruction is best relieved by inhalation with bronchodilator, mucolytic, glucocorticosteroid drugs

1. Ensure that the room where the baby is located has an influx of fresh air.
2. Wash the child to remove possible allergens from his face (if the attack is caused precisely by their exposure).
3. A hot foot bath at the beginning of an attack will help to significantly alleviate the condition.
4. Put the baby on the stomach.
5. Count the number of breaths per minute before starting assistance.
6. Today, inhalations with drugs that dilate the bronchi, promote sputum discharge, relieve inflammation, swelling and irritation of the mucosa (Ventolin or Berodual, as well as Lazolvan or Ambroxol) are considered the best way to relieve an attack of bronchial obstruction. Antitussive drugs for obstructive bronchitis are contraindicated! Inhalation can be carried out using a special device - a nebulizer. And you can buy an inhaler containing a medicinal mixture in a pharmacy. Inhalations are first done with each bronchospasm, and after the onset of relief - at bedtime.
7. In cases of severe obstruction, after a fifteen-minute inhalation with the above drugs, a glucocorticoid (Pulmicort or Budesonide) can be added to the solution.
8. Count the frequency of breaths after inhalation to verify the effectiveness of therapy.
9. And do not forget about the drinking regimen. Drinking plenty of water will facilitate the process of sputum discharge and its expectoration. And alkaline mineral water (Borjomi, Essentuki) will soften the throat, remove irritation.

When an allergic reaction of the child's immune system to an external irritant becomes the cause of an obstruction attack, the attack can be stopped within a few hours. If obstructive bronchitis was caused by pathogenic microflora, it will not be possible to overcome it quickly. Relief of the condition after treatment occurs within 2-3 days.

What can not be done?

With obstructive bronchitis, mustard plasters cannot be placed!

1. Rub the child with various balms, turpentine, aromatic oils. So you will only increase the allergic reaction, if it occurs, or the bronchospasm will increase due to the pungent smell of the rub.
2. Use any bee products for treatment due to their high allergenicity.
3. Put mustard plasters, in this case they will not help.
4. Water the baby with any herbal infusions and decoctions. It is not known what the immune system will react to them.
5. Use cough suppressants.
6. Antihistamines of the first generation are also contraindicated: Tavegil, Pipolfen, Suprastin. They dry the mucous membranes and thereby prevent sputum discharge. And it must, on the contrary, be liquefied and removed.
7. Engage in self-medication. Any drugs and procedures for the child should be prescribed by a doctor.

Diet and drinking regimen

An important role in achieving positive dynamics of treatment is played by a hypoallergenic diet.

Hypoallergenic diet for obstructive bronchitis - table

In the treatment of obstructive bronchitis, a hypoallergenic diet should be followed for at least 3 months. Then you can expand the child's diet, but gradually. For kids with allergies, a food diary is started, and products are introduced under the supervision of a doctor.

Still mineral water

To improve the drainage function of the bronchi and the speedy removal of sputum from them in a child with obstructive bronchitis, you need to drink regularly. Moreover, the baby should drink not just water, but alkaline mineral water.

You can also give him warm milk with butter or goat (badger) fat dissolved in it. But various herbal teas and compotes, although they are useful and have an expectorant effect, can be given to the child only after prior consultation with the doctor, because these drinks can cause allergies in the baby and only worsen his condition.

Microclimate

Another important point the microenvironment of the child. For the health of his respiratory system, this is really very important. Mucous membranes function normally only when they are sufficiently moistened. Dry mucous membranes are the cause of weakened local immunity.

• The room where the patient is located should be ventilated several times a day.
• Do wet cleaning regularly.
• You can buy a humidifier. This device will be useful for all family members.
• Avoid contact of the baby with carpets and soft toys. Replace feather pillows with padding pillows.

Viruses, microbes and allergens that enter the child's respiratory tract along with air cause their irritation and inflammation - swelling, accumulation of mucus, bronchospasm. Therefore, it is necessary to protect the crumbs to the maximum from contact with external stimuli.

A humidifier will protect the mucous membranes from dryness

Medicines

Drug treatment of obstructive bronchitis is aimed at interrupting the attack and eliminating the root cause of its development. Doctors are also working to improve respiratory function, enrich the blood with oxygen, eliminate the symptoms of intoxication, and restore metabolism.

The therapy includes measures to improve the cleansing of the bronchi from the mucus accumulating in them and relieve inflammation, for which bronchodilators, expectorants, and anti-inflammatory drugs are prescribed.

1. Inhalations. They are carried out with a special device - a nebulizer. It creates a cold vapor, which, when inhaled, easily reaches the small and medium bronchi, without burning or irritating them, and delivers particles to them. medicinal solutions. For inhalation, saline or alkaline mineral water is used with the addition of bronchodilators, mucolytics, antihistamines and corticosteroids.
2. Preparations for expanding the bronchi and relieving spasm. Berodual, Salbutamol, Fenoterol are second-generation beta-antagonists that are most often prescribed to children to relieve bronchospasm. With obstruction against the background of acute respiratory viral infections or acute respiratory infections, Atrovent will be most effective. Eufillin is used less frequently due to side effects and difficulty in selecting exact dosage. But it is used when other means of positive dynamics do not give.
3. Bronchodilators. Ascoril, Salmeterol, Clenbuterol. If there is no opportunity to make the child inhaled, he is prescribed syrups based on bronchodilators. But their use is associated with the appearance of side effects: involuntary muscle contractions, heart palpitations.
4. mucolytic therapy. Mucolytics - drugs that thin the sputum in the bronchi and promote its excretion. They can be used in the form of inhalations, or you can give the child in the form of syrup or tablets. Most often, with obstructive bronchitis, Ambroxol, Lazolvan, Fluditec are prescribed. As well as Acetylcysteine ​​(ACC), which is especially effective in the first days of illness, it is taken only orally.
5. Antihistamines. Zyrtec, Claritin, Parlazin. These drugs are prescribed for children whose obstructive bronchitis is caused by a reaction of mucous membranes to an allergen.
6. Antiviral. If the obstruction is the result of a respiratory viral infection, the underlying disease must be treated, and immunostimulating drugs are prescribed: Immunal, Anaferon, Arbidol.
7. Anti-inflammatory. Inflammation in the bronchi helps to remove Erespal, Fosidal, Inspiron, Bronchomax.
8. Antibiotics. If the baby has a high temperature (38–39 ° C) for longer than 3–4 days, or it rises again a few days after an attack of bronchial obstruction, the doctor will definitely recommend a course of antibiotics to the child. These are Amoxicillin, Ceftriaxone, Sumamed.
9. Glucocorticoids. In a complicated course of the disease and for the speedy relief of the condition, the use of glucocorticosteroids is indicated by inhalation. The most common of them is Pulmicort (you can use Budesonide). Its most effective use will be after inhalation with a bronchodilator drug. From hormone therapy refuse immediately after the onset of relief and replace it with a nonsteroidal one.
10. Vitamins. To strengthen the body's defenses, complex therapy of obstructive bronchitis necessarily includes a course of multivitamins. It can be Kinder Biovital (gel), Multitabs-Baby, Vitoron, Pangeksavit, Pikovit.

Acute obstructive bronchitis is usually caused by viruses and is treated with antiviral and anti-inflammatory drugs, but if the bacterial origin of the disease is proven, antibiotics are connected.

Medicines used to treat obstructive bronchitis - table

It is important not to forget that children under 6 years of age, any medicines should be given as syrups, suspensions or drops.

Medications for the treatment of obstructive bronchitis - photo gallery

Ascoril - bronchodilator Zyrtec - antihistamine ACC - mucolytic Pulmicort - solution for inhalation, glucocorticoid Amoxicillin - antibiotic Sumamed - antibiotic
Salbutamol - bronchodilator Pikovit - multivitamin complex
Berodual - antispasmodic, bronchodilator
Erespal - anti-inflammatory agent

Non-drug treatments

Treatment of obstructive bronchitis in children is always complex. In a severe course of the disease, an oxygen mask (oxygen therapy) or artificial ventilation of the lungs in intensive care units is shown to a small patient.

In addition to taking medications inside and inhalations, postural drainage, sound gymnastics, massage and physiotherapy are quite enough.

• postural drainage. Allows you to significantly facilitate the discharge of sputum from the bronchi. Making it is quite easy. The child is laid on his stomach so that his head is slightly below the level of the legs (you can put a pillow under the baby’s stomach), and lightly tap on the baby’s back with a palm folded in a boat. The duration of the manipulation is 15 minutes.
• Sound gymnastics. This technique involves pronouncing various sound combinations in a certain way so that vibrations are transmitted from the vocal cords to the bronchi, thereby relieving spasm and relaxing the smooth muscles of the respiratory tract.
• Massage. An indispensable assistant in the treatment of broncho-obstructive syndrome in children. It will strengthen the walls of the bronchi, facilitate the discharge of secretions and reduce coughing. You need to massage chest(avoiding the heart area), collar area, back along the spine. The greatest effect will be from the massage on the exhale. An older child can already be asked to inhale and hold the breath, and then slowly exhale while you knead and rub the muscles, alternating these movements with tapping, thereby accelerating blood circulation.
• Physiotherapy. Includes procedures such as ultra-high frequency therapy and electrophoresis. But such treatment is prescribed after the attack is stopped, and the cough has become productive.

Massage for obstructive bronchitis at home - video

Folk recipes

They can be used for the treatment of obstructive bronchitis only after mandatory consultation with the attending physician and with his approval.

1. Warm milk with figs will help soften the cough (add 2 fruits to milk and boil the drink for 15 minutes). Take during coughing fits 1 tablespoon.
2. Decoctions and infusions of chamomile, linden, mint, sage, coltsfoot, plantain, ivy, licorice root, all kinds of chest preparations help relieve inflammation in the bronchi, facilitate sputum discharge, and soften cough. You can buy herbs at any pharmacy. Medicines must be prepared according to the instructions on the package. But they can be given to a child only if he does not have a tendency to allergic reactions.
3. Teas from the leaves and fruits of raspberries, currants, viburnum, cranberries, lingonberries have an antipyretic and tonic effect.
4. Warm compresses and rubbing will relieve spasm and relax the bronchi. You can make a compress based on refined vegetable oil. To do this, heat the oil, moisten a terry towel in it, wrap the baby around the chest and back with this towel, cover the compress with plastic wrap, and put warm clothes on top of the baby. In this form, the compress is left overnight. Usually 3-4 wraps are enough for a significant improvement in the condition.
5. Rubbing with camphor oil will enhance the effect of massage and postural drainage, activating blood flow to the bronchi, acting on the mucous membrane and relieving spasm. Before rubbing, carefully examine the baby's skin and postpone the procedure if you find wounds or rashes on it.

Traditional medicine in the photo

Possible consequences and complications

• It is very important to timely and correctly diagnose obstructive bronchitis. After all, bronchial obstruction and bronchospasm can be the first manifestations of bronchial asthma in a child.
• If the disease is not treated, it can take chronic course and gradually acquire new complications (starting from COPD and ending with serious metabolic disorders in the body).
• Children who are prone to allergic reactions may develop recurrent obstructive bronchitis, when attacks are repeated several times a year.
• And the worst thing is that if a child is not provided with timely and qualified assistance during an attack of bronchial obstruction, this can even lead to suffocation and death.

Forecast and prevention

But under the condition of accurate diagnosis and correctly selected therapeutic measures, the forecasts of physicians for children with obstructive bronchitis are quite favorable. The disease is cured completely.

But vigilance should not be lost. In the first 6 months after the primary attack of bronchial obstruction, there are risks of relapses, which can be triggered by colds or allergies.

Therefore, it is important at this time to take very seriously measures for the prevention of acute respiratory viral infections, acute respiratory infections, and various kinds of allergic reactions.

1. Within six months, the child must be registered with a pediatrician. By the age of four, if there were no relapses, the baby is removed from the register.
2. A hypoallergenic diet and lifestyle are mandatory conditions for children who have a history of a tendency to allergies and cases of bronchial obstruction.
3. Compliance with the daily routine, long walks in the fresh air, an active lifestyle - all this contributes to the formation of strong immunity in the baby.
4. Mandatory vaccinations for seasonal outbreaks of respiratory viral diseases.
5. Dress your child for the weather.
6. Avoid crowded places where he can catch the flu.
7. Pungent odors, passive smoking, heavily polluted and dusty air. All this should be avoided by the child.

And remember, the older the child, the lower the risk of repeated attacks of bronchial obstruction.

Obstructive bronchitis is especially dangerous for children at an early age. This is due physiological features development of the child's body. But with timely seeking help from doctors, the chances of a complete recovery of the baby are great. Parents who have children prone to allergic reactions should be especially careful. But in this case, the prognosis is quite favorable, if you follow all the recommendations of the attending physician.

Obstruction syndrome is an obstruction of the airways caused by the accumulation of a large amount of thick mucous content. The respiratory system of a small child is imperfect, so even a slight inflammatory process can provoke the development of complications. How to normalize the breathing of a small patient and protect him from subsequent attacks? Today we are studying obstructive bronchitis in children, having considered all the details of this difficult disease.

Causes of the disease

Most often, obstructive bronchitis does not occur at once, but develops against the background of an already existing inflammatory process. The period of spread of infection is approximately 3-4 days, after which obvious symptoms of bronchial obstruction begin to be observed. So, the main causes of obstructive bronchitis:

Children under the age of one year are most susceptible to the disease, as well as older children with low immunity and existing diseases of various organs.

Symptoms of the disease

Obstructive bronchitis in a child is a disease that has an acute and chronic course. The only difference between these two forms is the frequency of obstructive attacks.. And often the first episode of the disease is repeated many times over the next few years. The main signs of the development of the disease:

• Unproductive obsessive cough. Attacks are observed at any time of the day, even more intensifying before bedtime and in the morning. In children infancy attacks often provoke vomiting.
• Increased body temperature and other signs of intoxication. Lethargy, drowsiness, moodiness - all these are symptoms feeling unwell caused by the onset of the inflammatory process.
• Runny nose and redness of the throat. This symptom characteristic of the viral etiology of the disease. In allergic bronchitis, the mucous throat is usually not hyperemic or there is a slight manifestation of redness.
• Respiratory failure, shortness of breath - leading clinical symptoms obstructive bronchitis. A large amount of viscous secretion accumulates in the bronchi, which cannot be removed by ordinary coughing due to spasm and swelling. Breathing becomes shallow, short and wheezing.

Symptoms of obstructive bronchitis are most dangerous for infants.. Impaired respiratory function leads to frequent bouts of vomiting and lack of oxygen. Progressive pathology can threaten with heart rhythm failure and changes in brain cells.

When is hospitalization needed?

Although obstructive bronchitis is quite treatable at home, sometimes urgent hospitalization may be required. Call to ambulance necessary in the following situations:

• obstruction syndrome develops in a child under the age of one year;
• severe intoxication of the body (the baby completely refuses to eat, the temperature reaches high readings, nausea and vomiting appear);
• severe shortness of breath;
• cyanosis of the nasolabial triangle and nails, indicating a lack of oxygen.

If we are talking about a repeated episode of obstructive bronchitis, then parents probably already know how to treat the disease and how to help the child restore breathing. But this does not negate the consultation with a pediatrician, since a similar clinical picture can be observed with pneumonia.

Medical treatment of obstructive bronchitis

With acute obstructive bronchitis in children, the symptoms and treatment is something that needs to be entrusted to a professional. First of all, the pediatrician must assess the condition of the child and the severity of the manifestation of the disease.. Relevant drug therapy and the treatment regimen is prescribed based on the cause of the pathology and the clinical picture. There is no one magic pill that can cure a serious illness. Therefore, the treatment of obstructive bronchitis in children at home is possible, but only after confirming the diagnosis and selecting a set of drugs. In case of low effectiveness of the prescribed treatment or a noticeable deterioration in the child's health, the diagnosis and the list of drugs are reviewed.

Antiviral and antibacterial agents

Since bronchitis is most often caused by viral infections, then at the initial stage of the disease, children are prescribed antiviral drugs. With a diagnosis of "obstructive bronchitis in children under one year old", the use of drugs in the form of suppositories or drops is indicated. The most popular of them are Genferon, Grippferon or Orvirem. From one to three years, drops and syrups with antiviral action are selected. Among them are Immunoflazid and Amizonchik. For children from three years old, it is possible to prescribe funds in tablet form, for example, Anaferon or Arbidol.

Obstructive bronchitis in a child is not a direct indication for antibiotic therapy. Antibiotics are prescribed in case of urgent need, if the disease was originally caused by a bacterial microflora or there is a deterioration in the condition of a small patient. The following signs may indicate the addition of a bacterial infection:

• persistent increase in temperature for three days;
• severe symptoms of intoxication of the body;
• an increase in the level of leukocytes in subsequent clinical analyzes blood;
• separation of purulent sputum, as evidenced by the characteristic yellow expectorant mucus;
• the appearance of moist rales, indicating the possible development of pneumonia.

If it is necessary to take antibiotics, a small patient is prescribed drugs latest generation with minimal side effects. Among them are Cefazolin or Augmentin.

Cough preparations

Obstructive bronchitis in a child is a dry cough without sputum or with a slight discharge. This does not indicate the absence of mucus in the bronchi, but only indicates the high viscosity of the mucous contents, which the child is not able to remove by himself by coughing. That's why first of all, mucolytic agents are prescribed, the action of which is aimed at diluting this sputum. The most popular drugs are Ambroxol, Lazolvan, Ambrobene.

If the cough becomes wet, but problems with sputum discharge continue to be observed, mucolytics are replaced with drugs with an expectorant effect. In pediatrics, preference is given to means plant origin, including Bronchosan, Gedelix, Gerbion, Doctor Mom or Prospan.

It is forbidden to treat obstructive bronchitis in children with antitussives. By suppressing the activity of cough receptors, they provoke even more accumulation of sputum, making it difficult for the child to breathe. This applies to all types of drugs, including those based on codeine and butamirate.

Drugs for the relief of obstructive syndrome

To relieve spasm from the bronchi and restore breathing, drugs are prescribed that stop the attack. For children over the age of 6 years, inhalations with Berodual's solution are shown up to three times a day. In total, inhalations using a nebulizer are carried out 5-6 times a day, alternating medicinal product with mineral water, such as "Essentuki" or "Borjomi".

As an alternative to nebulizers, bronchodilators such as Clenbuterol, Erespal or Ascoril can be used. Clenbuterol is prescribed to children under the age of 12 years in the form of a syrup in accordance with the age dosage. Ascoril syrup is indicated for children over the age of two years. In case of urgent need, it is possible to use the tablet form in the treatment of children over 6 years of age. Erespal with obstructive bronchitis, as well as the previous drug, is contraindicated in children under two years of age.

At the discretion of the doctor, Teopek or Eufillin may be prescribed.. Indications for their appointment can serve as frequent obstructive bronchitis, the threat of bronchial asthma.

All of these tools have serious limitations and side effects. Therefore, the treatment of children under the age of 6 years is recommended to be carried out in a hospital under the constant supervision of the attending physician.

Medicinal products of other groups

When drawing up a treatment regimen, all provoking factors and symptoms of the disease are taken into account, and, if necessary, others are added. medications. So, with the allergic nature of obstructive bronchitis, a small patient is shown taking antihistamines, such as Cetrin, Zirtek, Zilola and others. If observed moist cough with abundant sputum, other antiallergic drugs are used, for example, Suprastin or Tavegil.

With moderate or severe obstruction, the use of hormonal corticosteroids is indicated. If the condition of a small patient is more or less satisfactory, you can get by with an inhalation solution, for example, Pulmicort. If the syndrome should be stopped quickly, the child is prescribed Dexamethasone injections. Glucocorticosteroid injections may also be needed for obvious signs of an allergic reaction (including skin rashes).

ethnoscience

Obstructive bronchitis in a child does not tolerate experiments, and at the first symptoms of shortness of breath, you should consult a doctor. Any amateur activity can lead to the development of complications, so it is better to postpone grandmother's recipes until the doctor's visit. After making a diagnosis, you can add a couple of effective recipes traditional medicine but all of them should be discussed with the pediatrician. In addition, the doctor must monitor the dynamics, regularly monitoring the health of the child.

Since the treatment of folk remedies is based on the preparation of herbal infusions and honey mixtures, the use of these methods for allergic obstructive bronchitis is dangerous for the child's life.

The following compounds have a pronounced expectorant effect:

• black radish juice or onion with honey;
• decoction of sage in milk;
• carrots infused with honey;
• viburnum with honey;
• infusion of tangerine peel or buckwheat flowers.

It is important to remember that folk remedies help get rid of the symptom of the disease, but in no way eliminate its cause. So, as an independent method of treatment, they are not suitable and can only be prescribed in combination with drug therapy.

Additional conditions for recovery

Obstructive bronchitis in mild children is not an indication for hospitalization. Therefore, if a child is prescribed home treatment, the task of parents is to organize comfortable conditions for a speedy recovery. Key recommendations:

1. If the child does not have a fever, do not force him to lie in bed. But outdoor games are also contraindicated for the baby, as they can increase bronchospasm, provoking a deterioration in the condition.
2. Be sure to ventilate the child's room and carry out wet cleaning there. without using disinfectants and other household chemicals.
3. We monitor the level of humidity. In a dry and hot room, recovery is much slower.
4. If the general condition of the child is satisfactory, you can go outside with the baby. Fresh air will be helpful for recovery. But, as at home, keep an eye on the activity of the child, preventing the appearance of a new attack of shortness of breath.
5. Do not allow your child to inhale tobacco smoke.

Particular attention should be paid to the nutrition of the young patient. Infants are fed on demand. At 4 months, many babies get acquainted with the first fruits and juices, but it is better to postpone the introduction of complementary foods until complete recovery. Older children need to cook light food rich in vitamins.. These can be chicken broths, mashed potatoes, steamed vegetables, fresh salads and fruits. If the child does not agree to eat your healthy culinary delights, turn on the fantasy and turn the meal into fun. To do this, it is enough to serve a portion in an original and fun way, having built a funny face or some character from ready-made products.

Also, don't forget to drink. To thin the sputum, it is necessary to provide the body with a sufficient amount of fluid. It can be fruit juice, natural juice, compotes or just mineral water.

To exclude repeated bronchospasm, it is necessary to exclude from the diet all foods with a high level of allergenicity. These include citrus fruits, strawberries, chocolate. It is also better not to experiment with store-bought sweets.

Prevention

A small cough in a child after obstructive bronchitis may persist for some time. Coughing may not be strong, but at the same time, remnants of sputum come out. The main thing here is to monitor breathing and not neglect the need for examination by a pediatrician even after the disappearance of all symptoms. Relapse prevention is very simple:

• healthy sleep;
• strong immunity (proper food, vitamins);
• limiting contact with allergens and other provoking factors;
• daily wet cleaning in the apartment;
• walks in the fresh air away from highways;
• annual trips to the sea.

Complications

Noticing that the child began to cough, you should immediately sound the alarm. Otherwise, complications cannot be avoided. The most dangerous consequences:

• pneumonia;
• pleurisy;
• lung abscess;
• bronchial asthma;
• emphysema;
• heart and respiratory failure (with the possibility of death);

The task of parents is to prevent the sad development of events. To do this, it is enough to contact a pediatrician for advice at the first symptoms of the disease and strictly follow all his recommendations.