Laryngotracheitis or false croup in children: symptoms and treatment, first aid and general recommendations. Causes of false croup and risk factors

A fairly common syndrome during a viral or, less commonly, bacterial respiratory tract infection is false croup in children. Its danger lies in the rapid, and sometimes lightning-fast development, the need to take certain measures even before the arrival of the medical team. Children from one to 5 years of age are most susceptible to it, especially those who have suffered birth trauma, hypoxia during childbirth, or those who are artificially fed.

But even absolutely healthy, rarely ill children can suffer from false croup: an excessive immune response to the introduction of certain viruses and bacteria into the mucous membranes of the respiratory organs is assumed.

False croup- this is a lack of air intake into the child’s body, caused by a narrowing of the glottis due to edema. A child’s larynx is narrow (from 0.5 cm), and during infection its walls thicken and swell, which significantly reduces the lumen of the windpipe. Increased mucus production in response to infection also reduces the diameter of the airway. In addition, a reflex spasm of the ligaments is often associated, which makes it difficult for air to enter the lungs.

The cause of false croup is catarrhal diseases: ARVI, and parainfluenza (most often), scarlet fever,. If microbes from the tonsils penetrate into the larynx during a sore throat, false croup may develop. bacterial origin. It occurs less frequently than viral cereals, but is no less difficult to tolerate.

Children who are prone to allergies are predisposed to developing croup during an infectious disease.

Important! Unlike true croup, when an obstacle to the movement of air is created by dense diphtheria films blocking the throat, false croup occurs precisely because of the narrowing of the glottis.

Most often, false croup in children is an acute and ongoing condition. A subacute (gradually developing) course is observed in children with chronic processes - tonsillitis, adenoids, nasal polyps, and oral diseases. In this case, the symptoms of the disease are not detected immediately, but appear gradually, the body adapts to new conditions before the condition becomes more complicated. Therefore, laryngeal stenosis is often not detected immediately. Children with a clear picture of croup in subacute development feel satisfactory when acute course the condition is severe.

False croup in children: symptoms and treatment

Symptoms of false croup and stages of development of the syndrome

The main sign is that the likelihood of development with respiratory disease false croup is large, - respiratory failure. The slightest signs shortness of breath should alert parents, force them to be on alert, and take preventive measures.

Croup can occur suddenly, develop quickly and short period time to overcome the path from a mild illness to a severe irreversible condition. But in most cases it does not reach the terminal stage; from the bright manifestations of the disease the body returns to original state just as quickly. But for this you need to know the symptoms and be able to help the child in time.

False croup occurs in 4 stages. If timely measures are taken, negative dynamics can be stopped at stages 1–3. Symptoms of the disease are shown in the table.

Stage I. Compensation

Breathing features: shortness of breath only during emotional or physical stress. It is expressed not so much by increased breathing, but by lengthening the inhalation, the disappearance of the pause between inhalation and exhalation.

Feeling satisfactory, symptoms of the underlying disease (fever, cough, runny nose, etc.)

Outcome: Recovery or transition to the second stage.

Stage II. Subcompensation

Features of breathing: shortness of breath, even at rest, rapid breathing. Inhalation is difficult and accompanied by wheezing. To ensure breathing, auxiliary muscles are activated - the muscles of the chest, abdomen, and when inhaling, the wings of the nose inflate. Cyanosis (blueness) of the nasolabial triangle. Rough barking cough.

The child is restless, touches the collar of his shirt, feels afraid, and cries.

Outcome: Reverse development of the syndrome or transition to the stage of decompensation.

Stage III. Decompensation

Features of breathing: suffocation, paradoxical breathing - superficial and infrequent, pallor of the skin.

The child is lethargic, apathetic, there is no activity, the consciousness is unstable, confused.

Important! Spontaneous resolution of the syndrome at this stage is rare; urgent assistance is required.

Stage IV. Terminal

Features of breathing: respiratory arrest and drop in cardiac activity.

Increased pallor, loss of consciousness, involuntary passage of urine and feces.

Outcome: Clinical death.

Treatment of false croup syndrome

At the first signs of shortness of breath, it is necessary to take measures to stop the attack and eliminate the conditions for its development. The patient's parents should:

• Call immediately ambulance– if croup is suspected, the child needs medical examination and, based on the results, hospitalization or outpatient treatment;
• Create a calm atmosphere around the patient - do not shout, do not even talk loudly, express confidence in your behavior that the situation is under control;
• If the patient is frightened, take the child in your arms, do not leave him alone in the room - nervous tension causes a reflex contraction of the ligament muscles, which aggravates the situation;
• Ensure an influx of cool, moist air - it is best to open a window, even in winter (wrap up the child first) - cool air reduces the volume of mucous membranes, and moisture dilutes the secretions;
• You can carry out inhalation using a nebulizer - inhaling cold steam will improve the child’s condition;
• If an inhaler is not available, the child is taken into a bathroom filled with steam (it cools in the air), where it is useful to perform distracting foot baths.

These are simple, but urgent measures should help stop the development of false croup and wait for the arrival of doctors.

Important! In most cases, doctors suggest hospitalization - you should not refuse it: only in a hospital setting is it possible to provide round-the-clock qualified monitoring of the development of the disease.

Prevention of false croup

False croup is a disease of young children. This condition can occur in one child more than once, as a relapse during one illness or during the next illness.

And in adults and children over 6 years of age, croup is extremely rare, as is the case in infants under one year of age. To the younger one school age the danger of a severe development of events is very unlikely - the experience of overcoming various childhood illnesses takes its toll.

Since false croup in children occurs during infectious diseases, it is obvious that it is necessary to ensure that the child gets sick less. However, this does not mean that isolation is necessary to prevent infection. In children, whose immunity is rarely associated with infection, the body's reaction to accidental contact with a pathogen, even the most trivial one, may be excessive. And this is a direct road to the croup.

The most important thing is hardening the body. It is necessary to ensure that the temperature change environment, wind or draft did not become a problem or cause of infection. From the first days of life, children should breathe clean air, walk a lot every day, and be active. Warm and dry air irritates the respiratory tract more than frosty air. Nutritious food will ensure proper metabolism and development appropriate for age.

Contact with peers will teach the immune system to respond correctly to germs and viruses, most of which will not harm the child. These measures, of course, do not guarantee that the child will avoid croup, but it will be easier for the body (and parents) to cope with it.

Remember that only a doctor can make a correct diagnosis; do not self-medicate without consultation and diagnosis by a qualified doctor. Be healthy!

545 02/13/2019 6 min.

Scientific name false croup, a common childhood disease - acute stenosing laryngotracheitis. This is a very dangerous disease of the upper respiratory tract, which can have quite serious consequences. False croup occurs more often in the cold season, when the child is most susceptible to attack by microbes and colds. In the article we will consider the features of this disease, its causes and symptoms, how to treat and provide emergency care.

Laryngotracheitis is caused by viruses and bacteria such as:

• Pseudomonas aeruginosa;
• enterococcus;
• staphylococcus, including aureus;
• hemophilus influenzae;
• various E. coli;
• streptococcus.

These are the bacteria and microbes that are directly responsible for the development of laryngotracheitis in a child.

Prerequisites for the disease

What factors in the anatomical structure of the baby can lead to the appearance of false croup.

• A peculiar funnel-shaped larynx. This form is typical for the vast majority of children. As the baby grows, this form changes to that of an adult.
• The narrowed lumen of the larynx often becomes an aggravating factor, which leads to the development of false croup.
• If the vocal cords are high, this also complicates the baby’s health.
• Looseness and therefore vulnerability of the connective tissue of the larynx is a factor leading to rapid development viral infections.
• Weak respiratory muscles.

Causes of the disease

Why a child may develop false croup. Let's consider what its reasons are.

False croup - no independent disease, but a complication after major infections. Rescheduled adenovirus infection, as well as influenza, whooping cough, scarlet fever or measles may well provoke the development of laryngotracheitis. This happens, as a rule, in the case of advanced or untreated underlying disease. Chickenpox can also cause complications in the form of false croup.

The narrowing of the larynx, characteristic of false croup, often manifests itself as a reaction to the toxins with which the viral infection “bombards” the baby’s body.

It should be noted that false croup is an exclusively childhood disease, since the child’s respiratory tract is not yet sufficiently developed. And this specific “children’s” structure of the bronchi, as well as a huge number blood vessels and located nearby lymph nodes cause the child to develop false croup.

Most often, cases of the disease occur during transition periods - autumn, spring. It is in the off-season that a child has the greatest chance of catching an unpleasant cold and false croup as its complication. In addition, mothers often wrap their children up excessively in the spring or fall, causing them to sweat and then catch a cold.

False croup- the disease is contagious and is transmitted, like most of them - by airborne droplets. Therefore, contact of a sick child with other children is excluded. It is also necessary to disinfect toys, household items and furniture in the baby's room - the risk of infection remains when using common things.

Video of false croup in children: symptoms and treatment:

Risk factors

In what cases is it most likely that a child will develop this disease?

• Boys get sick more often than girls. Incredible, but this is a real documented fact. Moreover, boys get sick twice as often as the weaker sex.
• Congenital narrowing of the airways often leads to the onset of the disease.
• If the child is prone to colds and suffers from them for a long time, then there is a high risk of developing false croup as a result of one of the colds.
• Childhood obesity under three years of age can also lead to the disease.
• Various allergies to food or medicine are a complicating factor in children's lives.
• If there was a birth injury, the child becomes especially vulnerable.

Symptoms

It should immediately be noted that attacks of this disease are, as a rule, quite threatening in nature. And if medical care is not provided, the consequences can be dire. How exactly does false croup manifest itself in children?

During the day the child breathes heavily, with slight hoarseness. But since this condition does not bother him much, parents usually do not worry much for the time being. But it is very important to know.

At night, an attack of suffocation may begin. It is night attacks of asphyxia that are characteristic of this insidious disease. Night dyspnea is characterized by a number of breaths of about 50, while average rate - 35.

Shortness of breath is usually accompanied by a cough, which becomes sharp and barking. The body tries to use it to remove mucus accumulated in the upper respiratory tract.

If croup is complicated by an infectious disease or a cold, then along with the listed symptoms, the temperature may also rise. Sometimes it can rise to 40 degrees. Allergy, in combination with croup, will manifest itself as itchy, very disturbing rashes.

On video symptoms false croup:

The cervical lymph nodes increase in size, the child has no appetite.

The symptoms listed are related to mild stage false croup. Subsequent signs of the disease may be more dangerous.

These include:

• Nervous inhibition or, conversely, extreme excitement.
• Fingers and lips turn blue.
• Cardiac activity is activated, the pulse quickens.

If these symptoms appear, the child's condition requires immediate attention. In this case, parents need to call doctors and begin providing first aid.

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Urgent Care

How parents and loved ones can alleviate the condition of a child suffering from false croup.

It must be said right away that if you notice a child’s characteristic hoarse shortness of breath during the day, call medical help immediately, without waiting until night, when a severe suffocating attack may occur. It is better to prevent illness or make a mistake than to force a child to experience such painful attacks.

Methods of providing emergency care to a child

If an attack of false croup begins, the child breathes with difficulty, he is most likely very frightened by this. Therefore, it is necessary to calm the baby, pick him up, rock him: do everything to ease his uncomfortable psychological and physical state.

The larynx must be cleared of accumulated mucus. The best way to do this is to induce vomiting by pressing on the root of the child's tongue.

In the bathroom, fill the bathtub with baking soda. This will help humidify the air in the room and warm it up. Bring your child to the bathroom and sit him on a high chair. At the same time, his legs should be in a basin with warm water. The water should be closer to hot than cool. Such a temperature as the child can tolerate.

Video of emergency care for false croup:

You can give your baby an antispasmodic tablet. No-shpa or papaverine will do.

If the case is very severe, the child’s condition is of serious concern, and the doctors are still not coming, you can inject a 20% glucose solution and 10% calcium gluconate. Prednisolone administered intravenously is also an excellent way to alleviate the baby’s condition.

But if you don’t know how to give injections, then it’s better to wait for the doctors without risking the child’s already serious condition.

Treatment

The famous doctor Komarovsky has repeatedly stated that false croup can be cured most effectively when the symptoms and treatment correspond to each other. He says that antibiotics, which doctors usually prescribe for false croup, are not always necessary, and more gentle methods can often be used.

Komarovsky is in favor of carrying out treatment in more natural ways, taking into account all the manifestations of the disease, its stages and level of complexity. Antibiotics, Komarovsky believes, should be prescribed to a child only when there is a danger of developing a bacterial infection in the body, or it has already begun.

On video how to treat false croup in children:

Treatment methods:

• The child must always lie in bed. No games, walks or other active activities.
• In the event of a suffocation attack, the baby must be calmed down.
• Inflow required in the room fresh air. While the child is being ventilated, the child must be taken out of the room.
• To prevent the mucous membranes of the larynx from drying out during shortness of breath, an excellent solution would be to humidify the air with a steam generator or a special humidifier. If you don’t have these devices in your house, you can spray water into the air from a spray bottle.
• The child should drink more. In this case, the sputum dilutes faster and, accordingly, it leaves the respiratory tract faster.
• Inhalations with alkaline compounds will help alleviate the child’s condition.
• Cough suppressants are necessary if shortness of breath is accompanied by a dry cough.
• Pulmicort injections help in most cases both in the treatment of laryngotracheitis and in relieving acute symptoms.

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Prevention

What measures can be taken to reduce the risk of developing false croup.

Every effort should be made to ensure that the baby gets fewer colds and suffers from seasonal infections. To do this you need:

• Do not take your child to places where there is a risk of contracting an infection - crowded places, shops, hospitals. If someone at home is sick, it is necessary to limit the child’s communication with him.
• Don't wrap your baby up. Overheating often leads to a child getting sick.
• A proper nutritious diet is the key good health And normal development baby. Include vitamins, vegetables, herbs and fruits in your menu.
• Hardening helps the child get sick less. Carry out hardening activities according to his age.

On video prevention false croup in children:

It is imperative that colds be treated promptly. Don't start the disease. If left untreated, the risk of developing false croup increases many times over. Methods:

• During cold infections the child must be in bed.
• Ventilation and wet cleaning can clean the air and destroy many pathogenic microbes.
• Air humidification is a wonderful measure that can significantly reduce the risk of developing false croup, and simply alleviate the baby’s condition.
• Smoking is prohibited in the areas where the baby is.

As you can see, false croup is a rather dangerous childhood disease. We reviewed the main signs, symptoms, methods of treatment and prevention of this disease. Monitor your child's condition carefully so as not to miss warning signs. Conduct preventive measures and completely cure colds - and the risk of developing false croup will be reduced many times over.

None of the children are immune from such a serious complication as false croup. Syndrome with stenosis (narrowing) of the larynx can occur suddenly against the background of any viral disease, severe cold and even allergies. About how and why false croup develops and how to help your child necessary help, we will tell you in this material.

What is it?

Croup may develop as a complication during severe inflammation larynx. Its occurrence is always closely associated with severe swelling of the tissues, their increase in size, and, as a consequence, narrowing of the larynx in the narrowest place - in the area vocal cords.

True croup is swelling and difficulty breathing only in the area of ​​the ligaments; it occurs with diphtheria. False croup is very common and more reasons for occurrence. It is less dangerous than the true one, but if not treated in a timely manner or provided with incorrect assistance, it can also lead to death.

In children, the respiratory system has certain age-related differences that contribute to the development of croup. Their airways are loose and narrow, the larynx is smaller in size and proportions than in adults. As a result, severe swelling that accompanies, for example, laryngitis or laryngotracheitis can literally “cut off” the child’s oxygen.

At risk for this complication with ARVI, influenza and other frequent and typical childhood diseases, – children from birth to 3 years. This age group accounts for more than half of all reported cases of false croup. After 6-7 years of age, children are at much less risk of suffering from such a complication, and after 10 years of age, the risks are practically reduced to zero.

Reasons

Most often, the cause of the development of false croup is the parainfluenza virus, other pathogens of acute respiratory viral infections, influenza, and acute respiratory infections. The most severe forms of complications with stenosis are caused by influenza viruses of strains A and B, and, of course, adenoviruses. Bacteria themselves rarely cause inflammation and swelling of the larynx and adjacent areas respiratory system. But they can join as a secondary infection.

Croup rarely develops independently. In 99.9% of cases, false croup acts as a complication of rhinitis, pharyngitis, laryngitis, chickenpox, scarlet fever, as well as chronic tonsillitis in the acute stage. As associated factors we can consider a weak or weakened immune system of a child who, due to age and previous underlying disease, cannot resist the spread of the inflammatory process, prematurity, rickets, as well as others systemic diseases that the baby may have.

What distinguishes false croup from most diseases of the respiratory system is its ability to cause stenosis, in which the larynx closes critically and sometimes completely, preventing the child from breathing.

Muscle spasms only worsen the stenosis. And the mucus, which the mucous membranes actively produce during the inflammatory process, “complements” this alarming picture and creates an additional obstacle to the passage of air into the lower respiratory tract.

False croup can develop in stages, or it can stop at one of the stages and begin reverse development. Obstructive syndrome at the initial stage it causes mild oxygen starvation, but the child’s body, which knows how to compensate for everything, gives depth and richness to breathing and compensates for the condition as best it can.

If the swelling increases and the stenosis becomes more pronounced, the stage of decompensation will begin. Oxygen deficiency will hit cardiovascular system, kidneys and brain. This may cause severe consequences up to asphyxia or death from cardiovascular failure.

Species

False croup caused by inflammation of viral origin will be called viral, and if stenosis is a consequence of bacterial infection, then croup will be called bacterial.

However, information about the pathogen will be secondary; the doctor will put other information first - what type of croup does the child have according to the degree of complexity and severity of the stenosis.

According to this sign, false croup occurs:

• First degree. This is a compensated stenosis, in which the child experiences shortness of breath during activity, movement, or exertion. Inhalation is more difficult than exhalation.
• Second degree. This is croup with subcompensated disorders, in which shortness of breath appears in the child not only during exertion, but also at rest.
• Third degree. In this condition, oxygen starvation develops, shortness of breath is severe, lips may begin to turn blue, and the skin may turn pale. The child has noticeable difficulty breathing.
• Fourth degree. This is the last and most severe degree of complication, in which deep hypoxia develops, which can become fatal. All organs and systems of the child’s body suffer, and primarily the brain and nervous system. Some changes, even if the child can be saved, will be irreversible.

Symptoms

False croup does not develop from the very beginning of the underlying disease. Usually, the first signs of laryngeal edema with stenosis begin 2-3 days after the onset of the disease. Parents can spot warning signs based on the most important things: diagnostic symptom- the appearance of a dry barking cough, which is often called “seal barking.”

The cough is very rough and hysterical in nature. As the edema develops, hoarseness may appear, but the voice does not completely disappear with false croup, as happens with true, diphtheria. When crying or coughing, the voice will become louder, and this is one of the main differences between false croup and true croup.

Another characteristic feature- noisy breathing. It changes from the first minutes of croup development. It becomes dry, whistling, the degree of sound effects directly depends on the degree of narrowing of the larynx, on the stage of stenosis. In the initial compensated stage, shortness of breath will be insignificant, whistling will be episodic. At the second stage, shortness of breath will become dry and frequent, it will prevent the child from sleeping and concentrating, the first vascular disorders will begin - paleness of the skin will appear.

At the third decompensated stage, hoarseness and heart rhythm disturbances appear. The child ceases to be active, he is very drowsy, lethargic, because he experiences severe oxygen starvation. The baby may experience hallucinations, delusions, and episodes of loss of consciousness. At the last stage of false croup, the most characteristic symptoms- barking cough and wheezing when inhaling. The child's blood pressure drops and may appear muscle cramps, consciousness leaves him, plunging the baby into a hypoxic coma.

Most often, attacks of false croup occur at night. They are accompanied not only by severe shortness of breath and a suffocating cough, but also panic fear, crying, worrying child. The baby definitely needs emergency help.

Diagnostics

WITH correct definition Children's doctors usually have no problems diagnosing it. Complaints about the underlying (usually viral) disease, cough, runny nose, high temperature, shortness of breath will definitely force the doctor to listen more carefully to the child’s lungs. By the nature of wheezing, false croup is unlike any other disease; it is almost impossible to confuse it.

To verify the viral origin of the disease, as well as to identify possible bacterial infections who could join, take a swab from the throat for bacterial culture. If the doctor has reason to believe that the child has developed hypoxia caused by false croup, he will definitely conduct an analysis of the oxygen content in the blood, the so-called ABS (acid-base) test.

See the place of narrowing of the larynx, and also evaluate possible complications, helps x-ray. X-rays of the lungs and paranasal sinuses are prescribed.

Urgent Care

During an attack with false croup, you need to be able to provide emergency assistance correctly and quickly. It consists of immediately calling an ambulance. While the doctors are traveling, parents should try to calm the baby, because the inability to take a full breath frightens him, and during fright, the muscles spasm and respiratory failure becomes even more severe.

The child must be put to bed and covered with a warm blanket, all windows and vents in the house must be opened, and, if necessary, the child must be taken to the balcony so that he has constant access to fresh air. The flow of oxygen significantly improves the child’s condition.

Your baby can be given one dose of an antihistamine, approved by age and in strict accordance with age-specific dosages. It could be "Suprastin", "Loratadine", "Tavegil". These drugs help to quickly reduce tissue swelling, and as the swelling decreases, breathing will become more free.

No other drugs need to be given, with the exception of antipyretics if the child has a high temperature. In order not to complicate his already serious condition with febrile convulsions, after the thermometer shows a temperature above 39.0 degrees, you need to give "Paracetamol" or "Ibuprofen", but should be avoided acetylsalicylic acid ("Aspirin"), since it can lead to the development of Reye's syndrome in children.

This is where first aid ends. All other manipulations are performed by a doctor. In severe forms of false croup, the child may need intubation. Therefore, it is impossible to refuse hospitalization under any circumstances. Once removed, an attack of false croup may well return within a few hours, but it will occur again even more severely and rapidly.

Treatment

Mild false croup can be treated at home. Pathology medium degree are treated in a hospital, severe croup requires ward conditions intensive care.

• Mild degree. One of the most available ways Treatment of false croup in a mild stage with minor stenosis is inhalation. To carry out such procedures, it is best to use special devices - inhalers. Unlike a pot of potatoes or a bowl of boiling water, steam inhalers, when used correctly, do not cause burns to the respiratory tract.

If you have croup, you should not give your child inhalations with herbal and essential components. They are irritants and can increase the degree of stenosis.

For inhalation, it is advisable to use ordinary water vapor or saline solution. A nebulizer for croup is ineffective, since its principle of operation is to deliver fine particles medicinal substance to the lower respiratory tract (bronchi and lungs).

A doctor must prescribe inhalations. A child with false croup, even if expressed in a very mild and mild stage, must be observed by a specialist, since the line between mild stenosis and critical narrowing of the airways is too thin.

As the main treatment, drugs necessary to treat the underlying disease are prescribed. Usually these are some antivirals(if necessary - "Tamiflu", other drugs - at the request of the parents, since most modern antiviral drugs do not have proven effectiveness), vitamins, antipyretic drugs based on paracetamol. You can use a solution to gargle a sore throat. "Derinat".

• Average degree. It is best to treat false croup with severe shortness of breath and incipient hypoxia in a hospital, since the therapy will use quite serious medications, many intramuscularly and intravenously. Usually for removal respiratory failure use glucocorticosteroid hormones such as Prednisolone or Dexamethasone. In addition, the child is prescribed anti-inflammatory drugs, mainly non-steroidal, as well as intravenous solutions with nutrients, vitamins. Separately, it is worth mentioning the application vascular drugs, the introduction of which makes it possible to reduce negative impact oxygen starvation on the child’s brain and nervous system.

Dose "Dexamethasone" for medium-light false croup it is 0.6 mg per kilogram of the baby’s weight. If the symptoms are not too pronounced, taking the drug by mouth is allowed. With moderate severity of croup, the drug in the same dosage is most often administered intramuscularly.

For children with such false croup, inhalation with epinephrine is often performed. In this procedure, a nebulizer is used to disperse the medicine ( "Epinephrine") into very small particles that quite easily penetrate the bronchi, trachea and lungs. Most often, this helps avoid intubation. However, such treatment causes heated discussions among doctors - some experts claim that inhaling adrenaline is a placebo effect, others are confident that this is an excellent way to relieve an attack of respiratory failure. This inhalation is carried out in a hospital, since the child after it needs to be under medical supervision for several hours.

• Severe degree. In severe forms of false croup, staying in the intensive care unit is indicated until the threat of suffocation has passed. The child is then transferred to general department. Treatment consists of administering "Dexamethasone", inhalations with adrenaline, as well as oxygen supply from the outside. Every tenth baby with severe false croup requires endotracheal intubation. During the manipulation, a special tube is inserted into the trachea, which provides artificial patency respiratory tract.

However, not everything is so simple. Quite often the tube, like foreign body, injures the inflamed area of ​​the respiratory system, and then the so-called subglottic stenosis develops. That is why it is recommended to remove the tube as soon as the child begins to breathe on his own, without leaving it in the trachea “just in case.”

False croup (acute laryngeal stenosis, laryngotracheitis) is a special condition that develops mainly against the background of acute respiratory infections. It is called false in order to differentiate it from true croup, which develops with diphtheria and has similar symptoms (difficulty breathing, barking cough, hoarseness). Most often, children 1-5 years old are affected by laryngotracheitis.

The disease can be life-threatening for the child, so at the first sign of it, urgent qualified help is needed.

Reasons for appearance

In most cases, the development of false croup is facilitated by viral infections:

• flu;
• adenovirus;
• herpes.

Laryngotracheitis of a bacterial nature is less common, but it occurs in children in more complex forms than the viral one. Bacteria that can cause false croup:

• hemophilus influenzae;
• staphylococci;
• streptococci;
• pneumococci.

The disease can occur as a complication:

• tonsillitis;
• rhinitis;
• adenoiditis;
• after vaccination.

A special risk group includes children with overweight and a tendency to allergic reactions. False croup often develops in children who have had:

• birth trauma;
• hypoxia;

The peak incidence of laryngotracheitis in children under 5 years of age is due to anatomical features the structure of their respiratory organs. According to statistics, girls suffer from false croup less often than boys. After 6-8 years, children “outgrow”, false cereals disappear.

Classification and types of disease

By its nature, acute laryngeal stenosis can be viral or bacterial. According to the flow - complicated and uncomplicated.

There are 4 degrees of false croup:

• compensated (1st degree)– characterized by difficulty in inhaling during physical activity or stress;
• subcompensated (2nd degree)– difficulty breathing is observed even in a calm state;
• decompensated (3rd degree)– characterized by heavy paradoxical breathing, severe shortness of breath;
• terminal (4th degree)– a severe attack with hypoxia, which can be fatal.

Symptoms

Mostly, acute laryngeal stenosis occurs against the background of acute respiratory infections. Signs of the disease appear a few days after the onset of acute respiratory infections. This usually happens in the evening. IN daytime The child may have a fever or runny nose. In the evening your breathing pattern changes. It becomes bubbling, whistling and labored (stridor), making it difficult for the child to breathe and lacking oxygen.

How more swelling larynx, the louder the noise becomes when inhaling and exhaling. A harbinger of stridor in many cases is a dry, barking cough. Hoarseness can be considered a symptom of laryngotracheitis if it is accompanied by stridor. In other cases, it is considered a sign of laryngitis, which occurs without significant swelling of the larynx.

In addition, symptoms characteristic of colds are observed:

• general weakness;
• joint pain;
• enlarged cervical lymph nodes;
• increased body temperature;
• lethargy.

With degree 4 stenosis, the symptoms are as follows:

• stopping barking cough;
• disappearance of breathing noise;
• decrease in pressure;
• arrhythmia and weakness of breathing;
• There are convulsions and bradycardia.

The child's consciousness becomes confused and he may faint. Without timely emergency measures, asphyxia is possible.

Acute laryngeal stenosis must be differentiated from bronchial asthma. With false croup, inhalation is very difficult, and the noise when exhaling is almost inaudible. Asthma attacks, on the contrary, are accompanied by free inhalation and difficult wheezing exhalation.

Diagnostics

To identify false croup and begin proper treatment in a timely manner, an ENT specialist or pediatrician prescribes thorough examination sick. He examines the child’s larynx and listens to the airways.

Conducted:

• microlaryngoscopy;
• bacterial seeding of material from the throat;
• otoscopy;
• X-ray of the lungs and sinuses;
• rhinoscopy;
• pharyngoscopy;
• blood tests (PCR and ELISA, gas composition).

Treatment methods

It is advisable to carry out treatment in a hospital; attacks of false croup are very dangerous. Be prepared to provide first aid to your child.

Important! At the first symptoms of acute laryngeal stenosis, you must call an ambulance. Swelling of the larynx can be life-threatening for the child.

On our website you can learn about other diseases of the ENT organs in children. Read about sinusitis; written about catarrhal sore throat; Find out the articles about what to do if your child has ear pain. There is a page written about tracheitis; We have an article on treating a runny nose with folk remedies.

First aid during an attack

Before rendering qualified assistance According to doctors, parents should take measures to alleviate the baby’s condition:

• Calm the child and put him on the bed. The upper part of the body should be on a hill. A regular pillow will do.
• Open the window, humidify the air in the room (with a humidifier or using wet towels);
• Free the child from constrictive clothing that constricts the chest.
• Give the child a warm alkaline liquid (2% soda solution or Borjomi) to drink. This will help moisturize the mucous membranes and make phlegm thinner.
• Inhale with mineral water. It's good to use a nebulizer. (Read the article for more information about inhalation with a nebulizer).
• Place vasoconstrictor drops into the nose.
• To relieve swelling, you can give antihistamine(Erespal, Fenistil).
• In case of temperature and fever, give an antipyretic (Nurofen, Paracetamol).
• If breathing stops, induce vomiting. This will stimulate the respiratory center.

Drug therapy

After the ambulance arrives, the doctor will assess the severity of the child’s condition and determine his treatment regimen. At severe attacks You cannot risk the child’s health and hospitalize him in a hospital.

Therapeutic measures for stage 1 false croup:

• good air supply;
• drinking plenty of warm water frequently;
• mustard plasters on the calf muscles;
• inhalations with sodium bicarbonate solution, vitamin A, hydrocortisone, aminophylline;
• taking antispastic drugs (Papaverine, Atropine);
• hyposensitizing and sedatives(Pipolphen, Diphenhydramine);
• vitamin therapy.

If there is no effect from such treatment, it is carried out novocaine blockade in the nose It reduces swelling of the mucous membranes and relieves reflex spasm. For fever at stage 1 of laryngotracheitis, antibiotics are prescribed.

False croup grade 2 is treated in the same way as grade 1. Additionally used:

• humidified oxygen;
• administered intravenously hypertonic solutions glucose, calcium gluconate to relieve swelling;
• hormonal therapy (Hydrocortisone, Prednisolone);
• cardiac solutions are prescribed intravenously (Korglikon, Strophanthin);
• neuroleptic drugs (Promazine, Aminazine).

For grade 3 stenosis, Prednisolone is administered intravenously. The first dose should be ½ daily. They expand the intake of cardiac medications and give sodium oxybutyrate.

Antibiotics are administered wide range actions:

• Tetraolean;
• Tseporin.

If there is no result from treatment, laryngoscopy is performed. During the procedure, mucus and blood crusts are sucked out using a polyethylene catheter. Then the mucous membrane is lubricated with ephedrine, hydrocortisone, vaseline or peach oil. Sometimes bronchoscopy is indicated. During this procedure, the bronchi are washed, pus and mucus are removed, and antibiotics are administered intratracheobronically.

If all measures are ineffective or the child has severe progressive 4th degree stenosis, intubation or tracheostomy is indicated.

Read here about how to make a gauze diaper for a newborn with your own hands.

Prohibited actions

Laryngotracheitis is especially dangerous for children who are prone to allergies, overly excitable, and with lymphoid growths in the nasopharynx. Therefore, therapy for them must be selected with caution. Adviсe:

• In order not to increase swelling in allergy sufferers, you should not give citrus juice, honey, or raspberry jam.
• To avoid causing spasms of the laryngeal muscles, do not use essential oils, mustard plasters.
• There is no need to rush to give antitussives. Wet cough – protective function body. When you cough, phlegm containing harmful toxins is expelled.

Prevention measures

Since false croup in most cases is a consequence of colds and viral diseases, preventive measures are effective to help prevent them:

• harden the child;
• strengthen immunity; (Find out articles on how to increase a child’s immunity using folk remedies);
• provide adequate nutrition;
• use natural phytoncides;
• carry out vitamin therapy during seasonal colds;
• do not overcool the child;
• observe the rules of hygiene;
• Ventilate the child’s room more often and humidify it.

False croup is a common condition in children, which is caused by anatomical structure their respiratory organs. It can occur with every manifestation of an acute respiratory infection. Therefore, parents should be prepared for an attack and provide all available means to stop it. You definitely need to call an ambulance with symptoms of false croup, since there is a risk of complications, including asphyxia.

Sometimes it happens that small child against the background of an infectious disease of the respiratory tract, involuntary difficulty breathing occurs. The conducted research can frighten parents, because their baby is diagnosed with false croup. This pathological condition is quite dangerous, since in the absence of adequate therapeutic measures may end fatal. To prevent this from happening, you should understand in more detail the reasons that provoke the pathology, its symptoms and the main methods of treatment.

False croup in children: features of the disease

The disease false croup is not considered clinical practice true. Most likely, this condition can be called a syndrome that occurs when infectious lesion larynx and characterized by the appearance of hoarseness in children, barking, dry cough and unexpected attacks of suffocation. The disease is always associated with the development of an inflammatory process in the area of ​​the larynx, on its mucous membrane. False croup in children is characterized by the appearance of swelling in the throat, in the area of ​​the vocal cords, associated with catarrhal phenomena occurring there. In concept of this disease included several species, having an infectious etiology.

Doctors call the following types of this otolaryngeal disease false croup:

• stenosing laryngitis. Acute inflammation of the larynx, which in severe cases can spread to the trachea and bronchi. Usually develops after viral infection a bacterial type of microorganism will join;
• subglottic laryngitis. The pathological process is localized directly in the subvocal space. Depends on the characteristics of the anatomical structure of the larynx in children;
• subglottic laryngitis. The main area of ​​inflammation in this form of pathology is the subglottic region. This localization is associated with its filling not with elastic tissues, but with loose fiber, which does not give it a tight fit and facilitates the penetration of pathogenic microorganisms.

False croup in a child can occur once, but most often this pathological phenomenon characterized by episodic bursts that are associated with the entry of any, even the most harmless, infection into the baby’s body. Cases have been reported in clinical practice re-development so unpleasant and dangerous syndrome even with a normal runny nose. This disease is seasonal and most often the disease strikes children in the autumn and winter, but sometimes it is diagnosed in children in the summer.

Types and types of false croup in children

The classification of this rather dangerous substance in children depends on several factors and helps specialists in choosing proper treatment. False croup is of two types - bacterial and viral. This division of pathology is directly related to the nature of the origin of the disease. Also, false-type croup is usually classified according to the presence of complications into complicated and uncomplicated.

But most often in clinical practice in children, what is considered false croup, is divided according to the degree of development of stenosis in the larynx:

1. Compensated. Signs of pathology are minimal, there is only inspiratory shortness of breath, characterized by difficulty in breathing. It appears only after physical activity or when the baby is very restless;
2. Subcompensated. Inspiratory dyspnea can occur in a child even when he is at rest;
3. Decompensated. Shortness of breath becomes pronounced and very severe. A baby with this variety pathological condition Paradoxical breathing is often observed, in which reverse movement occurs chest, that is, it increases as you exhale and decreases as you inhale;
4. Terminal. With this type of laryngeal stenosis, young patients almost always develop severe hypoxia (oxygen starvation), almost always leading to the death of the child.

As can be seen from the above classification of the disease, laryngitis with stenosis in children, called false croup in medical circles, is a very dangerous pathological condition that requires immediate medical attention.

Causes of false croup in childhood

Problems associated with pathological swelling of the larynx worry many parents, which is why it is worth understanding what causes false croup in very young children and whether it is possible to avoid the appearance of this syndrome in the baby. The main reason that provokes in babies the development of this negative syndrome of “interception” of breathing, which accompanies some ENT diseases, is the anatomical structure of their upper respiratory tract. The baby’s larynx and trachea still have an increased softness of structure, so the edematous tissues surrounding them easily press on the weak breathing tubes, thereby blocking the flow of air into the lungs.

This is the main cause of false croup in children, but there are also a number of certain anatomical and physiological features that can short terms lead to the fact that an infectious disease of the larynx will end in this negative syndrome.

Experts note the following risk factors that are unique to young patients:

• functional immaturity of some reflexogenic zones, in which the parasympathetic nervous system temporarily becomes dominant. She is responsible for slowing down physiological processes, such as breathing. With age, by the age of 6 children, their maturity begins, and the threat of developing a pathological condition after any cold recedes;
• small diameter, softness and pliability of the cartilaginous skeleton of the larynx, which contributes to its regular compression by surrounding edematous tissues;
• its narrow lumen and funnel-shaped shape;
• increased excitability of the muscular corset located in the immediate vicinity of the glottis;
• excessive looseness of the mucous membrane associated with minimum quantity elastic fibers, which are penetrated by many blood vessels;
• disproportionate sizes and high location vocal cords.

But not all children are susceptible to the development of a pathological condition of the larynx, although its anatomical and physiological structure is the same for all children. Bound this factor with the fact that in order for false croup to develop, the reasons must be accompanied by a number of negative features. They increase the likelihood of swelling in the larynx area, which is dangerous for a small child.

The main risk factors provoking the occurrence of a pathological syndrome are considered to be the presence of a baby’s tendency to allergic reactions, trauma or paratrophy suffered during birth ( overweight baby associated with improper feeding).

False croup: symptoms and manifestations in children

The disease begins against the background of a cold, usually on the 2-3rd day of an acute inflammatory process in the larynx. The initial stage of this pathological syndrome, which occurs with the development of swelling in the upper respiratory tract, is characterized by the appearance of the main symptoms in the evening or at night. When false croup begins in young children, the symptoms are quite mild, but any parent should know them. This will make it possible to promptly notice the development of the disease and contact a specialist for emergency care. medical care, which can save a baby’s life.

Types of disease

The first alarming signs indicating the onset in the larynx area pathological process, are:

• dry and rough cough of a croaking or barking nature;
• shortness of breath due to the inability to take a normal breath;
• shallow, noisy and very rapid breathing.

This triad of signs is the most characteristic of false croup. It is from this that one can promptly suspect the development of the disease. In addition to specific manifestations, you should also pay attention to general symptoms. As leading otolaryngologists note, it consists in the fact that a sick child becomes restless and whiny, often takes a forced body position in which the sensations are not so strongly felt. negative symptoms. Experts also note that in some cases there may be fever and an increase in body temperature up to 40 ° C. Clinical manifestations with this pathology directly depend on what stage of development the laryngeal stenosis is at in a particular clinical case.

Their characteristics can be seen in the table:

STAGES OF LARRYNAL STENOSIS	CLINICAL MANIFESTATIONS
STAGE 1	Seizures are quite rare; in the absence of seizures, the baby is active and alert. The attack itself is characterized by the appearance of slight cyanosis on the nasolabial triangle, the child’s voice becomes hoarse, and at night short periods occur, accompanied by a dry and barking cough. Also at this stage of the disease, children have moderate shortness of breath.
STAGE 2	The child becomes restless and overly excited. Very noisy and heavy breathing is accompanied by tension in the neck muscles and retraction intercostal spaces. Almost constant shortness of breath appears, and periods of barking cough become noticeably more frequent. Paleness of the skin of the face and circumlabial cyanosis are constantly present. Also at this stage, the heartbeat noticeably accelerates and tachycardia appears.
STAGE 3	The baby is constantly in alternating states of inhibition or excitement, his consciousness is mostly confused. Shortness of breath becomes so severe that it makes it difficult to inhale. The exhalation is very short. The breathing process itself is also accompanied by retraction of the intercostal spaces and noticeable tension in the neck muscles. Skin take on an earthy hue and are constantly covered in cold, sticky sweat, and the legs, arms and face become bluish. The heart beats irregularly and very quickly
STAGE 4	Signs of false croup in children at this stage of development are very severe. The baby is completely unconscious. He tries to breathe, but instead gasps for air to no avail. open mouth. The baby's skin becomes completely cyanotic, the pupils are dilated, and breathing is shallow. Convulsions, irregular pulse and slow cardiac activity indicate the onset of complete suffocation

The symptoms of false croup listed in the table in children arise and progress when therapeutic and preventive measures are ignored or serious errors are made in their implementation. If parents are attentive to the health of the baby and notice the appearance of any abnormalities in it, such a development of events, ending in death for the baby, can be completely avoided. All that is needed for this is to promptly treat colds, as well as those that can provoke an attack of false croup in the baby. You should also remember the first alarming symptoms indicating the onset of a pathological condition. This will make it possible to call a doctor in a timely manner and take emergency measures to save the life of a child.

Diagnosis of false croup

Identification of a negative phenomenon affecting the glottis area does not represent experienced specialist no problem. In order to detect swelling in a child’s throat, the doctor only needs to conduct an initial visual examination of the throat using a laryngoscope based on the patient’s symptomatic complaints. With laryngeal stenosis there is a very characteristic clinical picture, which makes it easier to detect. The only difficulty is that it comes in 2 forms, and completely different ones are used to get rid of them. healing techniques. That is why parents often ask the question of how to identify false croup in a child without confusing it with another disease.

Otolaryngologists explain that this requires differential diagnosis. Only with its help can one exclude the more dangerous true form of the disease, the development of which is provoked by diphtheria. All studies must be carried out very quickly, since these pathological conditions associated with laryngeal edema count in minutes.

Diagnosis of false croup in children is performed using the following methods:

• microscopic and bacteriological examination of a throat smear, including bioculture and PCR (polymerase chain reaction), which makes it possible to most accurately identify the pathogenic causative agent of the disease and its sensitivity to antibiotics;
• ELISA (enzyme-linked immunosorbent assay). Makes it possible to identify the pathogen by detecting specific antibodies in the biomaterial;
• study of acid-base status and gas composition blood, helping to identify the level of redox reactions in the body and the ratio of oxygen and carbon dioxide content in it. These tests are necessary to assess the degree of hypoxia (oxygen starvation).

From instrumental methods research at differential diagnosis For laryngeal stenosis, farinogo- and laryngoscopy are used. In the event that a specialist suspects the development of complications, little patient Rhinoscopy, otoscopy and radiography are performed. Treatment of false croup in children can be prescribed only after the doctor has received all test results and confirmed the diagnosis.

How and with what to treat false croup in children: medications, drugs, inhalations

The main therapeutic goal in this pathological condition is to relieve laryngeal stenosis, as well as eliminate swelling and inflammation from its mucous surface. If a child is diagnosed with false croup, treatment should be prescribed by a qualified physician and carried out under his direct supervision. In addition to the use of certain therapeutic measures that can completely stop the disease, doctors advise completely eliminating the influence of negative factors that provoke an attack on the body.

Important! What to do if a child has false croup. All therapeutic measures for this disease, only a qualified doctor should prescribe it to children. Any self-medication can lead to tragic consequences, so if you notice the first signs of alarming symptoms in your baby, you must call an ambulance.

First aid for false croup in children consists of the following activities:

• calm down a frightened child. Any negative emotions, screaming and crying will only aggravate the serious condition and cause new spasms;
• provide free access to fresh air. To do this, open the windows in warm weather, and in cold weather a window will suffice;
• give the baby anything to drink warm drink with a liquid temperature in the range of 38-40 °C. It can be this or juice diluted with water. If the baby cannot drink on his own, you should feed him with a spoon;
• give to the child in age dosage any antiallergic antihistamine, for example Claritin, or Tavegil;
• make hot baths for your hands and feet, ensuring blood flow from the throat and inhalation soda solution(a teaspoon of soda per liter of water).

Such emergency care for false croup in children should be known to all parents, since thanks to it it is possible to prevent the onset of asphyxia before the doctors arrive. After the baby is admitted to the hospital and the doctor confirms the diagnosis, he will be prescribed a course of treatment.

Features of drug therapy

Important! If the doctors who come to the call recommend placing the child in a hospital, under no circumstances should you refuse. In most cases effective treatment This pathology is only possible in a hospital setting.

Therapeutic measures are prescribed for each child individually and depend on the diagnostic results, which help to determine the degree of development of the pathology. There are also general prescriptions for severe laryngeal stenosis. In no case should we forget that the listed medications should not be used independently, without consulting a doctor, as this can lead to serious consequences and even provoke death in the child:

• glucocorticoids. Doctors almost always prescribe Pulmicort. For false croup in children, it is considered very effective and is administered rectally, by injection or orally;
• antispasmodics. No-shpa helps children best, which comes first in the doctor’s prescriptions;
• antihistamines. In this group medicines preference is given to Diphenhydramine, Suprastin or Fenistil;
• sedatives, sedatives. The most harmless among them is considered to be valerian extract, which is prescribed to children;
• carried out with humidified, medical oxygen.

If the pathology has bacterial nature, and against its background infectious complications develop, in mandatory antibacterial drugs are prescribed, and for viral infections - . False croup is also treated with bronchodilators. It is also necessary to take into account how cough syndrome is relieved in this disease. Here, with unproductive, dry and barking cough, preference is given to antitussive drugs, and if there is abundant sputum in the larynx, specialists prescribe intravenous administration of calcium gluconate.

When the above course conservative therapy turns out to be ineffective, they resort to surgical intervention, which involves tracheostomy (dissection of the trachea) or intubation (insertion of a special tube into the larynx to facilitate air access).

Treatment of false croup in children at home: traditional medicine recipes

Many parents are concerned about the question of whether, with such a pathological condition, it is possible to carry out therapeutic measures at home, without going to the hospital for this. For the most part, the answer from otolaryngologists is negative, since acute attack false croup in children
stops only in stationary conditions. But if the pathological condition occurs in a child for the first time, and is not accompanied by strong severe symptoms or any complications, such a therapeutic approach is quite acceptable.

Komarovsky, a recognized pediatrician and famous TV presenter, also considers false croup possible. But, as he notes, only after the necessary diagnostic studies, and doctor’s prescription accordingly medication course. Recipes traditional medicine not only effective, but also safe, as they do not cause addiction and development serious consequences. Despite this, they cannot be used as monotherapy for childhood laryngeal stenosis.

Treatment of false croup at home using folk remedies is only permissible in combination with traditional medicines. Only such therapy can be effective in stopping the pathological phenomenon.

The following medicinal potions prepared according to folk recipes can provide effective help with false croup in children:

• infusion of peppermint Designed for spraying the baby's throat. To prepare it, you need to pour 250 ml of boiling water into a tablespoon of chopped herbs. The product is infused in a glass jar covered with a towel for half an hour, after which it is filtered and used to irrigate the baby’s neck after each meal;
• decoction of herbal collection treats inflammation and swelling of the pharynx from the inside. Mix the composition from 1 part each of crushed licorice root, coltsfoot leaves and plantain. A teaspoon of the prepared composition is placed in a small bowl, poured with a glass of boiling water and kept for 20 minutes in a water bath. Drink this decoction warm, 100 ml three times a day.

The given recipes effectively help in treatment, but they cannot be used if false croup occurs in children under one year of age. We should also not forget that to achieve positive results with the help of these means it is only possible to initial stages development of a pathological condition.

Consequences of the disease

With timely diagnosis of the disease and an adequate course of therapy, the prognosis will be positive, which cannot be said about completely ignoring the inflammatory process. In this case, the consequences of false croup can be disastrous.

After to inflammatory process, occurring in the area of ​​the glottis, will be joined by a pathogenic bacterial microflora, a purulent film begins to form in the larynx.

Against this background, the following complications of false croup arise:

• obstructive bronchitis;
• pneumonia;
• purulent meningitis.

All of them pose a direct threat not only to the health, but also to the life of the baby. In order to prevent such a development of the situation, it is necessary not only to take all measures to timely detection and treatment of the pathological condition, but also its prevention.

Prevention of false croup in children and adolescents

When a small child has a tendency to catch colds, he has a tendency to regular relapses of laryngeal stenosis. Mothers of such babies need to have a humidity tester, a humidifier and an inhaler at home. They will help to promptly prevent the development of another attack in the baby. Also, parents of children at risk for developing this pathological syndrome should know what measures should be taken to prevent its occurrence.

Prevention of false croup in children is as follows:

• the child’s adherence to a daily routine that allows sufficient time for sleep;
• mandatory hardening of the baby, which includes walking barefoot, contrast shower and other general strengthening activities;
• proper nutrition. Children should eat foods that contain sufficient amounts of vital important microelements, minerals and vitamins;
• preventing the development of viral diseases. To achieve this goal, it is enough not to visit crowded places. This advice becomes especially relevant during mass epidemics.

To strengthen the baby's throat, some parents give him small pieces of ice to suck. But it should not be ordinary, but therapeutic. Getting this kind of ice is not difficult at all. It is enough to freeze decoctions of those herbs that have an anti-inflammatory effect, such as calendula, sage or chamomile.

By following all these recommendations, it is possible to prevent the occurrence of a pathological condition even in those children who are prone to its development. The above preventive measures it is necessary to closely study until the child is five years old, since in children 4-5 years old such pathology of the larynx occurs in exceptional cases. This is due to the age-related increase in the trachea, and at the same time its lumen.

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