Obstructive bronchitis in children: a great danger for the little ones. What is obstructive bronchitis: symptoms and treatment of the disease in children Treatment of obstructive bronchitis in a 3-year-old child

The inflammatory disease obstructive bronchitis in children is a common phenomenon.

More often inflammatory process in children it occurs in an acute form with pronounced symptoms.

Lack of adequate treatment leads to the disease becoming chronic or developing bronchial asthma.

The peculiarity of the obstructive form of inflammation of the bronchi is the disruption of their patency due to the accumulation of sputum in the air ducts.

Self the word “obstruction”, which gives the pathology its name, means “constriction” or “spasm”.

Bronchial obstruction develops as a result of disruption of the process of discharge of secretions produced by the glands of the bronchi.

The occurrence of this phenomenon is due to the following reasons:

• muscle spasm, causing a narrowing of the lumen of the channels of the bronchial tree;
• loss of fluidity bronchial mucus due to increased viscosity;
• redundant mucus discharge due to inflammation;
• swelling of the mucous membrane respiratory tract, leading to additional narrowing of the lumen of the air ducts.

The complex of these changes is especially pronounced in children due to the peculiarities of the anatomical and physiological structure and functioning of the respiratory system.

In children under 7 years of age, the development of the disease is further accelerated by an imperfect immune system.

REFERENCE. According to WHO, the proportion of preschool children suffering from obstructive bronchitis (ICD code 10 J20) is close to 16% of all children seeking medical help. In 20% of patients childhood bronchitis develops against the background of ARVI. Children aged 1 to 3 years are most susceptible to pathology. The peak incidence occurs during periods of damp, cold weather: late autumn, early spring. Often the onset of the disease is associated with visiting kindergarten.

The incubation period of the disease is 7-12 days. During this time, descended from the nasopharynx into the bronchi harmful substances poison the mucous membrane, and a pathological inflammatory process begins in it.

Classification

Based on the duration of the course and severity of symptoms, the following forms of the disease are distinguished:

1. Spicy. Lasts 1-2 weeks. Characterized by severe symptoms. With timely and adequate therapy, it is quickly and completely cured.
2. Chronic. Recurrent form, occurring with exacerbations. Develops in the absence or improper treatment of the acute form. Periods of exacerbation can last a month or more.

Based on severity, the following degrees of bronchitis are distinguished:

• light, with minimally expressed symptoms, not causing breathing difficulties;
• average, accompanied by a strong cough, shortness of breath after physical activity, fever, general weakness;
• heavy, with significant difficulty breathing, high fever, significant deterioration general condition, severe shortness of breath even at rest.

CAREFULLY! Severe obstructive bronchitis can cause a child to stop breathing and develop heart failure. Therefore, a child in this condition is advised to be admitted to the intensive care unit for emergency care.

Reasons for development

In more than 50% of cases, the cause of the development of obstructive bronchitis in children under 3 years of age is a viral infection.

After 3 years, the frequency of complications in the form of this form decreases, but still remains in the leading position among all pathologies of the respiratory system.

The mechanism of disease development is simple: infection from the upper respiratory tract descends into the bronchi, disrupting their function.

IMPORTANT! One of the factors that increases the risk of developing the disease is the immaturity of the respiratory system of the baby born ahead of schedule. Anatomical defects in the respiratory organs of premature babies lead to disruption of their functioning and increase the likelihood of developing bronchitis.

Symptoms in children

Obstructive bronchitis begins with cough and swelling of the nasopharynx. A sign is increased coughing at night.

At the same time, during coughing attacks there is no secretion of sputum. Additionally, the following symptoms are observed:

Symptoms characteristic of obstructive bronchitis appear on the 3-4th day after the onset of the disease. Therefore, at the initial stage, many parents confuse the disease with a common cold and do not sound the alarm.

ATTENTION! A child suffering from obstructive bronchitis is characterized by frequent, shallow breathing.

Diagnostics

Diagnosis of the disease is based on examination of the patient by a doctor. Analysis clinical manifestations diseases and auscultation chest.

Whistling and wheezing during breathing, prolonged inhalation allow the doctor to make a preliminary diagnosis.

To confirm the diagnosis, laboratory tests are prescribed:

• blood analysis;
• allergy tests;
• chest x-ray;
• culture of sputum;
• bronchoscopy;

The specific set of tests depends on the severity of the disease.

Age of the child, presence of concomitant pathologies.

To prescribe adequate treatment, differential diagnosis with diseases with similar symptoms is also necessary:

Children over one year old with mild to moderate severity of the disease are treated on an outpatient basis under the supervision of a doctor.

Infants up to one year for treatment in mandatory hospitalized in a hospital.

IMPORTANT! Indications for hospitalization of a child of any age are a severe form of the disease, the presence of high fever and severe respiratory failure.

Regardless of the stage of the disease and severity of symptoms, apply complex treatment , including taking medications, physiotherapy, catering and maintaining hygiene measures.

Medication

In case of development of bronchitis against the background of viral ARVI and with symptoms similar to infection, treatment begins with taking antiviral agents: “Viferon”, “Kagotsel”. R "emantadine", "Arbidol".

Antibacterial therapy is not a mandatory element and is assigned to a child if the following conditions are met:

• high temperature for more than 3 days;
• severe intoxication of the body;
• discharge of purulent sputum;
• there is a risk of developing pneumonia.

Antibiotics are not used in the treatment of mild forms of the disease and its viral etiology. In one-year-old children, bronchitis is severe, so antibiotics are mandatory.

The following groups of drugs are prescribed:

1. Penicillins:"Amoxicillin", "Ampicillin", "Ospamox", "Augmentin".
2. Macrolides: Azitrox, Sumamed, Zitrolide, Roxithromycin.
3. Cephalosporins:"Cefaxon" , "Axitel", "Ketocef".
4. Combined antibacterial agents: “Biseptol”, “Ascoril”, “Kashnol”, “Bronchosan”.

An obligatory element of the treatment complex is sputum thinning drugs:

• "Lazolvan"
• "Ambroxol"
• "Bronchobos."

At the stage of active sputum production, expectorants begin to be taken:

• "Tussin"
• "Prospan"
• "Bronchicum".

To relieve spasms, bronchodilators are prescribed:

• "Erespal"
• "Ascoril"
• "Clenbuterol"
• "Teopek"
• "Eufillin."

Treatment with Teopek and Eufillin is carried out exclusively in a hospital under the supervision of a physician.

Such precautions are necessary due to serious contraindications and side effects of drugs. These medications are prescribed only when severe forms.

Patients prone to allergic reactions are additionally prescribed antihistamines: Cetrin, Zyrtec, Zizola; in severe cases, Prednisolone injections are used.

To increase immunity, the child is prescribed vitamin-mineral complexes and immunostimulants: “Bronchomunal”, “Imudon”.

Severe bronchospasm requires the use of blockers leukotriene receptors. The most effective drug in this direction is Singulair.

Taking Papaverine or No-shpa also helps relieve bronchospasm.

IMPORTANT! Drugs intended to reduce coughing attacks are contraindicated in case of bronchial obstruction. The goal of treatment is to promote the removal of phlegm, so a productive cough to speed up the process is even desirable.

Physiotherapy and diet

Physiotherapeutic procedures and diet are essential elements of successful treatment of bronchitis.

IMPORTANT! According to the well-known doctor Komarovsky in the Russian Federation, the salt chamber is not able to cure serious pathologies of the respiratory system. The doctor claims that the procedure helps to make breathing easier for children with allergies and only when they are indoors. Komarovsky considers sessions in a caving chamber a waste of money that would be better spent on an air humidifier for a children's room. According to the doctor, maintaining a normal level of humidity in the room helps to achieve a similar result in the treatment and prevention of bronchitis.

Video: Doctor Komarovsky, about the salt chamber

Dr. Komarovsky voices his point of view on treatment in a caving chamber for obstructive bronchitis.

Traditional methods

Traditional methods of treatment effectively complement drug therapy.

But they cannot completely replace medications prescribed by a doctor.

Cure obstructive bronchitis exclusively traditional methods impossible.

When treating bronchitis at home, medications prepared according to folk recipes are used as auxiliaries:

1. Radish juice with honey. 1 teaspoon juice black radish dilute in 250 ml of boiled water, add a teaspoon of honey.
2. Mucus-thinning decoction of elecampane. 2 tablespoons of the herb are poured into 200 ml of boiling water, left for 3-4 hours, and drunk 1 tablespoon 4-5 times a day.
3. Warming compress with oil. Heat the vegetable oil, soak a towel in it, apply it to the chest and cover it with film. The chest is covered with cotton cloth on top. The compress is applied at night for two weeks.
4. Rubbing the chest with camphor, menthol, natural oils. The procedure stimulates blood circulation. Inhalation bio active substances disinfects the bronchi, relieves spasms. Rubbing can be carried out only if the child has no tendency to allergies!

CAREFULLY! Treatment with herbal decoctions and infusions is possible if the child has no tendency to allergies after a control test. The use of folk remedies in an allergic person can cause complete respiratory arrest and death of the baby.

Prevention

Science has not developed a vaccine that can prevent the development of obstructive bronchitis in a child.

To prevent the development of bronchial obstruction in a baby, it is recommended to follow the following rules of prevention:

Timely diagnosis of obstructive bronchitis and compliance with the pediatrician’s recommendations for its treatment allows you to quickly restore the child’s respiratory functions and avoid the development of complications.

As your baby grows, the immune system strengthens, and the incidence of respiratory problems is dramatically reduced.

A child's constant cough will put any parent in a state of constant anxiety. You can assume that this is just a typical child's cough, and give the child some medicinal syrup. After a few days, it is clear that the child is not getting better, mothers and fathers take him to the pediatrician, who reports that the child has obstructive bronchitis. Often parents begin to panic and fuss because they do not know anything about bronchitis. We will talk about childhood bronchitis with obstruction, its symptoms, causes and treatment.

Pediatrician, gastroenterologist

For pediatricians, patients with bronchitis are part of their daily work. Respiratory system infections are most common in children. Almost all infants and primary schoolchildren develop bronchitis more than once a year. Usually, as soon as kindergarten begins, there is a sharp accumulation of pathogens, and many parents have the feeling that their child is constantly sick.

Obstructive bronchitis in children occurs much more often in winter than in summer, as everyone knows from personal experience. Cold air outside and dry heated air indoors increase the vulnerability of the bronchial mucosa to pathogens.

Whether the clinical course of bronchitis is uncomplicated or associated with bronchial obstruction is partly determined by the genetic predisposition of the child. Depending on family history and allergies, the risk can be increased many times over.

Health damage caused by exposure tobacco smoke, is a key point that cannot be underestimated.

The bronchi carry air from the trachea (breathing tube) to the lungs. When these pathways become inflamed, mucus production increases. This condition is called bronchitis.

Bronchitis can be 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 is. This condition is called “obstructive bronchitis”.

Broncho-obstructive symptoms can be caused by the following pathophysiological changes.

1. The smooth muscles of the bronchus contract, which leads to acute shortness of breath.
2. The mucous membrane of the respiratory epithelium swells due to inflammation, which narrows the bronchial lumen.
3. Increased mucus production also clogs the lumen.

In addition, due to inflammation in the respiratory epithelium, ciliary function is reduced and mucus cannot be transported adequately. Auscultation of the lung reveals wheezing.

Causes

In 90% of cases, acute obstructive bronchitis in children occurs due to viruses, and the remaining 10% are bacterial infections. A child may have chronic bronchitis with obstruction if he has repeated attacks of acute bronchitis that remain undiagnosed and untreated. Other causes of chronic obstructive bronchitis include 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:

• flu;
• parainfluenza;
• adenovirus;
• rhinovirus;
• respiratory syncytial virus;
• herpes simplex virus;
• human bocavirus.

The 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.

A child develops a bacterial infection due to the following bacteria:

• mycoplasma;
• chlamydia;
• hemophilus influenzae;
• Moraxella catharalis;
• Pneumococcus.

Even air pollutants can lead to obstructive bronchitis in children. One of the main air pollutants that can cause bronchitis is cigarette smoke. Research shows that if a pregnant woman is exposed to cigarette smoke or if there is cigarette smoke in the home after birth, it causes a recurrence of obstructive bronchitis in children.

Other causes of bronchitis with obstruction in children:

• fungal infection;
• chronic aspiration;
• gastroesophageal reflux;
• allergies.

Is obstructive bronchitis contagious?

Most children with obstructive bronchitis are contagious if the cause is an infectious agent such as a virus or bacteria. The infectious period for bacteria and viruses usually lasts as long as the patient has symptoms, although some viruses will be contagious for several days before symptoms appear. Contagious viruses that cause obstructive bronchitis are listed in the causes section.

Contagiousness subsides when symptoms subside. But bronchitis caused by exposure to pollutants, cigarette smoke, or other environmental substances is not contagious.

Symptoms of obstructive bronchitis in children

Cough

The main manifestation of obstructive bronchitis is cough. It tends to be dry and unproductive in the beginning. As secretion production increases, mucus becomes less viscous, making the cough more wet. Some babies have such severe coughing spells that they may vomit. After regression of obstructive bronchitis, an unpleasant dry cough may still remain for several days or weeks. This is due to transient hyperresponsiveness of the bronchial system due to inflammation caused by infection.

Shortness of breath and wheezing

Shortness of breath gradually increases with the severity of the disease. As a rule, children with obstructive bronchitis cannot breathe as usual when active and begin to cough. Shortness of breath at rest usually signals that COPD (chronic obstructive pulmonary disease) or emphysema has developed. A loud whistling sound is heard when exhaling, but in severe cases it can be heard when inhaling. This is caused by inflammation of the bronchi and narrowing of the respiratory tract.

Other symptoms

• Sensation of rattling in the chest.
• Moderate.
• Runny nose.
• Poor sleep due to cough.
• Chest tightness and pain.
• A tickling sensation in the back of the throat, which makes swallowing painful.
• General feeling of malaise.

Obstructive bronchitis in children under one year of age is manifested by blueness of the tips of the ears and nose, nails and lips

The above symptoms are especially dangerous for children under one year of age, since the body is not yet strong and the immune system has not been formed. This causes rapid progression of bronchitis with obstruction.

Diagnostics

Obstructive bronchitis may be suspected in patients with acute respiratory infection with cough. However, since many more serious illnesses lower respiratory tract cause cough, obstructive bronchitis should be considered a diagnosis of exclusion.

• Cytological examination of sputum in the diagnosis of obstructive bronchitis will be useful for persistent cough. The mucus that the child coughs up will be analyzed for the presence of infections and other pathological components.
• A chest X-ray helps the doctor rule out pneumonia or another lung infection. If anyone in the family smokes, this test is done to rule out lung problems due to exposure to secondhand smoke.
• Bronchoscopy may be required to rule out foreign body aspiration, tuberculosis, tumors, etc. chronic diseases tracheobronchial tree and lungs.
• Pulmonary functional test is a breathing test that uses a device known as a spirometer. The doctor will ask the child to blow into a device to measure the amount of air his lungs can hold and determine how quickly the child can exhale. This helps the doctor identify obstruction in children.
• Sometimes children with obstructive bronchitis may suffer from cyanosis. In this condition, there is not enough oxygen in the blood, which gives the skin a bluish tint. If your doctor observes a bluish tint to your skin, they will perform a test called pulse oximetry. It helps measure the amount of oxygen in the baby's blood. This is a painless, non-invasive test that involves attaching a small sensor to your child's finger or nose.

How and how to treat obstructive bronchitis in children

In general, bronchitis can be treated symptomatically because most cases are caused by a viral infection for which there is no specific treatment.

To achieve this goal, your doctor will prescribe a combination of medications that open up the bronchial airways and soften the mucus so it's easier to cough up. Bed rest is recommended.

Most effective means Controlling cough and sputum production in patients with chronic obstructive bronchitis is the prevention of environmental irritants, especially cigarette smoke.

Treatment of obstructive bronchitis in children includes taking a number of medications.

Bronchodilators

Bronchitis with obstruction makes it difficult for a child to breathe due to narrowing of the respiratory tract. Therefore, the doctor will prescribe bronchodilators.

They widen inflamed airways and reduce swelling. This allows the child to breathe more freely, without pain or discomfort.

Research (although limited) has shown benefit from bronchodilators and possible superiority to antibiotics for relief.

Albuterol and Metaproterenol relax the smooth muscles of the bronchi, having little effect on contractility hearts.

Theophylline and Ipratropium are used to control symptoms such as chronic cough, shortness of breath, and bronchospasm in stable patients with chronic obstructive bronchitis.

Systemic corticosteroids

These are Prednisolone, Prednisone, Dexamethasone.

For children with exacerbation of chronic obstructive bronchitis it is possible short course systemic corticosteroid therapy to relieve wheezing and inflammation.

Inhaled corticosteroids

Corticosteroids are the most powerful anti-inflammatory drugs. Inhalation forms are locally active and practically do not penetrate into the systemic circulation. In children who are stable with chronic bronchitis with obstruction, treatment with a bronchodilator long acting when combined with an inhaled corticosteroid, may help relieve chronic cough.

Beclomethasone causes direct smooth muscle relaxation and may reduce the activity and number of inflammatory cells, which reduces respiratory hyperresponsiveness.

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 the asthmatic response.

Mucolytics

Mucolytic drugs thin the bronchial mucus (phlegm) to make it easier to cough up. Among the mucolytics, the most famous are Acetylcysteine ​​and Ambroxol.

• Acetylcysteine ​​has an 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 (the substance that lines the inside of the alveoli of the lungs). This helps the lungs absorb and metabolize oxygen.

Some herbal substances, such as ivy, are also mucolytics. As a general rule, the therapeutic value of all these so-called cough syrups should not be overestimated. It is much more important that children drink enough and take inhalations.

Antibiotics

Antibiotics for obstructive bronchitis in children are prescribed in case of bacterial infection. The choice of the appropriate antibiotic depends on the age of the child, because in different age groups has its own predominant pathogenic group.

After obtaining an antibiticogram, antibiotic therapy can be determined according to the sensitivity and resistance of the bacteria. Between out-of-hospital and nosocomial infections bacterial spectra also differ. Sometimes it is impossible to distinguish between viral and bacterial infections because clinical picture and blood parameters can be quite similar. In this situation, the child will be treated with an antibiotic, although it is just a viral infection with a high fever.

Amoxicillin and Clavulanate (Augmentin)

This is a semi-synthetic 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 intolerances to the macrolide category. It is generally well tolerated and provides good coverage of most infectious pathogens, but is ineffective against Mycoplasma and Legionella species. The half-life of an oral dose is 1-1.3 hours. Penetrates well into tissues, but does not pass the blood-brain barrier, which makes it useless in the fight against neuroinfection.

Erythromycin

Erythromycin belongs to the group of macrolides. Macrolide antibiotics inhibit the growth or kill sensitive bacteria by reducing the production of important proteins that bacteria need to survive. It is prescribed for streptococcal, staphylococcal, mycoplasma and chlamydial infections.

Azithromycin

Used to treat some mild or moderate bacterial infections (including sinusitis, pneumonia). This is a macrolide antibiotic that works by stopping the growth of bacteria.

Do not give this medicine to a child younger than 6 months.

Tetracycline

Tetracycline acts on gram-positive and gram-negative organisms, as well as mycoplasma and chlamydial infections.

In certain cases, tetracycline is used if penicillin or another antibiotic cannot be used to treat severe infections such as clostridium, listeria, and others.

It is less effective than Erythromycin.

Tetracycline works best when 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). It is not recommended to lie down for 10 minutes after taking this medicine. For this reason, you should not take your dose right before bed.

Tetracycline may make the skin more sensitive to sunlight. Use sunscreen and dress your child in protective clothing when you must be in the sun.

Children under 8 years of age should not take tetracycline. Tetracycline can cause permanent tooth discoloration and may also affect a child's growth.

Cefditoren

This drug belongs to a class of drugs known as cephalosporin antibiotics.

Prescribed for exacerbation of chronic bronchitis, which is caused by sensitive strains of S pyogenes.

Cefditoren works best when taken with food.

Trimethoprim-sulfamethoxazole

Used to treat a certain type of pneumonia (Pneumocystis pneumonia) in immunocompromised patients. This drug is a combination of 2 antibiotics: sulfamethoxazole and trimethoprim. Like tetracycline, it has activity against whooping cough but has no effect against mycoplasma infections.

You should drink plenty of fluids while taking this drug to reduce your risk of developing kidney stones.

Do not give this medication to a child younger than 2 months old.

Amoxicillin

This drug is a penicillin-type antibiotic.

Derived from ampicillin, it has a similar antibacterial spectrum (some gram-positive and gram-negative organisms). It has a bactericidal effect similar to penicillin, acting on susceptible bacteria during the multiplication stage, it has excellent bioavailability and resistance to stomach acid, a wider spectrum of activity than penicillin.

Amoxicillin is less active than penicillin against Streptococcus pneumococcus; penicillin-resistant strains are also resistant to amoxicillin, but higher doses may be effective. The drug is more effective against gram-negative organisms (eg, N meningitidis, H influenzae) than penicillin.

Clarithromycin

Semi-synthetic macrolide antibiotic. It is also used to prevent certain bacterial infections.

Doxycycline

It is a synthetic bacteriostatic antibiotic wide range in the tetracycline class.

Children under 8 years of age should use Doxycycline only for severe or life-threatening conditions. This medication may cause permanent yellowing or discoloration of children's teeth.

Antibiotics work best if the amount of drug in the body is kept at a constant level. Therefore, antibacterial drugs should be taken at the same time every day.

Analgesics/antipyretics

Analgesics and antipyretics are often useful in relieving the lethargy, malaise, and fever associated with the disease.

• Ibuprofen. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). It reduces the production of substances that cause inflammation and pain in the body. Ibuprofen is used to reduce fever and treat inflammation or pain.
• . Paracetamol is a pain reliever and antipyretic. Children under 12 years of age should not take more than 5 doses in 24 hours. Use only the recommended amount of milligrams for the child's age and weight.

Do not give these drugs to a child under 2 years of age without consulting a specialist.

Nasal drops

Saline nasal drops are used to moisten and cleanse the lining of the nose. Vasoconstrictor nasal drops should be given if the eustachian tube swells in response to an upper respiratory tract infection to ensure ventilation of the middle ear. These drops should not be given for more than 7 days, otherwise they may cause irreversible damage to the mucosa.

Oxygen therapy

In the case of severe bronchial obstruction with spasms of the bronchial muscles, swelling of the bronchial mucosa and the formation of viscous secretions, ventilation in the respiratory tract and diffusion in the alveoli may be impaired. This causes partial or systemic oxygen deficiency. If a pulse oximetry test reveals that the oxygen saturation of the blood is too low, supplemental oxygen is needed.

This therapy is carried out to provide the body with additional oxygen, so that tissues and cells receive enough oxygen through the blood.

Oxygen is usually given through nasal cannulas. If young children cannot tolerate nasal cannulas, a mask may be used, especially during sleep.

Treatment for chronic bronchitis helps minimize all symptoms, but you must realize that the symptoms will never go away. They will keep coming back and your child will need regular, long-term treatment.

Why is obstructive bronchitis dangerous in children?

The child has high risk the appearance of complications due to obstructive bronchitis if:

• he has had a cough for more than three weeks;
• he coughs so much that he cannot sleep well;
• the child wheezes;
• he has difficulty breathing;
• the baby has a fever of 38 degrees or higher;
• he coughs up bloody mucus.

Children with undiagnosed and uncontrolled obstructive bronchitis are at risk of developing pneumonia, and chronic bronchitis with obstruction can lead to chronic obstructive pulmonary disease (COPD).

Pneumonia

Statistics show that out of every 20 cases of obstructive bronchitis, 1 pneumonia develops. This is a secondary bacterial infection of the lung caused by bronchitis. The bacteria infect the tiny air sacs (alveoli) in the lungs. Infants and children have a higher chance of developing pneumonia because their immune system is not strong enough to fight the infection.

If a child also has asthma or another condition that has weakened their immune system, they are at risk of developing pneumonia.

Symptoms of pneumonia:

• high fever;
• shortness of breath, even at rest;
• rapid pulse;
• lack of appetite;
• chest pain;
• cough;
• sweating and chills;
• lethargy.

When a child develops mild pneumonia, doctors will prescribe antibiotics, bed rest, and adequate fluid intake. This treatment takes place at home. However, if the infection is more severe, the child will need hospitalization to prevent respiratory failure.

Chronic obstructive pulmonary disease

Chronic obstructive bronchitis in children can become chronic obstructive disease lungs (COPD). This disease reduces the lungs' ability to function optimally and causes. It also makes the child more susceptible to other lung infections.

COPD is a progressive disease and symptoms get worse 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 your child to lead an active life.

Prevention of obstructive bronchitis in children

Bronchitis is not contagious. But the virus or bacteria that causes bronchitis is infectious. Therefore, the best way to prevent the disease is to make sure that the child does not become infected with a bacteria or virus.

1. Teach your child to wash their hands thoroughly with soap and water before eating.
2. Provide your child with a healthy and nutritious diet to ensure that their immunity is strong enough to fight off infectious pathogens.
3. Keep your child away from family members who have the flu or cold
4. Do not allow family members to smoke indoors, as passive inhalation of cigarette smoke can cause chronic bronchitis with obstruction.
5. If you live in a very polluted area, make your child wear a face mask.
6. Clean your baby's nose and sinuses with a nasal spray to remove allergens and pathogens from the nasal cilia.
7. Supplement your child's diet with vitamin C to strengthen his immunity.

Treatment of obstructive bronchitis in children with folk remedies

You can use home remedies to treat obstructive bronchitis to relieve the symptoms of the infection. However, consult your doctor before using these methods. This is especially necessary if the child is receiving medication for an infection. Certain home remedies may interact with the medication, resulting in adverse side effects.

1. Increase your fluid intake.

Cough and fever can dehydrate a child. So let him drink plenty of fluids. He should drink eight to ten glasses of water every day. It also helps thin mucus, making it easier for the body to eliminate it.

1. Humidifier.

When your child has trouble breathing while sleeping or playing, use a cool mist humidifier to add moisture to the air in the room. This will help him breathe easier. However, clean your humidifier periodically to prevent the spread of germs.

1. Cranberry juice.

Cranberry juice is high in vitamin C, which is an immunostimulant. This helps the baby's immune system fight infection.

1. Honey.

Honey has anti-inflammatory and antibacterial properties. It can alleviate the phenomenon of inflammation of the respiratory mucosa, thereby minimizing cough. You can add honey to warm water and give it to your baby as a drink.

1. Thyme.

Thyme will help clear mucus from your airways and also strengthen your lungs. Boil some dried thymes in a cup of water. Let it sit for 10 minutes. Strain. Mix the mixture with honey and give it to your child to drink.

1. Turmeric.

Turmeric has been used for centuries to fight infections. Its antiseptic and anti-inflammatory properties help the child with a cold. Mix a teaspoon of turmeric powder and a small amount of warm milk. Stir the turmeric well until it dissolves in the milk. Have your child drink the formula in the morning on an empty stomach for best results.

1. Magnesium sulfate.

Magnesium sulfate baths can relieve bronchial constriction and also cleanse the body of toxins. Add two cups of magnesium sulfate to your baby's bath water and let him sit in it for 30 minutes. Encourage him to inhale the steam for optimal results.

Don't give your child any home remedy, which suppresses cough. It is important for your child to cough up mucus as this will help them recover. If you want to soothe his throat, honey should be enough.

Conclusion

Children's obstructive bronchitis ranges from mild to severe with symptoms of respiratory failure. Don't ignore your child's cough; take him to the doctor. The last thing you want is for the infection to worsen and lead to complications such as pneumonia and COPD. With early diagnosis and proper treatment, bronchitis should not be a cause for concern.

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Diseases in which breathing is impaired are the most common in pediatric practice. The leading symptom of such diseases is cough. A pronounced narrowing in the bronchi can lead to it.

What it is?

With obstructive bronchitis, severe narrowing of the bronchi occurs - obstruction. This condition is caused by numerous causes and provoking factors. As a result of obstruction, breathing is impaired. A few days after the onset of the disease, all symptoms begin to progress, which leads to a deterioration in the baby’s condition.

The bronchial tree is covered with microscopic cilia. They are found on the surface of the cells that form the bronchi. After exposure to provoking factors, the movements of the cilia are disrupted, which also contributes to impaired sputum discharge and increases obstruction.

Causes

Any bronchitis develops only after exposure to various provoking factors on the child’s body. There are quite a large number of them. They are especially dangerous for newborns and infants.

The immunity of children of the first year has not yet fully formed. Any agent foreign to the child’s body can cause severe inflammation in the bronchi. This immediately leads to bronchial obstruction.

Reasons that can cause the disease include:

Viral infections. The most common culprits of the disease: influenza and parainfluenza viruses, MS virus, adenoviruses. They easily penetrate the baby's upper respiratory tract and quickly spread through the bloodstream, reaching the bronchi and lungs. Viral infections are the leading cause of bronchial obstruction in babies in the first months of life.

Bacteria. Streptococci, staphylococci and moraxella are the most common reasons, which can cause bacterial forms of the disease. These microorganisms contribute to the development of severe inflammation, which leads to a pronounced narrowing of the lumen of the bronchi. The disease caused by bacterial flora has a more severe course and requires intensive care.

Allergies. When an allergen enters the body, the immune system is activated. This contributes to a large release of various biologically active substances into the blood, which strongly spasm the bronchi. Against the background of allergies, breathing is significantly impaired and shortness of breath increases.

Inhalation of polluted air. Living next to major industrial enterprises or factories, the baby has a higher risk of bronchial obstruction. This occurs as a result of the constant entry of tiny toxic substances into the small bronchi. Industrial emissions quickly lead to the development of breathing problems.

Prematurity. In the third trimester of pregnancy, the final formation of the respiratory organs of the unborn baby occurs. This process occurs almost until the days of birth. If for some reason the child is born earlier, then the risk of underdevelopment of the respiratory organs increases several times. Such an anatomical defect often leads to impaired respiratory function.

Quick cessation of breastfeeding. Children who were breastfed completely a short time, have a higher risk of developing bronchitis. To fight various infections you need a good level of immunity. During breastfeeding, babies receive a large amount of immunoglobulin G. These protective antibodies help them not get sick during seasonal colds and protect them from the development of diseases of the bronchopulmonary system.

How does it arise?

The influencing provoking factor leads to the development of severe inflammation. Most viruses and bacteria enter the body through the upper respiratory tract. Settling on the epithelial cells lining the respiratory organs, they begin to have a strong toxic effect.

The incubation period varies and depends on the characteristics of the specific microorganism that causes the disease. On average, it is 7-10 days. At this time, the child does not make any complaints. Specific signs illness during incubation period can not be. Only weakened children may feel a little tired and drowsy.

After the end of the incubation period, the first specific symptoms, characteristic of of this disease. Active inflammatory process occurring in bronchial tree, contributes to the disruption of mucus and sputum discharge.

Babies who have anatomical defects in the structure of the bronchi have a very narrow lumen of the bronchi. Bronchial obstruction in such children develops much more often and is much more severe.

Kinds

The course of diseases accompanied by bronchial obstruction may be different. This depends on the initial state of the baby’s immunity, the features of the anatomical structure of the respiratory system, as well as the cause that caused the disease.

According to the frequency of occurrence, all obstructive bronchitis can be divided:

Spicy. These variants of the disease are appearing for the first time. They last, on average, 1-2 weeks. After the therapy, the baby is completely cured.

Chronic. May be recurrent. They occur with periods of exacerbations and remissions. If the treatment is not well-carried out or the baby has concomitant diseases, acute forms become chronic.

By severity:

Lungs. Occurs with minimally expressed symptoms. They are treated well. After the therapy, the babies fully recover. There are no long-term consequences of the disease.

Average. The cough is more severe, annoying. Body temperature with moderately severe obstructive bronchitis rises to 38 degrees. Shortness of breath may increase. The child's general condition suffers greatly. In some cases, hospitalization and more intensive therapy are required.

Heavy. They occur with a pronounced disturbance in the general condition and well-being of the baby. Body temperature rises to 38.5-39.5 degrees, severe shortness of breath, accompanied by signs of respiratory failure. Treatment is carried out only in a children's hospital, and if cardiopulmonary failure develops, in the intensive care unit.

Symptoms

Narrowing of the bronchial lumen and impaired sputum discharge lead to the child developing specific signs of the disease:

Cough. Appears 2-3 days after the end of the incubation period. A hacking cough bothers the baby more during the daytime. May be paroxysmal.

Dyspnea. Occurs in moderate to severe disease. With shortness of breath the amount increases breathing movements in one minute. Babies breathe more often. This symptom can be seen from the outside, paying attention to the movements of the chest during breathing.

Pain in the chest when coughing up. With bronchial obstruction, the sputum becomes very dense and thick. All attempts at coughing lead to increased pain in the chest area.

Increased body temperature. It increases to 37-39.5 degrees. Bacterial forms of the disease are accompanied by a higher temperature.

Blue discoloration of the nasolabial triangle. The skin in this area of ​​the face is very thin and sensitive. A pronounced decrease in the level of oxygen in the blood leads to the development of acrocyanosis (blue discoloration) of this area. Against the background of a pale face, the nasolabial triangle contrasts strongly.

Poor nasal breathing and redness of the pharynx. These secondary signs occur with viral and bacterial infections and often appear in a child with obstructive bronchitis.

Severe drowsiness and poor health. Sick children refuse to eat and begin to act up. Little children are more willing to be held. Prolonged coughing attacks lead to the baby starting to cry.

Thirst. It appears during severe intoxication of the body. The more severe the disease, the more clearly this symptom manifests itself in the baby.

Active movements of the ribs during breathing. Breathing movements have a large amplitude and become visible from the side.

Loud breathing. During breathing movements, bubbling sounds are heard. They arise as a result of the passage of air through tightly closed bronchi.

Diagnostics

At the first appearance of signs of bronchial obstruction, the child should be shown to a pediatrician. The doctor will conduct a clinical examination and recommend additional examinations. Such tests are needed to determine the severity and cause of the disease.

To diagnose obstructive bronchitis, use:

General blood analysis. An increase in the number of leukocytes and an accelerated ESR indicate the presence of an inflammatory process. Changes and shifts in the leukocyte formula make it possible to clarify the viral or bacterial nature diseases.

Biochemistry of blood. Allows you to identify the presence of complications that develop with respiratory pathology. Also used for differential diagnosis.

X-ray of the chest organs. This method is used in children older than one year. This study allows you to determine the degree of narrowing of the bronchi, as well as identify concomitant lung diseases.

Spirometry. Helps evaluate functional disorders. Indications of forced inhalation and exhalation allow doctors to draw a conclusion about the presence and severity of bronchial obstruction.

Specific laboratory tests to identify allergens. Necessary to establish the cause of bronchial obstruction in children with an allergic form of the disease.

Differential diagnosis

Narrowing of the lumen of the bronchi occurs not only with obstructive bronchitis. Bronchial obstruction syndrome may occur with various diseases. In order to correctly establish a diagnosis, differential diagnosis is required.

Most often, obstructive bronchitis can be confused with:

Stenosing laryngotracheitis. Most often caused by viruses. It usually occurs 3-4 days after the onset of a viral infection. Characterized by the appearance of a barking cough and severe shortness of breath.

Obliterating alveolitis. With this disease, the inner epithelial layer of the bronchi grows, which leads to the appearance and accumulation of foamy sputum. Usually the cough is paroxysmal. Often the disease leads to various complications.

Acute bronchitis. The symptoms are similar. Only spirometry can accurately establish the correct diagnosis.

Cystic fibrosis. This disease is congenital. Typically, children develop poorly and lag behind their peers in physical development. During an exacerbation, a severe cough appears with difficult to clear and very viscous sputum. The course of the disease is quite severe. The disease requires systemic treatment.

Consequences and complications

Frequent obstructive bronchitis can lead to the development of persistent breathing problems in children. With reduced immunity, the baby experiences new exacerbations over a relatively short period of time.

Poorly performed treatment or untimely diagnosis of the disease contribute to the development of complications in the future. Persistent bronchial obstruction can lead to the development of bronchial asthma, especially if the cause of the narrowing of the lumen of the bronchi is an allergy.

Prolonged and persistent cough contributes to the formation of bronchiectasis. With this pathology, the distal sections of the bronchi expand with the formation additional cavities. Bronchiectasis contributes to the appearance of shortness of breath with increasing respiratory failure. Surgery is performed to eliminate this condition.

During an exacerbation of obstructive bronchitis caused by bacterial infection, the inflammatory process may spread to the lungs.

In this case, pneumonia or abscesses appear. They, in turn, lead to a deterioration in the baby’s well-being. Intensive antibiotic therapy is required to eliminate purulent formations.

Treatment

To eliminate the unfavorable symptoms of the disease, various methods of therapy are used. After examining the child and establishing a diagnosis, the pediatrician will recommend a specific treatment regimen, which is provided for in the clinical guidelines. These medical developments contain the necessary algorithm for doctors’ actions when identifying a specific pathology.

Obstructive bronchitis should be treated from the first days after the onset of symptoms. Early prescription of medications helps to cope with all the adverse manifestations of the disease and prevent chronicity. Medicines that eliminate bronchial obstruction and promote better mucus discharge are prescribed by the attending physician.

For the treatment of obstructive bronchitis use:

• Agents with mucolytic effects. They help thin thick mucus and facilitate its easier passage through the bronchopulmonary tree. Preparations based on ambroxol are widely used in pediatric practice. "Ambrobene", "Lazolvan", "Flavamed" help eliminate even a severe cough. Prescribed according to age, 2-3 times a day for 7-10 days.
• Antipyretic. Prescribed when the temperature rises above 38 degrees. In children, various paracetamol-based products are used. Not prescribed for long-term use. May cause allergic reactions and side effects.
• Bronchodilators. P Designed to eliminate blockage in the bronchi and improve breathing. They are usually prescribed in the form of aerosols or inhalations. The effect is achieved in 10-15 minutes. Short-acting bronchodilators based on salbutamol act within 5 minutes.
• Combined drugs containing bronchodilators and anticholinergic drugs. To improve bronchial conduction in children, “Berodual” is used. Prescribed by inhalation. The dosage and frequency of inhalations is carried out taking into account the age of the child. Usually the drug is prescribed 3-4 times a day.
• Antihistamines. Helps cope with adverse symptoms of allergic forms of the disease. In children, drugs based on loratadine, Claritin, and Suprastin are used. Prescribed 1-2 times a day, usually in the first half of the day. Discharged for 7-10 days. For more severe cases - for 2-3 weeks.
• Vitamin complexes enriched with selenium. These substances are needed to combat intoxication. Biologically active ingredients, which are present in the vitamin complex, help the baby fight infection and improve the functioning of the immune system. Selenium is needed for the active functioning of the immune system.
• Glucocorticosteroids. Used for severe and long-term illness. Pulmicort inhalations are usually prescribed. The drug is prescribed for long-term use. Apply 1-2 times a day until a lasting good result is achieved. May cause side effects with long-term use.
• Leukotriene receptor blockers. Helps quickly eliminate bronchospasm. They have a lasting effect. The drug "Singulair" begins to have an effect within 2 hours after administration. Apply once a day.

Treatment at home

You can help your child cope with the disease not only with the help of medicines and pills. The use of medicines prepared at home also helps to eliminate a persistent cough and improve the child’s well-being.

To methods that are safe and effective for self-use, include:

Warm, plenty of drink. Alkaline mineral waters heated to a temperature of 40-45 degrees are perfect. They are prescribed 20 minutes before or an hour after meals, 3-4 times a day. The course of treatment is 7-10 days. You can use “Essentuki” or “Borjomi”.

Liquorice root. This wonderful remedy improves mucus discharge and promotes better expectoration. Should be used with caution, keeping in mind the possible allergic reactions. Works great even with a strong cough.

Breast fees. Such pharmaceutical drugs includes several medicinal plants with expectorant and anti-inflammatory effects. Licorice, coltsfoot, and sage help relieve coughs and improve bronchial conduction.

Radish juice. To prepare this home medicine An ordinary black radish will do. To prepare 250 ml of drink, you only need 1 teaspoon of juice. Before use, add honey to taste.

Breathing exercises

It is used after the acute process has subsided. Typically, such gymnastics is carried out 5-6 days after the onset of the disease. The correct sequence of breathing movements helps normalize the functioning of the respiratory system and cope with adverse symptoms.

In order to improve the outflow of mucus, when performing breathing exercises, a sharp and short breath is taken. Exhale – quite slow and smooth. While exhaling, you should count to 5. Each set of exercises consists of 3-4 repetitions. It is recommended to practice every day. Even during remission breathing exercises will be very useful.

See the video below for more details on how to do breathing exercises.

Nutrition

The diet of a baby suffering from bronchial obstruction must be complete and contain all the necessary nutrients and vitamins.

Breastfeeding should not be canceled during the acute period of illness. Together with mother's milk, the baby receives all the necessary protective antibodies that help him fight the infection that causes bronchitis.

Older children should eat small meals, at least 5-6 times a day. A child's diet should include a variety of protein foods. It is better that your baby receives some source of protein with each meal. Veal, rabbit, chicken or fish are perfect.

Try to choose leaner varieties. Fatty foods take longer to be absorbed by a weakened child's body. You can supplement proteins with cereals and vegetables. Fresh ones also work well as protein dishes. dairy products. They make a great afternoon snack or second dinner.

All dishes are best steamed, baked or stewed. They should have a more liquid consistency. Fruit and vegetable purees are great for younger children. It is not necessary to give your child foods from jars. Homemade cauliflower or potato purees are a good choice.

The baby must drink enough liquid. As drinks you can use compotes, various fruit drinks and juices made from fruits and berries. Frozen fruits are also suitable for preparing healthy decoctions. Try to give your child more boiled water. This will help eliminate the adverse symptoms of intoxication.

Prevention

To prevent your baby from getting obstructive bronchitis, use the following recommendations:

Visit the dentist regularly with your child. Often the presence of carious and untreated teeth leads to the development of various infectious pathologies. Make sure your child brushes his teeth regularly.

Avoid catching colds. Any frequent respiratory diseases, which mainly occur during the cold season, lead to disruption of the respiratory system and reduce immunity. The risk of bronchial obstruction in frequently ill children increases several times.

Strengthen your immune system. Active walks on fresh air, good nutrition and a proper daily routine contribute to the normal functioning of the immune system.

Treat inflammatory diseases of the upper respiratory tract in a timely manner. Children suffering from chronic otitis media or sinusitis are more likely to develop obstructive bronchitis in the future. To prevent this, regularly visit an otolaryngologist with your child.

Use special room humidifiers. Too dry air contributes to breathing problems. Room humidifiers help create a comfortable and physiologically favorable microclimate in any room.

After the complex of treatment, the children feel much better. Their breathing normalizes and shortness of breath goes away. With properly selected therapy, the transition from acute to chronic does not occur. Compliance with preventive recommendations helps prevent the occurrence of new exacerbations in the future.

Dr. Komarovsky will tell you more about obstructive bronchitis in the video below.

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 the child can be cured with inhalations and warming procedures. The baby’s condition can deteriorate sharply, it all depends on the form of the disease and age. Therefore, home treatment should always be coordinated with your doctor. To speed up recovery, you need to maintain optimal humidity and temperature in the room.

Content:

What is bronchitis? Types of disease

This is the name for inflammation of the bronchial mucosa. The disease is infectious and allergic in nature. Often the inflammatory process appears against the background of colds and flu. Most often, children get infectious bronchitis during the cold season, when the body's immune defense weakens.

The infection enters the child’s body from the outside by inhaling contaminated air. It is also possible to activate one’s own opportunistic microflora, which is facilitated by hypothermia of the body and decreased immunity.

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

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

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

At 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 abnormalities 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 mucous membrane dries out, blocking the respiratory passages. In this case, the ventilation of these organs is disrupted.

Causes of the disease

The causes of bronchitis in children are:

If treatment of bronchitis in children is not carried out in a timely manner or turns out to be ineffective, then the disease from an 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 bronchospasm attacks.

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 conditions, and the presence of smokers in the house.

Symptoms of various types of bronchitis

The structure of the respiratory system in children has its own characteristics. Their respiratory passages are narrower, which makes them possible to quickly close when swelling of the mucous membrane occurs. Congenital defects development of the lungs or bronchi is more pronounced in infants. After 1-1.5 years, deviations often disappear.

Children's immunity is still developing and their susceptibility to infections is increased. The respiratory muscles are weaker, causing ventilation respiratory organs worse than in adults. In addition, the lung capacity of children is smaller, which contributes to the accelerated spread of pathogens.

In children, the thermoregulation of the body is not sufficiently developed. They overheat faster and catch colds more easily.

Note: Spasm and swelling of the bronchi (obstruction) develops especially quickly in infants. The resulting lack of oxygen is life-threatening.

Types of acute bronchitis

There are the following types of acute disease:

1. Simple bronchitis. The manifestations are the mildest. There are no symptoms of lack of air.
2. Obstructive bronchitis. Heavy and dangerous condition, in which respiratory failure may occur.
3. Bronchiolitis. Inflammation of the bronchioles (bronchial tubes with a diameter of 1 mm located in the area of ​​transition to the lungs) occurs. This leads to blockage of the pulmonary vessels and the occurrence of heart disease.

Bronchitis of any type begins with the appearance of signs of a cold, which then become characteristics inflammatory process.

Symptoms of simple bronchitis

Against the background of a cold, the child experiences general weakness, headache, severe dry cough for up to 7 days. Drying of mucus leads to hissing in the bronchi. If the inflammation also affects the larynx, a barking cough appears. The temperature rises to 37°-38° (depending on the severity of the disease). Gradually, a dry cough turns into a wet one. Gurgling wheezing appears. 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, general health.

If the disease is neglected, the child may experience complications such as bronchiolitis and pneumonia. Sometimes a disease that occurs in a viral form has an unusual course. After the virus dies (about a week), the child feels better, but then his condition worsens sharply: the temperature rises, the cough intensifies, and the headache gets worse. This indicates that a bacterial infection has joined the viral infection and urgent treatment with antibiotics is required.

The infectious 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 due to a viral or allergic form diseases. The main signs of obstructive bronchitis are noisy, hoarse breathing with prolonged exhalation, paroxysmal cough ending in vomiting, retraction of the intercostal muscles during inspiration, and 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 plays with a pet (for example, at a party) or inhales paint during repairs.

Signs of obstruction sometimes appear around the 4th day of illness with influenza or acute respiratory infections. Characteristic attacks are dry coughs that do not bring relief. Whistling sounds are heard in the lungs.

Up to 4 years of age, relapses of the disease are possible, then 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 develop 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. Initially, it occurs in a child if he is actively moving, but over time it also appears at rest. During inhalation, you can hear a characteristic hissing sound. 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 rise. The face swells and turns blue. Continuous cough with scanty sputum does not provide relief, causing chest pain. Manifestations of this condition are also dry mouth, rare 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 occurs easily, without fever and is manifested only by a cough. In complicated cases, the temperature is high, bronchospasms and suffocation occur.

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 disease transitioning to the recovery stage. At this moment, it is important to facilitate the removal of mucus and cleanse the bronchi of infection. This is easier for older children, since they already understand that they need to cough and spit out mucus.

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

In infants, due to difficulties with the removal of mucus from the bronchi and its stagnation, the main symptoms are often attacks of severe coughing with shortness of breath. At the age of 2-6 months, the disease usually occurs in the form of bronchiolitis.

Typically, recovery from uncomplicated bronchitis occurs within 7-8 days. If bronchitis is complicated by obstruction, it can manifest itself within several weeks and develop into pneumonia.

Diagnosis of bronchitis

Based on the nature of the cough and the type of sputum produced, the doctor determines what type of bronchitis occurs in the child. Sputum white is characteristic of viral inflammation, and a greenish-yellow tint appears 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 in exhaling, swelling of the chest, and retraction of muscles in the intercostal area is determined.

Using a general blood test, the number of leukocytes is determined and the presence of an inflammatory process is established.

At dangerous complications(severe coughing attacks accompanied by high fever 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. Using a special device, the patency of the airways is examined during inhalation and exhalation.

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

To make a diagnosis, the presence of characteristic wheezing and shortness of breath, as well as the frequency and strength of the heartbeat, is important.

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

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

Treatment of bronchitis

First of all, parents must remember that it is under no circumstances acceptable to self-medicate. As pediatrician E. Komarovsky emphasizes, small child with bronchitis, not only uncontrolled use of medications can harm, but also misuse home treatments.

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 water). At home, when treating simple bronchitis, the child should stay in bed if he has a high temperature. As soon as it returns to normal, the child needs walks in the fresh air.

It is necessary to often drink warm tea, compote (liquid consumption should be increased by 1.5 times compared to usual). This helps to liquefy mucus and remove it 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. The infant is placed to the breast as often as possible and given additional water.

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

Medicines prescribed for children with bronchitis

For acute bronchitis, the doctor prescribes antiviral drugs such as arbidol, anaferon, influferon, interferon, taking into account the age and weight of the child.

Antibiotics for bronchitis they provide effective action only when the disease is bacterial in nature. They are prescribed when thick sputum is yellow-green in color, and there is a high temperature, difficulty breathing, and 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 onset antiviral treatment. Antibiotics are necessary if a child develops bronchiolitis and there is a risk of it developing into pneumonia. Children are usually prescribed azithromycin, zinnat, suprax, 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.

To thin sputum during bronchitis and cough, the drug Fluifort is used, which has proven itself in the treatment of children. It comes in the form of a syrup, which is convenient to give to a child, and even kids like the pleasant taste. Basics active substance The syrup contains carbocisteine ​​lysine salt, it helps to liquefy and remove mucus from the lungs. Fluifort restores the structure of the mucous membranes of the respiratory system, facilitates breathing, and significantly reduces the frequency and intensity of cough. The effect of the drug is noticeable within the first hour after use and lasts up to 8 hours. The neutral pH of the syrup makes it completely safe.

Warning: Children under 2 years of age should never be given expectorants. Taking them will intensify the coughing attack. Liquefied mucus can enter the airways and lungs, leading to even more serious complications.

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

Antihistamines(Zyrtec - for children over 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. The procedures are carried out using a special inhaler. Such agents as salbutamol and Atrovent are used.

As additional procedures chest massage, therapeutic breathing exercises, and physiotherapeutic treatment (ultraviolet irradiation, electrophoresis) are prescribed. Procedures are not performed during the period of exacerbation of the disease.

Video: Therapeutic massage for coughs

The use of traditional methods for bronchitis

Traditional medicines based on natural ingredients help alleviate a child’s condition with bronchitis, preventive treatment to prevent relapses and strengthen the immune system. Such drugs, after consultation with the doctor, are taken as an addition to drug treatment.

Note: The famous Moscow doctor, chief pulmonologist of Russia, Professor L. M. Roshal, strongly recommends using the “Monastic Collection”, composed 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 cannot be used by everyone.

A decoction of coltsfoot can be used as an expectorant; a decoction of St. John's wort, which has a bactericidal and anti-inflammatory effect, is good for soothing coughs in cases of simple bronchitis. A well-known cure for cough for bronchitis and pneumonia is baked radish with honey, oatmeal broth. Soda inhalations also help.

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

The most important measure to prevent bronchitis is timely treatment colds, runny nose, infectious diseases of the throat and upper respiratory tract. The child must be hardened, accustomed to physical education, and he must spend a lot of time in the fresh air. It is necessary to add vitamins to your diet all year round.

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

The obstructive form of bronchitis is one of the most dangerous diseases. In terms of severity, it ranks second after. Most often, the disease affects children under the age of 6-7 years. This is due to the fact that babies have very narrow openings in the bronchi.

The inflammatory process provokes the accumulation of large amounts of mucus in the bronchial canals, which leads to thickening of the mucous membrane and clogs the bronchi.

general description

Obstructive bronchitis is a severe spasm of the bronchi that prevents the mucus that forms from leaving. Accompanied by high temperature. It is most dangerous for children under 1-2 years of age. because they do not have a developed cough reflex, which promotes the removal of sputum. With a severe coughing attack, the child may even suffocate.

With obstruction the mucous membrane of the bronchi grows, clogs the respiratory channels. Phlegm and mucus accumulate in them, making breathing difficult. The accumulation of sputum causes severe inflammation and swelling of the bronchi, which leads to serious oxygen starvation.

Causes of occurrence, why it is dangerous

In addition to hereditary anomalies of the esophagus, diseases of the gastrointestinal tract and nasopharynx, there are many causes of bronchitis. The disease can be caused by:

Prone to bronchial obstruction premature babies with weakened immune systems. Risk factors are genetic predisposition (rickets, cystic fibrosis, congenital pulmonary hypoplasia, etc.), passive smoking, polluted atmosphere. Obstructive bronchitis can occur against the background of any cold or hypothermia. Undertreated diseases of the nervous system lead to obstruction.

Consequences of obstructive bronchitis:

Classification

There are three forms of obstructive bronchitis: acute, chronic and allergic.

Acute form occurs against the background of a viral infection. The first signs of the disease can be noticed within a few days after the onset of ARVI or influenza. A severe cough with wheezing and difficulty breathing appears.

Chronic or recurrent obstructive bronchitis is the result of an untreated acute form. It is characterized by morning coughing attacks, sweating, fatigue, and low fever. The disease can occur several times a year and can be caused by hypothermia.

Allergic form Obstructive bronchitis in children is paroxysmal in nature and occurs during close contact with an allergen. Often accompanied by a runny nose and lacrimation, but does not cause an increase in temperature.

Any type of bronchial obstruction is dangerous and occurs in a very severe form, especially before the age of 2 years. This disease must be treated only in a hospital so as not to cause serious complications.

Specific and nonspecific signs

With obstructive bronchitis, the following primary symptoms develop:

Secondary signs:

The danger lies in the rapid progression of the disease, rapid swelling bronchi, which leads to oxygen starvation.

How to recognize the disease

Infants suffer from obstruction of the small branches of the bronchi (bronchioles). Obstructive bronchitis in children under one year old called bronchiolitis. The very first symptoms of the disease are fever, runny nose, paroxysmal cough, and suffocation. Severe swelling of the mucous membrane occurs, preventing the discharge of sputum. The child cries constantly and cannot sleep. The disease develops very quickly and often leads to serious complications.

For children aged 1 to 4 years It is obstructive bronchitis that is most often diagnosed. It usually appears after undergoing viral infections and is caused by bronchospasm. At an early stage of the disease, the cough may be rare and weak.

If the disease is not treated in time, then after 3-4 days, severe coughing attacks, wheezing, and fever appear, heavy, rapid, wheezing difficulty breathing, and bloating of the chest. Additional symptoms- runny nose and sore throat. The cough gets worse at night.

In children 4-6 years old obstructive bronchitis is treated faster. Thanks to the development of the respiratory muscles, the cough becomes productive, and the baby can independently get rid of sputum. The healing process is also accelerated by the fact that at this age more serious medications can be prescribed.

If you notice at least some of the listed symptoms, you should urgently call a doctor. Under no circumstances should you self-medicate or use “proven” folk remedies without consulting a specialist.

Children under 2 years of age with signs of obstruction are subject to immediate hospitalization.

Diagnostic measures

The diagnosis of obstructive bronchitis is made by a doctor based on examining and listening to the lungs. Appointed. and talk about a serious inflammatory process.

To confirm the diagnosis and exclude pneumonia, an x-ray is prescribed. If the pulmonary pattern is enhanced, but there are no foci of infiltration or darkening, then obstructive bronchitis is diagnosed.

How the treatment works and what to do if this happens at night - read the article on our website.

We invite you to learn about antibiotics that are used in the treatment of pyelonephritis in children.

And here there is an article about the signs and treatment of another disease in children - cystitis.

How and with what to treat

Treatment of acute obstructive disease for up to a year is carried out only in a hospital setting. From 2 years and older can be treated at home provided that the child’s condition is satisfactory and does not cause concern. A doctor must draw up a treatment plan.

Mandatory procedures:

• inhalation with saline solution;
• rinsing the nasopharynx;
• physiotherapy;
• massage;
• diet;
• plenty of warm drinks.

How to do massage for obstructive bronchitis in children, watch the video:

If bronchitis has infectious origin or the disease is severe, with prolonged high fever, then they may be prescribed antibiotics. Used to relieve bronchospasm antispasmodics(No-shpa or Papaverine).

In case of obstructive bronchitis, under no circumstances should you take antitussive drugs: only expectorants that thin sputum (based on ambroxol) are used.

In severe cases, the doctor may prescribe hormone therapy, sometimes with intravenous administration of Eufilin. Antiviral drugs are effective medicines, for example, Erespal, immunomodulators (Interferon,). For severe allergy symptoms, antihistamines are used.

Required conditions:

• maintaining high humidity in the room;
• regular ventilation;
• adherence to a hypoallergenic dairy-vegetable diet;
• daily wet cleaning of the room;
• frequent and abundant drinking (non-acidic fruit drinks, teas, mineral water without gas).

For obstructive bronchitis in children do not use warming ointments, mustard plasters and essential oils , at high temperatures do not apply compresses or heat. Before starting treatment folk remedies, you need to consult with your doctor and make sure that the child does not have allergies, immediately call your pediatrician and listen to what Dr. Komarovsky says on this topic.

Forecast and preventive measures

With proper and timely treatment, obstructive bronchitis goes away completely and does not recur. But the disease can be recurrent and can lead to serious consequences.

At risk are children prone to allergies, with elevated levels of immunoglobulin in the blood. At frequent relapses obstructive bronchitis develops into asthma.

Preventive measures:

It is very important to observe the correct temperature (18-21C) and humidity (at least 65%). Avoid contact with allergens, do not take your child to crowded places during epidemics, protect from inhaling tobacco smoke, and often walk in the fresh air (preferably in the forest or near a pond).

By following these recommendations, you can maintain your baby’s health and prevent the onset of the disease and the complications it causes. If it was not possible to avoid the disease, then you need to consult a doctor who will determine how to cure obstructive bronchitis in your child.

Need to strictly follow the pediatrician’s instructions and do not try to cure the disease on your own. Is it dangerous. In case of severe disease, do not refuse hospitalization.

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