True and false croup in children. Symptoms and treatment of false croup in children: how to save a child’s life

If for an adult an acute respiratory viral infection, or as it is popularly called a “cold,” goes away in a week, without causing, in addition to snot and malaise, and maybe a cough, any special troubles, then for children it is not such a simple disease. Or rather, a group of diseases. The danger lies in the addition of complications, one of which (it is also one of the most dangerous) is false croup. More precisely, this disease is correctly called acute stenosing laryngitis (OSL) or laryngotracheitis (depending on whether only the larynx or larynx is affected, it is “larynx” and trachea in Latin), it is also sometimes called subglottic laryngotracheitis. In the future, with your permission, I will use the abbreviation OSLT. I think the decoding is already clear.

Croup (from the English Scottish croup - to croak) is an inflammation of the mucous membrane of the larynx, accompanied by wheezing, barking or croaking cough and difficulty breathing (mainly during inspiration). False croup is named so in order to distinguish it from true croup, which is observed in diphtheria and has similar symptoms. With diphtheria, the obstruction of the airways, and therefore the difficulty of air passage, is caused by specific dense films and there is no swelling with it, and the cause is false croup– swelling of the mucous membrane and loose tissue of the larynx and trachea.

False croup is a viral disease of the upper respiratory tract. The infection causes inflammation, swelling and increased production of mucous discharge in the tracheal area in the area of the subglottic space in the area vocal cords. Usually the disease goes away on its own, however, 5 - 10% of children will still need hospitalization. Therefore, there is no need to do anything on your own; always call an ambulance. Most often, croup or OSLT develops in children of the second and third year of life, somewhat less often - in infancy(6 - 12 months) and in the fourth year of life. OSLT rarely occurs in children over 5 years of age and never in the first 4 months of life.

In the occurrence of stenotic laryngitis and laryngotracheitis, the leading role belongs to influenza viruses, parainfluenza, adenoviruses and respiratory syncytial, as well as viral-viral associations. The overwhelming factor causing the inflammatory process in the larynx and trachea, accompanying the development of croup syndrome, is the parainfluenza virus. It accounts for approximately half of all viral OSLTs. Along with viruses, bacterial flora, activated during ARVI or added as a result of nosocomial infection, plays an important role in the development of an unfavorable (severe, complicated) course of OSLT.

Anatomical and physiological features of the children's larynx and trachea (because of them, croup occurs): small diameter, softness and pliability of the cartilaginous skeleton; short narrow vestibule and funnel-shaped larynx; high and disproportionately short vocal folds; hyperexcitability of the muscles closing the glottis; functional immaturity reflexogenic zones and hyperparasympathicotonia. In the mucous membrane and submucosa - abundance lymphoid tissue with a large number of mast cells, blood vessels and poor development of elastic fibers. Unfavorable background factors also play a role: constitutional anomalies (exudative-catarrhal and lymphatic-hypoplastic diathesis); drug allergy; congenital stridor; paratrophy (obesity); birth injury, childbirth by caesarean section; post-vaccination period; sensitization by previous frequent acute respiratory viral infections.

When can a child “catch” the disease?

In the off-season. In winter, everything is clear to parents - it’s frosty outside, they need to dress their child warmer. And with the onset of spring, I really want to throw off my heavy clothes as soon as possible! But the first rays of the sun are deceptive, the air is still cold - and the baby becomes a victim of ARVI. Where respiratory diseases, there is false croup. Or, on the contrary, the warmth has already arrived, and caring mothers are still wrapping their baby up in winter. But on a walk, children either run around like clockwork or sit in the sandbox - and it’s easy for a sweaty child to catch a cold! From this point of view, thaws in the middle of winter are also dangerous.

A virus (most often it is parainfluenza virus type 1, as well as RS virus, adenovirus, influenza viruses, measles), once on the mucous membrane of the larynx, causes its inflammation - laryngitis. Against the background of inflammation, mucus accumulates in the lumen of the larynx, swelling of the fatty tissue and reflex spasm of the glottis occurs, which leads to a narrowing of the lumen of the larynx (larynx stenosis) and, as a result, a sharp difficulty in breathing.
What does it look like? The first manifestations of croup are always sudden. As a rule, they happen at night when the child is already sleeping. And this frightens both the child and his parents even more. During the day, you might notice a slight hoarseness in your breathing, but it is so insignificant that it is barely perceptible to the ear. By the evening, the child becomes lethargic - but who doesn’t become like that after an active day, especially after a long walk? In fact, at this time the virus is already active in the body. In his sleep, the child tosses and turns, it is difficult for him to breathe (after all, swelling of the throat has already begun), he begins to cough. The cough with croup is very characteristic - dry, “barking” or “croaking”. The child breathes more often than usual, up to 50 breaths per minute (the norm at the age of 3-5 years is 25-30). This is how the body tries to make up for the lack of oxygen. The temperature may rise. Very quickly the cough becomes more and more severe, and if at this time the child does not wake up and the parents do not provide urgent help, then there is a high probability of loss of consciousness and suffocation!

OSLT disease comes in 4 degrees:

1st degree stenosis (compensated). Clinically characterized by all the signs of OSLT. With anxiety and physical exertion, there is an increase in the depth and noise of breathing, and inspiratory shortness of breath appears. There are no clinical signs of hypoxemia (excess carbon dioxide in Corvi). Through compensatory efforts of the body, the gas composition of the blood is maintained at a satisfactory level. The duration of laryngeal stenosis ranges from several hours to 1-2 days.

Stenosis of the 2nd degree (subcompensated). Strengthening of all clinical symptoms of OSLT. The characteristic stenotic breathing is clearly audible at a distance and is observed at rest. Inspiratory shortness of breath is constant. Compensation for stenosis occurs by increasing the work of the respiratory muscles by 5-10 times. Retraction is noted yielding places chest at rest, aggravated by tension. Children are usually excited, restless, and their sleep is disturbed. The skin is pale, perioral (around the mouth) cyanosis appears, intensifying during a coughing attack, and tachycardia. The symptoms of 2nd degree laryngeal stenosis can persist for a longer time - up to 3-5 days. They can be constant or have a paroxysmal nature.

Stenosis of the 3rd degree (decompensated). It is characterized by signs of respiratory decompensation and circulatory failure, a sharp increase in the work of the respiratory muscles, which does not prevent the development of hypoxemia, hypoxia, and hypercapnia. External and tissue respiration is disrupted, the level of oxidative processes in the tissues, mixed acidosis appears. General state heavy. Severe anxiety, accompanied by a feeling of fear, is replaced by lethargy and drowsiness. The voice is sharply hoarse, but complete aphonia is not observed. The cough, initially rough and loud, becomes quiet and superficial as the narrowing of the lumen of the larynx increases. Shortness of breath is constant, mixed. Breathing is noisy, frequent, with a sharp retraction of the yielding areas of the chest. In this case, you should pay attention to the severity of the retraction of the lower end of the sternum, which can appear already in the 2nd degree and sharply intensifies in the 3rd degree of laryngeal stenosis. As stenosis increases, breathing becomes arrhythmic, with uneven depth and paradoxical excursions of the chest and diaphragm. Noisy, deep breathing gives way to quiet, superficial. Expressed Clinical signs hypoxemia. Auscultation above the lungs first hears rough wheezing of a wirey nature, then a uniform weakening of breathing. Heart sounds are muffled, tachycardia, paradoxical pulse (loss of pulse wave on inspiration). Arterial hypotension may be recorded.

4th degree stenosis (asphyxia). The condition is extremely serious and is developing deep coma, there may be convulsions, body temperature drops to normal or subnormal numbers. Breathing is rapid, shallow or arrhythmic with periodic apneas. Heart sounds are muffled, bradycardia occurs, and then asystole. Hypoxemia and hypercapnia reach extreme values, and deep combined acidosis develops.
In addition to obstructive respiratory failure the severity of the condition is determined by the severity of toxicosis and the addition of complications. I wrote all this to you not to scare you with horror stories, but to make you realize that croup cannot be treated on its own, it is dangerous for the baby’s life. Call a doctor in any case, even if you think the attack has already passed. OSLT is prone to relapses (repetition of an attack), and may become more severe.

How to get ahead of an attack and what to do?

The first and most important thing is to calm down yourself and calm the child. The child's excitement and crying intensify the cough, which, in turn, intensifies the manifestations of croup, forming a “vicious circle.”
Already when the first symptoms appear (difficulty wheezing, wheezing, the first hesitant cough), it is necessary to pay attention to the climate in the room. There should always be in the house Fresh air- ventilate rooms as often as possible. False croup is a disease in which fresh air is your assistant. After all, it helps saturate the blood with oxygen.
The child must be placed in an elevated position, half sitting, with pillows or a blanket under his head and shoulders.

Free him from restrictive clothing. Unbutton all the collars of your shirt so that nothing can restrict your chest.

Give the child warm liquid to drink. With croup, a child loses fluid quite easily. Therefore, it is very important to give your child water all the time. It is better to give juices than milk. Drinking frequently thins mucus and prevents dehydration.

Don't forget about hydration. Inhalations are one of the main means in the fight against false croup, and a humid atmosphere in an apartment is a serious preventative measure. It’s good if the house already has a humidifier, but if you haven’t made this useful purchase yet, you can make do with improvised means. Wet rags on batteries and water containers in each room are suitable.

Apply mustard plasters to the area calf muscles. This will redistribute the blood to the legs and distract it from the larynx, thus preventing the swelling from getting worse.

If the child heat- Give an antipyretic in an age-appropriate dose.

Call vomiting reflex if breathing stops. It reflexively excites respiratory center, which is located next to the emetic.

Antihistamines (anti-allergy) drugs - to remove allergic reaction and relieve swelling.

Of course, if signs of false croup occur, you should immediately call an ambulance or take the child to the nearest hospital. Do not forget that even an attack that has passed easily can happen again and again. And its consequences are irreversible. While inhalation can still be done at home, tracheal intubation is a complex procedure that requires special conditions And constant monitoring specialists. So if the doctor insists on hospitalization, it is better not to risk the child’s health and take him to the hospital.

Usually the attack lasts 20-30 minutes, and, gradually, the child’s condition improves. If it still hasn’t improved, then let’s hope that the ambulance you called has already arrived, and now professionals will help the child.

Medical treatment is determined by the severity of the stenosis, its duration, as well as the presence of toxicosis caused by ARVI, the age of the child, and his premorbid (pre-painful) state.
For stenosis of the 1st degree, the following is necessary: wide access of air; distraction therapy - mustard plasters on calves and circular hot baths at a water temperature of up to 38-39 degrees. C, copious, frequent warm drink(tea, Borzhom, milk with soda), steam alkaline inhalations(4% solution of sodium bicarbonate with vitamin A, aminophylline, hydrocortisone); antispastic therapy (atropine, papaverine orally in age-related doses); sedatives and hyposensitizing agents (diphenhydramine, pipolfen, etc.), vitamins. If there is no effect - intranasal novocaine blockade, helping to reduce swelling of the laryngeal mucosa and relieve reflex spasm. Already at this stage of stenosis, especially in the presence of fever, it is recommended to prescribe antibiotics. It is advisable to place the child in a room where the air is humidified with steam.

For grade II stenosis, in addition to the above remedies, humidified oxygen is widely used; in order to reduce swelling of the mucous membrane of the respiratory tract - hypertonic solutions IV (20-30 ml of 20% glucose solution, 5-10 ml of 10% calcium gluconate solution); hormonal drugs: hydrocortisone, prednisolone; cardiac medications (strophanthin or corglycon intravenously or digoxin orally), diuretics; neuroleptics (aminazine, promazine, etc.).

For stenosis III degree intravenous prednisolone (1.5-2 mg/kg), with the first dose being half the daily dose; cardiac drugs are more widely used; antibiotics wide range actions (ceporin, tetraolean, etc.), as well as sodium hydroxybutyrate (GHB). If there is no effect, a therapeutic laryngoscopy is performed, during which the mucus is sucked out with a polyethylene catheter, dry bloody crusts are removed, the mucous membrane is lubricated with a solution of ephedrine, hydrocortisone, peach, apricot or Vaseline oil. Sometimes direct laryngoscopy is repeated several times. For grade III stenosis, therapeutic bronchoscopy is also indicated (removal of mucus, pus, crusts, bronchial lavage, intratracheobronial administration of antibiotics), but it must be full readiness to immediate tracheostomy.

If the measures listed above are ineffective, the severity of stenosis does not decrease, and there is a tendency to progress cardiovascular failure(paradoxical pulse is noted - loss of the pulse wave, adynamia, pallor of the skin increase against the background of persistent cyanosis of the lips, limbs, etc.), intubation or tracheostomy is indicated.

The prognosis for grade III stenosis and asphyxia is serious; in grades I-II and early treatment - favorable. I also listed this so that you understand how serious this disease is.
Prevention: prevention of ARVI, especially in children with allergic diathesis.

It should be noted that difficulty breathing due to laryngeal stenosis occurs not only with viral infections. The cause of stenosis can also be diphtheria (the so-called true croup, when diphtheria films formed on the mucous membrane of the larynx sharply narrow its lumen), foreign body, allergic edema, laryngospasm (with a decrease in the level of calcium in the blood), etc. Therefore, only a doctor can determine the real reason difficulty breathing, correctly assess the patient’s condition and determine treatment tactics.

How to prevent croup?

Unfortunately, croup is a viral disease, therefore, antibiotics do not work for it, therefore, their prescription is not justified, as with other viral infections. Try to ensure that your child does not come into contact with patients suffering from any viral infections, follow the basic rules of hygiene, if there is a sick person in the house, if the child has an acute respiratory viral infection, try to give him water as often as possible. Don't use aromatic oils as inhalations, because they can cause severe irritation respiratory tract in a child. Do not smoke near your child, especially around a child who has a respiratory illness.

As a rule, false croup in children is classified as one of those diseases that parents know little about, but which anyone can encounter. Therefore, our task is to talk about it so that everyone understands the specifics of this disease and the features of its occurrence.

The essence of this disease is that the child’s larynx and trachea become the site of localization inflammatory process. These organs have a lot of loose tissue, so when they get into the source of inflammation, they swell quite quickly. As a result, the child cannot breathe.

You need to know that false croup in children does not occur independently, it becomes the result of other diseases ( viral infection, measles, as well as influenza, whooping cough and scarlet fever). Besides, common cause false croup is an allergic reaction. As a rule, such a disease occurs precisely in childhood. This is due to the structural features of the trachea and larynx, which have the shape of a funnel (cylindrical in adults), and these organs in children are much narrower. Additionally, we note that a child’s larynx contains a larger number of blood vessels, which increases the risk of swelling and spasms. False treatment, which needs to be carried out in a hospital, is also related to the age of the child: the younger the child, the more severe the attack.

Medicine distinguishes two types of disease - true croup and diphtheria. In principle, both types cause cough, however, there are significant differences between them. So, with films on the throat, they appear gradually, which is accompanied by an enlargement of the lymph nodes, a strong increase in body temperature, and in the presence of false croup, the attack occurs sharply and rapidly. Moreover, breathing becomes difficult as a result of strong

False croup in children, the symptoms of which are manifested in hoarseness of voice, lethargy, possible increase temperature can occur in every child. Therefore it is important to carry out preventive procedures. As noted earlier, false croup in children occurs against the background of acute respiratory infections, so you need to start with their prevention. One of the most simple ways is gargling. Moreover, you should start gargling with water at room temperature. Its reduction should be gradual. And after a few months it should become almost icy. Remember that it is important to do everything here gradually, without undue haste, so as not to provoke the development of the disease.

It is also necessary to monitor the food that the child eats. After all, false croup in children can be the result of an allergic reaction. It is necessary to increase the level of consumption of dairy products (milk, kefir, cottage cheese).

Remember that if you do encounter this problem, it is important to help your child immediately and independently. First of all, after calling an ambulance and waiting for its arrival, you need to increase the air humidity in the room. Open the windows immediately, then it is better to inhale. To moisturize, you can turn on special humidifiers, and also hang wet sheets and things on the radiators and headboard. It is better to immediately give the child an antihistamine, which will eliminate the allergic reaction, if any.

When the doctor arrives, he must determine the degree of complexity of the stenosis. And if he insists on transporting the child to the hospital, you should not resist this. Because the disease is so insidious that, having relieved one attack, the next one may occur, and even when no one expects it. Therefore, you should constantly keep the child’s condition under control and never exclude the possibility of false croup!

False croup is a disease that most often affects children, and it manifests itself with many signs that are quite easily confused with other ailments. The consequences of the disease can be quite complex, so parents should remember that a lot depends on them - timely contact with a doctor will help to begin treatment immediately. How false croup manifests itself in children, the symptoms and treatment of this dangerous disease, features and unpleasant consequences - it is better to study everything in advance so as not to allow yourself to be taken by surprise.

Symptoms of false croup that should prompt immediate medical attention

Questions that parents often have are what false croup is in children, the symptoms and treatment of this disease, how dangerous it is for the child and whether it will cause irreversible processes in the small body. The first thing you need to know is that this disease is quite serious, and if left untreated, it can lead to dangerous consequences for the baby’s health. That is why it is so important to start treatment as early as possible - the chances of a successful recovery increase several times.

Symptoms of the disease that parents should pay attention to:

night coughing attacks accompanied by shortness of breath, difficulty breathing;
sputum is practically not coughed up, which often leads to injuries to the respiratory tract; blood may be seen in the scanty mucus released;
hoarseness of voice appears;
often coughing attacks turn into severe vomiting;
the child’s skin turns pale, fingertips and lips acquire a threatening blue tint;
temperature rises;
The baby is bothered by a runny nose and severe sore throat.

Already the first signs of the disease should be a reason to go to the doctor - it is strictly not recommended to start treatment on your own.

Treatment of false croup in children with pharmaceutical drugs

It is better to learn from a doctor about how false croup develops in children, the symptoms and treatment of the disease, and what can threaten the baby, who should be contacted at the first signs of the disease. In the presence of complications, treatment should be carried out only in medical institution, under the supervision of specialists. Usually prescribed complex impact on the disease - a combination of several drugs.

Treatment of false croup in children is carried out with the following formulations:

Suprastin, Tavegil (antihistamines);
inhalations with naphthyzine to constrict blood vessels;
diuretics;
Pulmicort (hormonal medicine);
Algirem, Arbidol (antibacterial drugs).

To quickly remove mucus and reduce the intensity of cough attacks, it is likely that the doctor will prescribe antitussive drugs - Ambrobene, Lazolvan. Regardless of which particular remedy was prescribed, the dosage, duration of treatment and number of doses per day are determined only by the doctor. It is strictly not recommended to independently increase or decrease intake or replace medications with analogues.

False croup, treatment at home

If a doctor diagnoses false croup during examination, start treatment at home only with his permission, if complete absence complications. Typically used here pharmaceutical drugs or herbal compositions against cough, which is the main sign of the disease and brings the baby the most suffering.

To treat a cough, you can use pharmaceutical compositions, but you can successfully cope with the disease with gentle traditional methods. For these purposes, you can use a milk-based product that actively causes expectoration. If the last dose of the composition is taken just before bedtime, the child will sleep peacefully throughout the night, without debilitating anxiety attacks.

Preparation:

Bring milk to a boil (200-220 ml).
Remove from the stove, put baking soda (15 g) and a small piece of butter (20 g) into the hot liquid.
Stir the product until smooth.

The baby should drink this remedy in one go. You can give it to your child at least 3 times a day; the next day, expectoration will be more active.

How to help a child if false croup develops, Komarovsky

Often, parents who are caught by surprise begin to panic, not knowing how to alleviate the baby’s condition. There are several recommendations on how to reduce the intensity of the main signs that distinguish false croup; Komarovsky advises doing this:

ensure an influx of fresh cool air(open the windows, take the baby out onto the balcony or street);
let steam into the bathroom and let the child breathe moist air;
hold the baby's legs and arms under warm water, allowing them to warm up;
place mustard plasters on the soles of the feet to allow blood to flow out of the larynx and reduce swelling;
drip any vasoconstrictor into the nose;
Give your child some alkaline milk to drink mineral water or soda.

Another important rule is that if nocturnal attack does not lose its intensity, immediately call emergency help.

Treatment of true croup, how it happens, what is best to use

True croup is one of the most serious diseases that most often affects children, and treatment of this disease is possible only in a hospital. Under no circumstances should you begin to influence warning signs independently, if the doctor has determined this particular diagnosis, treatment of true croup should be carried out comprehensively, and not always by taking medications. Most often for successful fight additional therapy is used for the disease.

Treatment of the disease occurs with the following drugs:

anti-diphtheria serum (injected into a vein or muscle, depending on the stage of development of the disease);
detoxification compounds (if the disease develops rapidly, plasmapheresis may be used);
antiallergic medications;
cardiovascular drugs.

Treatment may vary slightly; everything depends on the development of the disease and the characteristics of the small organism. If the stenosis of the larynx is too obvious, it is possible to perform an operation during which the larynx is dissected and a special tube is inserted to allow the child to breathe.

Treatment of diphtheria croup - how it happens, what is used

Diphtheria croup – serious disease which, if left untreated, can lead to fatal consequences. This is why it is so important not only to consult a doctor in a timely manner, but also not to attempt to treat diphtheria croup on your own - the consequences of this can be too severe.

Treatment should be carried out only in a hospital - the child is contagious, so he should be isolated from others. If there are no complications, the baby is given anti-diphtheria serum, which significantly alleviates the baby’s condition. Simultaneously with the administration of the composition, it is possible to take antihistamines. The length of a child’s stay in hospital depends on the degree of development of the disease, if treatment was undertaken on time and took place without dangerous manifestations, then on full recovery it will take a little time.

When the top Airways a viral infection affects the person, the person’s voice becomes hoarse, shortness of breath appears and barking cough, breathing becomes heavy and noisy. These symptoms are enough for a doctor to diagnose a patient with false croup. The disease mainly affects children from three months to three years.

The disease is classified as dangerous, since death can occur with high probability, if the patient is not provided in time medical care. False croup occurs mainly at night. A calmly sleeping baby suddenly begins to cough. A wheezing occurs in the throat, and the child begins to choke. Similar symptoms scare parents, but this is how false croup begins in children.

False croup - dangerous disease, therefore, it is imperative to know first aid measures and symptoms in which you need to see a doctor

What is false croup?

False croup is a very dangerous disease of the respiratory system, which occurs against the background of an acute respiratory viral infection. Young children most often suffer from manifestations of false croup. This is due to the anatomical and physiological characteristics the structure of their body:

The diameter of a child's larynx is only 0.5 cm. When an infection enters the respiratory system, the walls of the larynx thicken and swell. This causes the airway in the throat to shrink.
The body's response to infection is to produce large quantity mucus. It also reduces the diameter of the paths through which air enters.
Added to all this is a reflex spasm of the laryngeal muscles, which prevents air from entering the lungs in sufficient quantity.

Attacks of false croup occur most often at night. In 90% of cases they go away on their own, but it still happens that a child urgently needs qualified medical assistance, otherwise something irreparable may happen. That is why, in order to avoid such situations, you need to call a doctor as soon as the first signs of false croup appear.

Narrowing of the larynx most often occurs in children aged two to four years. Sometimes six-month or one-year-old infants also suffer from this disease. In children over five years old, the incidence of false croup is not as high. This is due to the peculiarities of the development of the larynx.

Children younger age have a tendency to develop false croup. The reason for this is the following anatomical properties:

short length of vocal folds;
cone-shaped larynx;
the diameter of the cartilaginous skeleton is too small;
overly excitable muscles adjacent to the glottis.

The disease does not appear in all children, but only in those who are included in the so-called risk group. These include children:

boys (they are 3 times more likely to suffer from false croup than girls);
with allergies to medications and food;
with birth injuries;
with congenital narrowness of the airways;
overweight;
have recently been vaccinated;
who get sick very often and for a long time.

The danger of false croup is that due to laryngeal stenosis, it becomes more and more difficult for the child to breathe.

In this regard, the disease has another name - stenosing laryngitis, which is accompanied by a constant narrowing of the lumen of the larynx (we recommend reading:).

Causes of the disease in children

This article talks about typical ways to solve your issues, but each case is unique! If you want to find out from me how to solve your particular problem, ask your question. It's fast and free!

False croup is a viral disease that occurs as a result of damage to the respiratory system. Laryngeal stenosis may be based on:

flu;
whooping cough;
herpes;
mycoplasma;
adenovirus;
scarlet fever;
chlamydia;
measles;
parainfluenza;
RS virus;
chicken pox.

Acute laryngotracheitis can develop against the background of scarlet fever or other viral disease

Except viral causes of false croup in children, microbial ones are also isolated. These infections include:

hemophilic;
staphylococcal;
Pseudomonas aeruginosa;
streptococcal;
enterococcal, etc.

Medical practice has shown that for the development of laryngeal edema in a child, special conditions, which are inherent only to the child’s body. This:

cone-shaped larynx;
high vocal cords;
rapid reaction of the laryngeal muscles to any stimuli due to a high degree of excitability;
the unique anatomy of the larynx and trachea, inherent only in children (due to their softness, they can be compressed by the tissues located around them);
short length of vocal cords;
immature nervous system;
imperfect regulation of reflexes;
predisposition to swelling.

The disease is much more common in boys than girls

False croup is a dangerous disease that does not occur on its own. It appears as a complication after such diseases:

pharyngitis;
adenoiditis;
tonsillitis;
acute rhinitis.

Most often, the disease manifests itself in spring and autumn. It is at this time that children most often suffer from colds, which can result in the development of false croup. The fact is that caring mothers dress their children heavily in the off-season. As a result, kids sweat and catch colds.

In addition to all the above reasons why a child can become a victim of false croup, one more should be mentioned - this is contact with a sick baby. The disease is contagious and can be transmitted by airborne droplets. That is why a small sick patient must be isolated from other children, and all his toys, furniture and other items of use must be disinfected.

Symptoms and stages of the disease

Every attentive parent will be able to suspect false croup in a child even at its first manifestations.

Since this disease is a consequence of infectious diseases, mothers and fathers should Special attention give to a baby who is sick and starts coughing badly. False croup is accompanied by the following symptoms:

stridor (breathing with a sound resembling a whistle) (we recommend reading:);
state of lethargy or overexcitation;
labored breathing;
bouts of coughing that resemble barking;
sinking of the chest wall;
hoarseness in the voice.

In medicine, false croup is divided into several stages. Each of them has its own characteristics. 4 stages of croup:

compensated;
subcompensated;
decompensated;
terminal.

The first stage of false croup is characterized by overexcited behavior of the child, as a result of which he has difficulty breathing. During inhalation, sporadic wheezing occurs, a barking cough begins, and shortness of breath appears. At this stage, oxygen still enters the body in sufficient quantities.

The onset of the disease is accompanied by severe shortness of breath

The second stage (subcompensated) is characterized by noisy breathing and increased shortness of breath. The child becomes even more restless, the cough becomes rougher, and during attacks the skin becomes pale and protrudes. cold sweat, skin the mouth area turns blue. These manifestations indicate that the body is experiencing oxygen deficiency.

At the decompensated stage of croup, lethargy and lethargy become apparent in the child. Noisy breathing is replaced by quiet breathing, arrhythmia, hypercapnia, and hypoxemia appear. The pressure drops sharply, the voice becomes hoarse, and the skin becomes bluish.

The last stage of croup is terminal. child in critical condition. He may have seizures or develop a coma. Blood circulation slows down, which can result in asphyxia. If the child does not receive immediate medical attention, the risk of suffocation is very high.

Diagnostic methods

In order to diagnose false croup in a patient, it is enough for the doctor to:

review your medical history (for example, if symptoms arose as a result of ARVI);
conduct objective examination(commit visual inspection, monitor indicators blood pressure, assess the nature of breathing and heart function, listen to the chest in order to identify whistling dry rales).

Videoendostroscopic examination of the larynx using a rigid endoscope

To confirm the diagnosis, doctors use the laryngoscopy method, which can be used to visually assess the condition of the laryngeal mucosa. For this, a special device is used - a laryngoscope. This method makes it possible to identify redness and swelling of the mucous membrane, as well as narrowing of the laryngeal lumen.

In addition to laryngoscopy, doctors use such additional methods diagnostics like:

microscopic examination of a smear taken from the throat;
bacteriological analysis of a throat smear;
polymer color reaction (makes it possible to detect the causative agent of the disease);
analysis of the acid-base state of the blood and its gas composition (helps to assess the degree of hypoxia);
identification of specific antibodies to identify the pathogen.

Features of treatment

First aid for a child

The child’s speedy recovery depends on timely first aid. False croup is a disease that cannot be delayed.

Croup may be the culprit serious complications. That is why, as soon as the first symptoms of the disease appear, it is necessary:

call an ambulance;
provide the baby with an elevated position (sit him in his arms or put him on the bed);
calm the child;
ventilate the room and humidify the air in it;
give your baby plenty of warm drinks;
provide access to cold air (you can wrap up the child and go out with him to the balcony or, alternatively, bring the baby into the bathroom, in which the tap with cold (not hot!) water is open);
Prepare a warm foot bath for the child (for reflex vasodilation).

An attack of croup can be stopped by pressing on the root of the tongue. The same effect will be obtained if the baby is tickled under the nose. It is important to know that any steam treatments(for example, inhalation or rubbing) are strictly prohibited for this disease.

Hospital treatment

The main treatment for false croup in a child is carried out in a hospital setting. It consists in:

preventing further attacks;
relieving swelling;
fight against the inflammatory process.

Therapy that can only be prescribed qualified specialist, includes:

injections with hormonal drugs(help relieve swelling of the larynx);
inhalations with Naphthyzin and saline (make breathing easier);
anti-infective treatment (antibiotics and antiviral drugs);
sedatives (to calm the baby);
diet and drinking plenty of fluids.

For false croup, one of the methods of complex treatment is inhalation

If the stenosis occurs in a severe stage, the patient undergoes tracheal intubation with the installation of a breathing tube. IN extreme cases(if suffocation occurs), a tracheotomy is performed with the installation of a breathing tube.

Therapy at home

If treatment takes place at home, then all doctor’s recommendations must be strictly followed. The patient needs:

provide fresh air (ventilate and humidify the room where the baby is);
give an alkaline drink or medicines, promoting the removal of mucus from the respiratory system;
do not feed food that can irritate the walls of the throat;
give throat soothers;
use (strictly as prescribed by your doctor) antihistamines to relieve swelling and relieve cough;
in case of severe stenosis, give anti-inflammatory drugs;
give antifungals and antibacterial agents if an infection is detected.

The child's room should always be well ventilated and humidified

Preventive actions

Preventative measures that will help prevent false croup include:

False croup (from the Scottish “croup” - to croak) is an acute inflammatory process of the larynx, which in humans develops against the background of infection. This disease leads to a narrowing of the lumen of the larynx, and as a result, difficulty breathing. The prefix “false” is added to distinguish it from true croup (diphtheria), which has very similar symptoms.

In otolaryngology it is also called:

stenosing laryngotracheitis,
acute laryngeal stenosis,
subglottic laryngitis,
subglottic laryngitis.

Most often, false croup is in modern world occurs in children aged 1 to 3 years, which is due to insufficient large sizes and funnel-shaped larynx, as well as loose fiber subglottic area. The incidence is seasonal, peaking at the beginning of winter.

Children school age do not suffer from false croup. In adult patients, only the diphtheria form of croup is noted.

Causes

This disease usually develops as a complication of an upper respiratory tract infection, such as influenza virus, ARVI, pharyngitis, acute rhinitis, measles, scarlet fever, chicken pox, herpes, whooping cough, etc. It can also begin during an exacerbation of chronic tonsillitis.

False croup bacterial etiology(streptococci, Haemophilus influenzae, pneumococci, staphylococci) has a more severe course of the disease and is much less common. It occurs as a complication of pharyngitis.

The development of this disease is promoted by:

weakened state of the child’s body due to birth trauma,
artificial feeding,
decreased immunity,
avitaminosis,
fetal hypoxia suffered during childbirth,
short vocal cords,
abundance of lymphatic formations in the mucous membrane,
diathesis,
rickets.

Unlike laryngitis, with false croup the inflammatory process is accompanied by stenosis of the larynx, which leads to disruption of the passage of air into the respiratory tract. Insufficient oxygen supply to the body initial stage diseases can be compensated for by more intense breathing and hard work respiratory muscles. In turn, clearly defined stenosis already leads to oxygen starvation(hypoxia), resulting in disruption of work of cardio-vascular system and CNS.

Symptoms

Clinical manifestations consist of a triad of symptoms:

hoarse voice,
"barking" dry cough,
heavy and noisy breathing.

Viral croup begins suddenly, and often begins to show the first signs during sleep. The disease may be preceded by malaise, hyperthermia, weakness, mild runny nose and cough.

Degree of severity of signs of stenosis:

Compensated. It includes all those symptoms that appear only under certain physical activity, i.e. shortness of breath when inhaling (inspiratory). In this case, the blood gas composition is normal.
Subcompensated. Increased symptoms begin to appear even at rest. In order to inhale, you have to use additional muscles, due to which respiratory process accompanied by noise that can be heard at a distance. There may be cyanosis around the mouth and pale skin, and the patient may be restless and agitated. This condition of the child continues for 3-4 days and can take the form of pronounced attacks. It is best to start treatment at this stage to avoid adverse consequences.
Decompensated. Main sign the onset of this stage - sharp deterioration condition. This is due to dramatic changes in gas composition the patient's blood. All symptoms take on a permanent character and noticeably increase: shortness of breath intensifies, a more restless state is observed, periodically replaced by drowsiness, breathing is irregular (arrhythmic), cough is superficial.
The terminal stage is asphyxia. The patient's condition is extremely serious. Breathing periodically stops, and coma may develop due to a severe lack of oxygen in the blood.

Diagnostics

To diagnose treatment, you will need the help of an otolaryngologist, therapist or pediatrician. If complications are observed in the bronchi or lungs, the patient will also be referred to a pulmonologist. In the presence of laryngeal tuberculosis, the examination is carried out jointly with a phthisiatrician, in case of syphilis with a venereologist, respectively.

To diagnose croup you will need:

characteristic clinic,
laryngoscopy and auscultation data,
medical history,
additional research.

Auscultation of the lungs allows you to listen to dry wheezing rales. Wet wheezing indicates worsening painful condition. The laryngoscopy picture will allow you to assess the extent of the inflammatory process, how much the larynx is narrowed, and also reveals fibrinous films that are characteristic of diphtheria. Microscopy and analysis of throat smears (bacteria culture) make it possible to verify the causative agent of the infection. Syphilis is detected using the RPR test. A blood test allows you to judge at what stage of the disease the patient is.
If complications develop, the child must undergo otoscopy, pharyngoscopy, chest x-ray, lumbar puncture or rhinoscopy, depending on the nature of the complications.

With whooping cough, retropharyngeal abscess, bronchial asthma and laryngeal tumors, differential diagnosis of croup is carried out.

Treatment

If a patient has true croup, he is immediately transferred to infectious diseases department stationary clinic. Depending on the severity of the condition, immediate treatment is carried out by administering anti-diphtheria serum intravenously or intramuscularly. Detoxification treatment is also used, which consists of administering a solution of glucose, cocarboxylase and glucocorticosteroids (according to indications) using a dropper. In case of severe intoxication, extracorporeal hemocorrection methods can be used.

False croup can be cured by taking a course of antihistamines, antiseptics and sedatives. If you have a dry cough, you should take antitussives such as oxeladine, glaucine, codeine, prenoxdiazine, and if you have a wet cough, take mucolytics (ambroxol, carbocisteine, acetylcysteine).

The administration of glucocorticosteroids is necessary in the most severe cases of decompensated laryngeal stenosis. Viral croup can be treated with antiviral drugs (proteflazid, interferon alfa-2b). Bacterial false croup or threat re-infection require antibiotic therapy. An antibiogram during bacterial culture will help you select the most appropriate antibiotic. If there are signs of hypoxia, oxygen therapy is performed.
Pronounced stenosis of the larynx, in which there is a threat of asphyxia, is an indication for tracheotomy.

On early stages For treatment, inhalations with saline solution are quite sufficient. More severe stages require emergency medical and sometimes surgical intervention.

Prevention

Since false croup is of viral origin, taking antibiotic drugs cannot prevent the development of the disease. The tendency to pathology of this type is due solely to the congenital predisposition of the patient and the characteristics of the virus that caused the disease. Therefore any specific methods There is no prevention yet.

General prevention:

avoid all contact healthy child with infected patients
observe the rules of hygiene,
maintain normal humidity in the children's room,
drink purified water,
Avoid the presence of strong odors in the immediate vicinity of children.

To prevent true croup and diphtheria, mass vaccination of children (from 3 months of age) is carried out.