All causes of frequent bronchitis in a child. Bronchitis in children: acute, obstructive bronchitis, symptoms, treatment Constructive bronchitis in children

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

Pediatrician, gastroenterologist

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

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

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

The health damage caused by exposure to tobacco smoke is a major point that should not be underestimated.

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

Bronchitis is associated with bronchial obstruction. The risk of obstruction depends on the lumen of the inflamed bronchus: the smaller the lumen, the more likely clinically significant bronchial obstruction. This condition is called "obstructive bronchitis".

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

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

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

The reasons

In 90% of cases, acute obstructive bronchitis in children is due to viruses, and the remaining 10% are bacterial infections. A child may have chronic obstructive bronchitis if they have recurring attacks of acute bronchitis that go undiagnosed and untreated. Other causes of chronic bronchitis with obstruction include living in a region with persistent industrial pollution and passive inhalation of cigarette smoke.

Viral infections that are responsible for the development of obstructive bronchitis include:

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

The child may have a secondary bacterial infection leading to obstructive bronchitis. However, it is rare in children who do not have immunodeficiency or cystic fibrosis.

In a child, a bacterial infection develops due to the following bacteria:

mycoplasma;
chlamydia;
hemophilic bacillus;
moraxella catharalis;
Pneumococcus.

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

Other causes of bronchitis with obstruction in children:

fungal infection;
chronic aspiration;
gastroesophageal reflux;
allergies.

Is obstructive bronchitis contagious?

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

The contagiousness goes away when the symptoms subside. But bronchitis caused by exposure to pollutants, cigarette smoke, or other environmental substances is not contagious.

Symptoms of obstructive bronchitis in children

Cough

Cough is the main manifestation of obstructive bronchitis. At first, it tends to be dry and unproductive. With increased secretion production, the mucus becomes less viscous, making the cough wetter. Some babies have such severe coughing spells that they may vomit. After regression of obstructive bronchitis, an unpleasant dry cough may still remain for several days or weeks. This is due to transient hyperreactivity of the bronchial system due to inflammation caused by infection.

Shortness of breath and wheezing

Shortness of breath gradually increases with the severity of the disease. Typically, children with obstructive bronchitis cannot breathe normally when they are active and begin to cough. Shortness of breath at rest usually signals that COPD (chronic obstructive pulmonary disease) or emphysema has developed. A loud whistling sound is heard on exhalation, but in severe cases it can be heard on inspiration. It is caused by inflammation of the bronchi and narrowing of the respiratory tract.

Other symptoms

Feeling of rattling in the chest.
Moderate.
Runny nose.
Poor sleep due to cough.
Tightness and pain in the chest.
Tickling sensation in the back of the throat, resulting in soreness when swallowing.
General feeling of being unwell.

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

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

Diagnostics

Obstructive bronchitis may be suspected in patients with an acute respiratory infection with cough. However, because many more serious lower respiratory infections cause coughing, obstructive bronchitis should be considered a diagnosis of exclusion.

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

What and how to treat obstructive bronchitis in children

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

To achieve this goal, the doctor will prescribe a combination of drugs that open up the bronchial airways and soften the mucus so that it can be more easily coughed up. Bed rest is recommended.

The most effective means of controlling cough and sputum production in patients with chronic obstructive bronchitis is to avoid environmental irritants, especially cigarette smoke.

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

Bronchodilators

Obstructive bronchitis makes it difficult for a child to breathe due to narrowing of the airways. Therefore, the doctor will prescribe bronchodilators.

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

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

Albuterol and Metaproterenol relax bronchial smooth muscle with little effect on cardiac contractility.

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

Systemic corticosteroids

These are Prednisolone, Prednisone, Dexamethasone.

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

Inhaled corticosteroids

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

Beclomethasone causes direct relaxation of smooth muscles and can reduce the activity and number of inflammatory cells, which reduces the hyperreactivity of the respiratory tract.

Fluticasone has extremely strong vasoconstrictive and anti-inflammatory activity.

Budesonide reduces inflammation in the respiratory tract by inhibiting multiple types of inflammatory cells and reducing the production of mediators that are involved in the asthmatic response.

Mucolytics

Mucolytics cause bronchial mucus (sputum) to thin to make it easier to cough up. Among the mucolytics, the best known are Acetylcysteine and Ambroxol.

Acetylcysteine has an anti-inflammatory effect.
Bromhexine activates enzymes that break down mucus molecules and stimulate glandular cells to increase mucus production, reducing its viscosity.
Ambroxol is the result of the breakdown of Bromhexine. In addition to its effects, it stimulates the production of surfactant (a substance that lines the inside of the lungs' alveoli). This helps the lungs absorb and absorb oxygen.

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

Antibiotics

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

After obtaining an antibitikogram, antibiotic therapy can be determined according to the sensitivity and resistance of bacteria. Bacterial spectra also differ between community-acquired and nosocomial infections. Sometimes it is not possible to distinguish between viral and bacterial infections because the clinical picture and blood parameters can be very similar. In this situation, the child will be treated with an antibiotic, even though it is just a viral infection with a high fever.

Amoxicillin and clavulanate (Augmentin)

It is a semi-synthetic antibiotic with a broad spectrum of bactericidal activity covering both gram-negative and gram-positive microorganisms. It works by stopping the growth of bacteria.

It is a good alternative antibiotic for children with an allergy or intolerance to the macrolide category. It is generally well tolerated and provides good coverage for most infectious pathogens, but is ineffective against Mycoplasma and Legionella species. The half-life of an oral dose is 1-1.3 hours. It penetrates well into tissues, but does not pass the blood-brain barrier, which makes it useless in the fight against neuroinfection.

Erythromycin

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

Azithromycin

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

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

Tetracycline

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

In certain cases, tetracycline is used when penicillin or another antibiotic cannot be used in the treatment of severe infections such as clostridium, listeria, and others.

It is less effective than erythromycin.

Tetracycline works best when taken on an empty stomach one hour before or two hours after a meal. Each dose should be taken with a full glass of water (240 milliliters). It is not recommended to lie down for 10 minutes after taking this medicine. For this reason, do not take the dose right before bed.

Tetracycline can make the skin more sensitive to sunlight. Use sunscreen and wear protective clothing for your child when you need to be in the sun.

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

Cefditoren

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

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

Cefditoren works best when taken with food.

Trimethoprim-sulfamethoxazole

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

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

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

Amoxicillin

This drug is a penicillin-type antibiotic.

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

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

Clarithromycin

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

Doxycycline

It is a synthetic broad-spectrum bacteriostatic antibiotic in the tetracycline class.

Children under 8 years of age should use Doxycycline only in cases of severe or life-threatening conditions. This medicine may cause permanent yellowing or discoloration of teeth in children.

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

Analgesics/antipyretics

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

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

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

Nasal drops

Nasal drops with saline solution are used to moisturize and clean the nasal mucosa. Vasoconstrictive nasal drops should be given if the Eustachian tube swells in response to an upper respiratory tract infection to ensure middle ear ventilation. These drops should not be given for more than 7 days, otherwise they can lead to irreversible damage to the mucosa.

oxygen therapy

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

This therapy is carried out to provide the body with additional oxygen, so that tissues and cells through the blood receive a sufficient amount of it.

Oxygen is usually given through nasal cannulas. If small children cannot tolerate nasal prongs, a mask may be used, especially while sleeping.

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

What is dangerous obstructive bronchitis in children

A child is at high risk of complications due to obstructive bronchitis if:

he has been coughing for more than three weeks;
he coughs so hard that he cannot sleep well;
the child wheezes;
it is difficult for him to breathe;
the baby has a fever of 38 degrees and above;
he coughs up bloody mucus.

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

Pneumonia

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

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

Symptoms of pneumonia:

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

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

Chronic obstructive pulmonary disease

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

COPD is a progressive disease and symptoms get worse over time. Since the lungs suffer irreversible damage, treatment and lifestyle changes are the only way to slow down the progression of the disease and allow the child to lead an active life.

Prevention of obstructive bronchitis in children

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

Teach your child to wash their hands thoroughly with soap and water before eating.
Provide your child with a healthy and nutritious diet so that their immune system is strong enough to fight infectious pathogens.
Keep your child away from family members who have the flu or a cold
Do not allow family members to smoke indoors as passive inhalation of cigarette smoke can cause chronic obstructive bronchitis
If you live in a very polluted area, have your child wear a face mask.
Clean your child's nose and sinuses with a nasal spray to remove allergens and pathogens from nasal cilia.
Supplement your child's diet with vitamin C to boost their immune system.

Treatment of obstructive bronchitis in children with folk remedies

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

Increase your fluid intake.

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

Humidifier.

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

Cranberry juice.

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

Honey.

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

Thyme.

Thyme will help clear mucus from the respiratory tract of mucus, as well as strengthen the lungs. Boil some dried thyme in a cup of water. Let it infuse for 10 minutes. Strain. Mix the mixture with honey and let the child drink.

Turmeric.

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

Magnesium sulfate.

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

Do not give your child any home remedy that suppresses a cough. It is important that the child coughs up mucus, as this will help him recover. If you want to soothe his throat, honey should suffice.

Conclusion

Children's obstructive bronchitis is from mild to severe with symptoms of respiratory failure. Do not ignore the cough that the child has, take him to the doctor. The last thing you want is for the infection to get worse and lead to complications like pneumonia and COPD. With early diagnosis and proper treatment, bronchitis should not be a cause for concern.

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Obstructive bronchitis, the main symptom of which is the narrowing (obstruction) of the bronchi and the resulting difficulty in exhaling, is a very common variant of lower respiratory tract damage among children, especially younger ones. The prerequisites for the development of obstruction in babies, even against the background of relatively easy flowing, are created by a physiologically narrow lumen of the bronchi in children under the age of 3 years.

In addition to anatomical and physiological features, predisposing factors to the formation of obstructive bronchitis are:

allergies and a tendency to allergic reactions;
smoking - both passive and active.

With its high prevalence, obstructive bronchitis has a very bright clinic, often frightening parents, which leads to the healing of the child with potent and not always necessary drugs.

The main symptoms of obstructive bronchitis

Loud whistling or hoarse breathing heard at a distance;
bloating of the chest and retraction of the intercostal spaces during breathing;
paroxysmal excruciating cough, sometimes to vomiting.

What is dangerous obstructive bronchitis

Bronchitis is usually mild and responds well. However, the addition of an obstruction aggravates the child's condition, and in some cases can pose a serious threat to his life.

When emergency hospitalization is required

Severe intoxication syndrome in obstructive bronchitis is an indication for hospitalization.

Obstruction in a child under the age of 1 year.
Against the background of obstruction, symptoms of intoxication are expressed (high temperature, weakness, lethargy, a sharp decrease in appetite, nausea).
There are symptoms of respiratory failure: and acrocyanosis. Shortness of breath is an increase in the frequency of respiratory movements by 10% or more compared to the age norm. It should be borne in mind that the respiratory rate in children is very variable and increases greatly with anxiety, crying, during the game. Therefore, the calculation is best done during sleep. For young children (1-3 years old) with uncomplicated bronchitis, the frequency of breathing during sleep should not exceed 40 per 1 minute. Acrocyanosis is the appearance of cyanosis of the nails, a nasolabial triangle, indicating a lack of oxygen.

But even in cases where a child receives treatment at home, this should not mean the absence of medical advice. Even if the baby is prone to frequent obstructions and you are perfectly familiar with the treatment regimen, you should not neglect a doctor's examination. The doctor will determine the child's need for certain medications, adjust their dosage depending on the severity of the condition. In addition, do not forget that obstructive bronchitis can be hidden under the mask, and often repeated obstructions often lead to the formation.

Treatment of obstructive bronchitis

Mode

Bed rest is shown to the child only against the background of temperature. In its absence, the regime is relatively free, but it is desirable to control the child's physical activity: most children subjectively tolerate obstruction well and can run and play until severe shortness of breath appears.

Outdoor walks are not only allowed, but even recommended - you can walk twice a day for 1-1.5 hours. You should walk with your child every day, dressing him according to the season and weather conditions (in case of strong wind and frost, walks are excluded). Places for walking should be chosen, adhering to the following rules:

away from dusty roads and highways;
away from playgrounds and other gatherings of children, so as not to provoke the child to active games.

Diet

During the period of fever, it is shown in a warm form, liquid and semi-liquid consistency (soups, mashed potatoes). For the entire period of the disease, a plentiful drink is recommended, which helps to relieve intoxication and thin sputum: compotes and fruit drinks from fresh berries, decoctions of dried fruits, freshly squeezed juices (not from citrus fruits), weak tea, alkaline mineral water. Honey, chocolate, citrus fruits (except tea with lemon), spices are excluded from the diet - these are highly allergenic foods that can cause bronchospasm.

Home hygiene and other features of caring for a sick child

Be sure to ventilate the room daily, especially before going to bed (in the absence of a child). It is advisable to carry out daily wet cleaning, at least partially, but without the use of detergents and disinfectants, especially chlorine-containing ones. Control air humidity: in summer and winter, in well-heated rooms, use humidifiers or replace them with improvised means (spray mesh on windows and curtains with a spray gun, put a container of water in the room, etc.). Excessively dry air aggravates and delays the disease, contributes to the occurrence of exacerbations.

Avoid contact of the child with synthetic detergents and protect him from passive smoking.

Medical treatment

Antibiotics and antivirals

For older children, metered-dose aerosol inhalers (Salbutamol, Berodual, etc.) can be used.

Until now, theophylline tablets (Eufillin, Teopek) are prescribed, especially for the treatment of children with. However, compared to inhaled forms, they are more toxic and cause more unwanted side effects.

Fenspiride (Erespal)

Erespal is a modern drug with anti-inflammatory activity, reducing excessive sputum production and helping to relieve bronchial obstruction. Its appointment from the first days of the disease reduces the likelihood of complications, speeds up the treatment process.

Antiallergic drugs

Antihistamines are indicated for children with allergic manifestations and a tendency to. In children older than 6 months, second-generation drugs (Zirtek, Claritin) are used. With abundant liquid sputum, antihistamines from the first generation (Suprastin, Tavegil) can be prescribed for "drying".

Hormones

Hormonal drugs can quickly relieve inflammation and obstruction of the bronchi. They are shown in severe and moderate obstructive bronchitis and are usually prescribed by inhalation (through a nebulizer). The most commonly used Pulmicort.

Other drugs

Against the background of high temperature, the use of antipyretics is mandatory. At the end of treatment (when the number of drugs taken simultaneously does not exceed 3-4), multivitamins are recommended. A good effect is sometimes given by the connection of homeopathic preparations.

Physiotherapy and warming treatments

In the acute period, physiotherapy is ineffective. With a prolonged cough after relief of obstruction, electrophoresis, UHF, and a laser are recommended. At home, you can perform neutral-thermal compresses, warming up with salt, buckwheat, potatoes. The use of mustard plasters, herbal ointments and balms, inhalations with essential oils and other pungent odor agents for the treatment of obstructive bronchitis is strictly prohibited, especially in children under 3 years of age - they often provoke bronchospasm.

Massage and therapeutic gymnastics

To improve sputum discharge, massage, gymnastics and special body positions (postural drainage) are used. The massage is carried out by vibration: tapping on the back of the child with palms folded in a “boat”. Older children are asked to take a deep breath, a smooth long exhalation, and tap on the exhale. The babies are laid with a pillow under the tummy (head down) and massaged, quickly tapping with their fingertips.

Postural drainage is carried out as follows: in the morning, without getting out of bed, the child hangs his head and body from the bed, resting his palms or forearms on the floor, and remains in this position for 15–20 minutes.

Gymnastics should be carried out with the simultaneous implementation of breathing exercises for enhanced exhalation. As separate breathing exercises, blowing out candles, inflating balloons is suitable.

What else do you need to know

It is important to remember that obstructive bronchitis can be caused by a combination of infectious and non-infectious factors or only by non-infectious causes. In young children, the development of obstruction by a foreign body is possible, in adolescents - bronchitis due to smoking, obstructive bronchitis of allergic origin is common.

The hallmarks of a foreign body obstruction are:

Someone around saw the child swallow or inhale a small object.
Cough and shortness of breath came on suddenly, while playing or eating. Prior to this, the child was absolutely healthy.

In such situations, immediate hospitalization is necessary with a consultation with an ENT doctor, an X-ray examination, and, if necessary, bronchoscopy and other procedures.

Obstructive bronchitis due to smoking can be suspected when the child's condition is relatively satisfactory, but the cough is strong, whistling, especially in the morning, for a long time.

Allergy obstruction is a common occurrence. Bronchitis in children prone to allergies occurs both due to infection and without it, when the obstruction is caused by provoking factors or contact with the allergen. Obstructive bronchitis is prolonged, recurring, the risk of formation is high.

Prevention of obstructive bronchitis

With frequent episodes of obstructive bronchitis, the allergic nature of the disease should be excluded.

With repeated episodes of obstructive bronchitis, measures must be taken to prevent its development. Allergic children require maximum restriction from contact with allergens and provoking factors, which can be tobacco smoke; excessively dry air in the room; strong odors from new toys, furniture, repairs, etc.

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

Causes of the disease

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

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

Symptoms of the disease

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

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

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

When is hospitalization needed?

Although obstructive bronchitis is quite treatable at home, sometimes urgent hospitalization may be required. Calling an ambulance is necessary in such situations:

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

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

Medical treatment of obstructive bronchitis

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

Antiviral and antibacterial agents

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

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

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

If it is necessary to take antibiotics, a small patient is prescribed drugs of the latest generation, which have a minimum of side effects. Among them are Cefazolin or Augmentin.

Cough preparations

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

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

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

Drugs for the relief of obstructive syndrome

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

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

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

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

Medicinal products of other groups

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

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

ethnoscience

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

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

The following compounds have a pronounced expectorant effect:

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

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

Additional conditions for recovery

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

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

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

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

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

Prevention

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

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

Complications

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

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

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

Obstructive bronchitis occurs in children of all ages. It is considered as an inflammation that affects the mucous membranes of the bronchi. The disease got its name from the word "obstruction", which means "spasm", "narrowing". Doctors register pathology in every fourth child of 2 years old - at an early age, the child's body is most susceptible to diseases of the respiratory system.

What causes bronchospasm

Often, the inflammatory process is triggered due to infection of different parts of the respiratory tract. Its causative agents are adenoviruses, rhinoviruses and the influenza virus. Some children suffer from mycoplasmal lesions of the bronchi. In recent years, babies are increasingly sick due to the influence of food and household irritants. Their impact on the body is dangerous by the transformation of allergic bronchitis into bronchial asthma or a chronic form of the disease.

Seasonal rhinitis and skin rashes after eating certain foods increase the sensitivity of the body to the intake of certain substances. Further hit of the smallest doses of an irritant causes unpredictable reactions. With an increase in the number of allergens, the severity of the manifestation of reactions increases. The interaction of the body with an irritating substance leads to problems with the bronchi.

Obstructive bronchitis can develop due to abnormalities such as:

How the disease manifests itself

As a rule, obstructive bronchitis develops in an infected organism. Parents notice the first symptoms on 2-3 days from the onset of the disease or hypothermia of the crumbs. In children with weakened immunity, pathologies of the kidneys, liver, digestive system, bronchitis can show its signs within 24 hours. Traditionally, kids complain of general malaise, nausea, runny nose, discomfort in the throat. These symptoms in children 3 years old are accompanied by vomiting, defecation disorder, fever.

As the pathology progresses, manifestations of bronchospasm increase. If at first children have difficulty exhaling air, then after a few days they complain of problems with inhalation. The frequency of breathing and the duration of expiration are lengthened, and noise and whistling escape from the patient's respiratory tract, which are easy to hear at a distance.

A characteristic symptom of bronchospasm is a dry cough with a small amount of sputum. Viscous mucous contents are difficult to separate. An unproductive cough is especially annoying at night. In this case, the pathology can occur in a child without a temperature.

In infants of the 1st half year of life, the clinical picture of acute obstructive bronchitis is expressed by the following changes:

runny nose;
hoarse cry;
chest swelling;
debilitating cough to vomiting;
retraction of intercostal tissues on exhalation;
noisy breathing with whistling and hoarseness;
elevated temperature - with bronchitis of this type, it keeps at around 38 - 39 ° C.

At an older age, the listed signs of illness in children are supplemented by soreness in the area of the back between the shoulder blades and the separation of yellowish sputum. The wheezing becomes so loud that it can be heard from the next room. Perhaps the accession of angina or cervical lymphadenitis.

Inflammation of the bronchial mucosa is diagnosed by a pediatrician and a pulmonologist. If the disease is associated with the influence of irritants, consultation of an allergist-immunologist is required. Children are referred to an otolaryngologist to exclude sinusitis. After listening to complaints, external examination and listening to breath sounds, small patients are given referrals for a number of tests:

x-ray;
blood analysis;
sputum culture;
spirometry. The study requires the child to take strong breaths, which allows the specialist to assess the completeness of the work of the lungs. Children older than 5 years are referred for spirometry.

The danger of inflamed bronchi

Delayed therapy of the bronchial mucosa is fraught with asthma. Sometimes the pathology proceeds with the same symptoms as obstructive bronchitis, but asthma attacks predominate in its clinic. To prevent the development of complications, parents of children suffering from bronchitis for more than 3 r. per year, should consult a doctor and undergo an additional examination. Running asthma with respiratory failure is dangerous with a fatal outcome.

Inflammation of the mucous membranes of the bronchi can be successfully dealt with at home, if the disease does not worsen the condition of the child. But there are a number of adverse changes that require urgent hospitalization of the patient:

dyspnea;
clear signs of intoxication;
cyanosis of nails and nasolabial triangle.

It is also not necessary to treat infants at home. Before reaching 1 year they need to be placed in a hospital.

Caring for a sick child

If a baby is diagnosed with obstructive bronchitis, Dr. Komarovsky draws the attention of parents to living conditions. The patient's room should be ventilated daily. When carrying out wet cleaning, do not use detergents and disinfectants.

Since insufficient air humidity leads to drying of the mucous membrane of the nasal cavity and oropharynx, it is necessary to put a moisturizing device or a container of water in the nursery. You can just periodically spray the liquid from the spray bottle.

Medical therapy for obstruction

In the early stages of the development of pathology, children should be treated with antiviral agents. Crumbs up to a year for rectal administration are prescribed suppositories Genferon. Their nose is dripped with Grippferon. Orally give Orvirem syrup. From the age of 3, babies are given Arbidol or Kagocel tablets.

Antibiotics are prescribed according to indications. The doctor makes a choice from Cefazolin, Macropen, Augmentin. The appointment of medications is justified with severe intoxication, inflammation, confirmed by a blood test, signs of pneumonia, and the release of a purulent mucous mass of a yellow-green hue.

In addition to eliminating harmful viruses and bacteria, the correct treatment of bronchitis includes a course of taking funds to thin and accelerate sputum rejection. For this purpose, babies are usually given Lazolvan, Ambroxol, Mucosol, Fluditec, etc. For better expectoration, patients should be treated with syrups with phyto components (Gerbion, Bronchosan, Doctor Theiss, Bronchipret).

Babies older than 6 months, prone to allergies, doctors suggest treating Claritin and Zirtek. To expel liquefied sputum, Tavegil and Suprastin are prescribed.

To relieve obstruction, treatment is supplemented with inhalations. Procedures are done using a nebulizer filled with a mixture of Berodual and saline. The patient should inhale the vapors 2 - 3 r. in a day. It is also recommended to use ultrasonic inhalers that are powered by the mains.

In the absence of equipment, you can use special devices with pocket inhalers. Salbutamol, Flixotide, Ventolin are suitable as mixtures for them. The effectiveness of therapy appears immediately. In severe recurrent bronchitis and moderate obstruction, Pulmicort is prescribed by inhalation.

Home Therapy Options

Compresses and rubbing help to alleviate the condition of the child at home - under the influence of heat, the muscles of the bronchi relax and obstructive bronchitis recedes. Compresses with warm vegetable oil allow you to quickly get rid of a cough. A towel is moistened in a refined product and applied to the child on the chest. From above, the compress is covered with cellophane and the baby is dressed in warm pajamas. Positive results of therapy appear after 3 wraps.

If, due to frequent bronchitis, the baby does not have time to get rid of the cough completely, an oil-honey compress will help warm up the insides. The mixture is prepared from an equal amount of butter and bee products. The components are melted over low heat and cooled. The composition is applied to the chest and back of the child, the body is wrapped with a cotton towel and polyethylene. In the "wrapper" the baby should stay until the morning. A weekly course of daily compresses will bring long-awaited relief.

In some cases, obstruction is treated with massage. Properly performed manipulation strengthens the walls of the bronchi and facilitates expectoration of sputum. At home, the baby is kneaded with a collar zone, chest area and back muscles lying along the spine. Postural massage is carried out by tapping with palms folded in a boat along the back. The patient, whose head hangs from the bed, is placed under the stomach with a pillow and a 15-minute postural session is arranged.

For children with obstruction, breathing exercises are recommended. Exercises that stimulate sputum discharge will be taught by the doctor during the consultation. The simplest options are blowing out candles and blowing up balloons with your mouth. Sound gymnastics is performed as the pronunciation of sounds and their combination in a special way. The created vibrations go to the bronchi and relieve spasms.

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

What it is?

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

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

Causes

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

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

Causes that can cause illness include:

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

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

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

Inhalation of polluted air. Living near large industrial enterprises or factories, the baby has a higher risk of bronchial obstruction. This occurs as a result of the constant ingress of the smallest toxic substances into the small bronchi. Industrial emissions quickly lead to the development of respiratory failure.

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

Rapid withdrawal from breastfeeding. Babies who breastfed for a very short time have a higher risk of developing bronchitis. To fight various infections, you need a good level of immunity. During breastfeeding, babies receive a large amount of immunoglobulins G. These protective antibodies help them not to get sick during the period of seasonal colds and protect against the development of diseases of the bronchopulmonary system.

How does it arise?

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

The incubation period is different and depends on the characteristics of the particular microorganism that causes the disease. On average, it is 7-10 days. At this time, the child does not make any complaints. There are no specific signs of the disease during the incubation period. Only weakened children can feel a little fatigue and drowsiness.

After the end of the incubation period, the first specific symptoms characteristic of this disease appear. The active inflammatory process that occurs in the bronchial tree contributes to the violation of the discharge of mucus and sputum.

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

Kinds

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

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

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

Chronic. May be recurrent. Occur with periods of exacerbations and remissions. With insufficiently high-quality treatment or the presence of concomitant diseases in the baby, acute forms become chronic.

By severity:

Lungs. Occurs with minimal symptoms. Well treated. After the therapy, the babies fully recover. There are no long-term consequences of the disease.

Medium degree. The cough is stronger, hacking. Body temperature in obstructive bronchitis of moderate severity rises to 38 degrees. Shortness of breath may increase. The general condition of the child suffers greatly. In some cases, hospitalization and more intensive care are required.

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

Symptoms

The narrowing of the bronchial lumen and the violation of sputum discharge lead to the fact that the child has specific signs of the disease:

Cough. Appears 2-3 days after the end of the incubation period. Hacking cough worries the baby more in the daytime. May be paroxysmal.

Dyspnea. Occurs in moderate to severe disease. With shortness of breath, the number of respiratory movements per minute increases. Babies breathe faster. This symptom can be seen from the side, paying attention to the movements of the chest during breathing.

Soreness in the chest when expectorating. With bronchial obstruction, sputum becomes very dense and thick. All attempts to cough lead to increased soreness in the chest.

Increase in body temperature. It grows to 37-39.5 degrees. Bacterial forms of the disease are accompanied by a higher temperature.

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

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

Severe drowsiness and impaired well-being. Sick kids refuse to eat, begin to act up. Small children are more likely to be held. Long bouts of coughing lead to the fact that the baby begins to cry.

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

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

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

Diagnostics

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

For the diagnosis of obstructive bronchitis used:

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

Biochemistry of blood. Allows you to identify the presence of complications that develop in the pathology of breathing. It is also used for differential diagnosis.

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

Spirometry. Helps to assess functional impairment. Indications of forced inspiration and expiration allow doctors to conclude the presence and severity of bronchial obstruction.

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

Differential Diagnosis

The narrowing of the lumen of the bronchi occurs not only in obstructive bronchitis. Syndrome of bronchial obstruction can be with various diseases. In order to correctly establish the diagnosis, differential diagnosis is required.

Most often, obstructive bronchitis can be confused with:

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

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

Acute bronchitis. The symptoms are similar. Only spirometry allows you to accurately establish the correct diagnosis.

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

Consequences and complications

Frequent obstructive bronchitis can lead to the development of persistent respiratory disorders in children. With reduced immunity, the baby has more and more exacerbations within a relatively short period of time.

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

Prolonged and hacking cough contributes to the formation of bronchiectasis. With this pathology, the distal sections of the bronchi expand with the formation of additional cavities. Bronchiectasis contributes to the appearance of shortness of breath with an increase in respiratory failure. Surgery is performed to correct this condition.

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

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

Treatment

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

Treat obstructive bronchitis should be from the first days, after the onset of symptoms. Early prescription of drugs helps to cope with all adverse manifestations of the disease and prevent chronicity. Drugs that eliminate bronchial obstruction and contribute to better sputum discharge are prescribed by the attending physician.

For the treatment of obstructive bronchitis use:

Means with mucolytic action. They help thin thick sputum and make it easier to discharge along the bronchopulmonary tree. Ambroxol-based preparations are widely used in pediatric practice. "Ambrobene", "Lazolvan", "Flavamed" help to eliminate even a strong cough. Assigned by age, 2-3 times a day for 7-10 days.
Antipyretic. Appointed when the temperature rises above 38 degrees. In babies, various means based on paracetamol are used. Not prescribed for long-term use. May cause allergic reactions and side effects.
Bronchodilators. P designed to eliminate blockage in the bronchi and improve breathing. They are usually prescribed in the form of aerosols or inhalations. The effect is achieved in 10-15 minutes. Short-acting salbutamol-based bronchodilators act within 5 minutes.
Combined drugs containing bronchodilators and anticholinergic drugs. To improve bronchial conduction in children, Berodual is used. It is prescribed by inhaler. The dosage and frequency of inhalations is carried out taking into account the age of the child. Usually the drug is prescribed 3-4 times a day.
Antihistamines. Helps to cope with adverse symptoms in allergic forms of the disease. In children, drugs based on loratadine, Claritin, Suprastin are used. Appointed 1-2 times a day, usually in the morning. Discharged for 7-10 days. With a more severe course - for 2-3 weeks.
Vitamin complexes enriched with selenium. These substances are needed to combat intoxication. The biologically active components that are present in the vitamin complex help the baby fight infection and improve the functioning of the immune system. Selenium is needed for the active functioning of the immune system.
Glucocorticosteroids. They are used in severe and prolonged course of the disease. Usually prescribed inhalations "Pulmicort". The drug is prescribed for a long-term use. It is applied 1-2 times a day until a stable good result is achieved. May cause side effects with long-term use.
Leukotriene receptor blockers. Help to quickly eliminate bronchospasm. They have a lasting effect. The drug "Singular" begins to exert its effect within 2 hours after ingestion. It is applied 1 time per day.

Treatment at home

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

Methods that are safe and effective for self-administration include:

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

Liquorice root. This wonderful remedy improves sputum discharge and promotes better expectoration. It should be used with caution, mindful of possible allergic reactions. Works great even for severe coughs.

Chest fees. The composition of such pharmaceutical preparations includes several medicinal plants at once, which have an expectorant and anti-inflammatory effect. Licorice, coltsfoot, sage help to cope with cough and improve bronchial conduction.

Radish juice. To prepare such a home remedy, an ordinary black radish is suitable. To prepare 250 ml of drink, you only need 1 teaspoon of juice. Before use, add honey to taste.

Breathing exercises

It is used after the acute process subsides. Usually such gymnastics is carried out on the 5-6th day from the onset of the disease. The correct sequence of respiratory movements helps to normalize the functioning of the respiratory system and cope with adverse symptoms.

In order to improve the outflow of sputum, when performing breathing exercises, a sharp and short breath is taken. Exhalation is quite slow and smooth. During exhalation, count up to 5. Each set of exercises consists of 3-4 repetitions. It is recommended to practice every day. Even during remission, breathing exercises will be very useful.

How to conduct breathing exercises, see more in the video below.

Food

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

Breastfeeding in the acute period of the disease should not be canceled. Together with breast milk, the baby receives all the necessary protective antibodies that help him fight the infection that causes bronchitis.

Older kids should eat fractionally, at least 5-6 times a day. A variety of protein foods should be included in the child's diet. It is better that with each meal the baby receives some source of protein. Great for veal, rabbit, chicken or fish.

Try to choose more lean varieties. Fatty foods are absorbed longer by a weakened children's body. Proteins can be supplemented with cereals and vegetables. Fresh fermented milk products are also good as protein dishes. They make a great afternoon snack or second dinner.

All dishes are best steamed, baked or stewed. They should be more fluid. For younger children, fruit and vegetable purees are perfect. It is not necessary to give the child products from jars. A good choice would be homemade mashed cauliflower or potatoes.

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

Prevention

In order for the baby not to get sick with obstructive bronchitis, use the following recommendations:

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

Don't get colds. Any frequent respiratory diseases that mainly occur in the cold season lead to disruption of the respiratory system and reduce immunity. The risk of bronchial obstruction in frequently ill babies increases several times.

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

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

Use dedicated room humidifiers. Too dry air contributes to respiratory failure. Room humidifiers help to create a comfortable and physiologically favorable microclimate in any room.

After the complex treatment, the kids feel much better. Their breathing normalizes, shortness of breath disappears. With properly selected therapy, the transition of an acute process into a chronic one does not occur. Compliance with preventive recommendations helps prevent the occurrence of new exacerbations in the future.

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