What to do if the child has hard, heavy or frequent breathing, wheezing is heard? Frequent shallow breathing. Shallow breathing in a child Shallow breathing during sleep

Tachypnea is the term a doctor uses to describe a patient's breathing if it is too fast and shallow, especially if it is due to the patient's lung disease or other medical cause.

The term "hyperventilation" is usually used when the patient takes frequent and deep breaths due to anxiety or panic.

Causes of rapid and shallow breathing

Rapid, rapid breathing has many possible medical causes, including:

blood clot in a lung artery;

Lack of oxygen (hypoxia);

Infection of the smallest airways in the lungs in children (bronchiolitis);

pneumonia or any other lung infection;

Transient tachypnea of ​​the newborn.

Diagnosis and treatment of rapid and shallow breathing

Rapid and shallow breathing should not be treated at home. It is generally considered to be a medical emergency.

If the patient has asthma or COPD, he needs to use inhaler medicines prescribed by a doctor. If possible, the patient should be immediately examined by a doctor, so it is important to contact the emergency department as soon as possible with this symptom.

You should go to the emergency room if the patient is breathing rapidly and if:

bluish or grayish skin, nails, gums, lips, or around the eyes;

With each breath pulls in the chest;

It is difficult for him to breathe;

Rapid breathing for the first time (never happened before).

The doctor will need to perform a thorough examination of the heart, lungs, abdomen, head, and neck.

Tests that the doctor may prescribe:

Study of the concentration of carbon dioxide in arterial blood and pulse oximetry;

chest x-ray;

Complete blood count and blood chemistry;

Lung scan (allows comparison of ventilation and lung perfusion).

Treatment will depend on the cause of the rapid breathing. Initial care may include oxygen therapy if the patient's oxygen levels are too low.

Respiratory disorders

Normally, at rest, a person’s breathing is rhythmic (the time intervals between breaths are the same), the breath is slightly longer than the exhalation, the respiratory rate is respiratory movements (“inhale-exhale” cycles) per minute.

With physical activity, breathing quickens (up to 25 or more breaths per minute), becomes more superficial, most often remains rhythmic.

Various respiratory disorders make it possible to roughly assess the severity of the patient's condition, determine the prognosis of the disease, as well as the localization of damage to a specific area of ​​the brain.

Symptoms of impaired breathing

• Incorrect breathing rate: breathing is either excessively rapid (at the same time it becomes superficial, that is, it has very short inhalations and exhalations) or, on the contrary, is greatly reduced (often it becomes very deep).
• Violation of the rhythm of breathing: the time intervals between inhalations and exhalations are different, sometimes breathing can stop for a few seconds / minutes, and then reappear.
• Lack of consciousness: not directly related to respiratory failure, but most forms of respiratory failure occur when the patient is in an extremely serious condition, in an unconscious state.

Forms

• Cheyne-Stokes breathing - breathing consists of peculiar cycles. Against the background of a short-term lack of breathing, signs of shallow breathing begin to appear very slowly, then the amplitude of respiratory movements increases, they become deeper, reach a peak, and then gradually fade to a complete lack of breathing. Periods of no breathing between such cycles can be from 20 seconds to 2-3 minutes. Most often, this form of respiratory failure is associated with bilateral damage to the cerebral hemispheres or a general metabolic disorder in the body;
• apneustic breathing - breathing is characterized by a spasm of the respiratory muscles with a full breath. Respiratory rate may be normal or slightly reduced. Having fully inhaled, a person convulsively holds his breath for 2-3 seconds, and then slowly exhales. It is a sign of damage to the brain stem (the area of ​​\u200b\u200bthe brain in which vital centers are located, including the respiratory center);
• atactic breathing (Biot's breathing) - characterized by disordered respiratory movements. Deep breaths are randomly replaced by shallow ones, there are irregular pauses with no breathing. It is also a sign of damage to the brain stem, or rather its back;
• neurogenic (central) hyperventilation - very deep and frequent breathing with an increased frequency (25-60 breaths per minute). It is a sign of damage to the midbrain (a region of the brain located between the brain stem and its hemispheres);
• Kussmaul breathing - rare and deep, noisy breathing. Most often, it is a sign of a metabolic disorder throughout the body, that is, it is not associated with damage to a specific area of ​​\u200b\u200bthe brain.

The reasons

• Acute cerebrovascular accident.
• Metabolic disorders:
  • acidosis - acidification of the blood in severe diseases (renal or liver failure, poisoning);
  • uremia - accumulation of protein breakdown products (urea, creatinine) in renal failure;
  • ketoacidosis.
• Meningitis, encephalitis. They develop, for example, in infectious diseases: herpes, tick-borne encephalitis.
• Poisoning: e.g. carbon monoxide, organic solvents, drugs.
• Oxygen starvation: respiratory failure develops as a consequence of severe oxygen starvation (for example, in rescued drowning people).
• Tumors of the brain.
• Brain injury.

A neurologist will help in the treatment of the disease

Diagnostics

• Analysis of complaints and anamnesis of the disease:
  • how long ago there were signs of respiratory failure (violation of the rhythm and depth of breathing);
  • what event preceded the development of these disorders (head trauma, drug or alcohol poisoning);
  • how quickly the breathing disorder appeared after the loss of consciousness.
• Neurological examination.
  • Assessment of the frequency and depth of breathing.
  • Assessment of the level of consciousness.
  • Search for signs of brain damage (decrease in muscle tone, strabismus, pathological reflexes (absent in a healthy person and appearing only with damage to the brain or spinal cord)).
  • Assessment of the state of the pupils and their reaction to light:
    • wide pupils that do not respond to light are characteristic of damage to the midbrain (the area of ​​\u200b\u200bthe brain located between the brain stem and its hemispheres);
    • narrow (pinpoint) pupils that react poorly to light are characteristic of damage to the brain stem (the area of ​​\u200b\u200bthe brain in which vital centers, including the respiratory center, are located).
• Blood test: assessment of the level of protein breakdown products (urea, creatinine), blood oxygen saturation.
• Acid-base state of the blood: assessment of the presence of acidification of the blood.
• Toxicological analysis: detection of toxic substances in the blood (drugs, drugs, salts of heavy metals).
• CT (computed tomography) and MRI (magnetic resonance imaging) of the head: allow you to study the structure of the brain in layers, to identify any pathological changes (tumors, hemorrhages).
• It is also possible to consult a neurosurgeon.

Treatment for respiratory problems

• Requires treatment of the disease, against which there was a violation of breathing.
  • Detoxification (fight against poisoning) in case of poisoning:
    • drugs that neutralize toxins (antidotes);
    • vitamins (groups B, C);
    • infusion therapy (infusion of solutions intravenously);
    • hemodialysis (artificial kidney) for uremia (accumulation of protein breakdown products (urea, creatinine) in renal failure);
    • antibiotics and antiviral drugs for infectious meningitis (inflammation of the meninges).
• The fight against cerebral edema (develops with most severe brain diseases):
  • diuretic drugs;
  • hormonal drugs (steroid hormones).
• Drugs that improve brain nutrition (neurotrophic, metabolic).
• Timely transfer to artificial lung ventilation.

Complications and consequences

• By itself, respiratory failure is not the cause of any serious complications.
• Oxygen starvation due to irregular breathing (when the rhythm of breathing is disturbed, the body does not receive the proper level of oxygen, that is, breathing becomes “unproductive”).

Prevention of respiratory disorders

• Prevention of respiratory disorders is impossible, as this is an unpredictable complication of severe diseases of the brain and the whole body (traumatic brain injury, poisoning, metabolic disorders).

• Sources

M. Mumenthaler - Differential diagnosis in neurology, 2010

Paul W. Brazis, Joseph C. Masdew, Jose Biller - Topical Diagnosis in Clinical Neurology, 2009

Nikiforov A.S. – Clinical neurology, v.2, 2002

Proper breathing is the key to health

Physiologically correct breathing not only ensures the normal functioning of the lungs, but also, thanks to the respiratory movements of the diaphragm, as already mentioned, improves and facilitates the activity of the heart, activates blood circulation in the abdominal organs.

Meanwhile, many people breathe incorrectly - too often and superficially, sometimes they unconsciously hold their breath, disrupting its rhythm and reducing ventilation.

Thus, shallow breathing harms both healthy and even more sick people. It is not economical, since during inhalation the air remains in the lungs for a short time and this has a bad effect on the absorption of oxygen by the blood. At the same time, a significant part of the lung volume is filled with non-renewable air.

With shallow breathing, the volume of inhaled air does not exceed 300 ml, while under normal conditions it is on average, as already noted, 500 ml.

But, perhaps, a small volume of inhalation is compensated by an increased frequency of respiratory movements? Imagine two people who inhale the same amount of air for a minute, but one of them takes 10 breaths per minute, each with a volume of 600 ml of air, and the other - 20 breaths, with a volume of 300 ml. Thus, the minute volume of breathing for both is the same and equal to 6 liters. The volume of air contained in the airways, i.e. in the so-called dead space (trachea, bronchi) and not involved in the exchange with blood gases, is approximately 140 ml. Therefore, with an inhalation depth of 300 ml, 160 ml of air will reach the pulmonary alveoli, and in 20 breaths this will be 3.2 liters. If the volume of one breath is 600 ml, 460 ml of air will reach the alveoli, and within 1 minute - 4.6 liters. Thus, it is quite clear that infrequent, but deeper breathing is much more effective than shallow and frequent.

Shallow breathing can become habitual as a result of various reasons. One of them is a sedentary lifestyle, often due to the peculiarities of the profession (sitting at a desk, work that requires standing in one place for a long time, etc.), the other is bad posture (the habit of sitting hunched over for a long time and bringing shoulders forward). This often leads, especially at a young age, to compression of the chest organs and insufficient ventilation of the lungs.

Quite common causes of shallow breathing are obesity, constant fullness of the stomach, liver enlargement, intestinal distention, which limit the movement of the diaphragm and reduce the volume of the chest during inspiration.

Shallow breathing can be one of the reasons for insufficient supply of oxygen to the body. This leads to a decrease in the natural non-specific resistance of the body. Respiratory failure may occur in connection with chronic diseases of the lungs and bronchi, as well as intercostal muscles, since patients are unable to produce normal respiratory movements for some time.

In the elderly and elderly, shallow breathing may be associated with a decrease in chest mobility due to ossification of the costal cartilages and weakening of the respiratory muscles. And despite the fact that they develop compensatory adaptations (these include increased breathing and some others) that maintain sufficient ventilation of the lungs, the oxygen tension in the blood decreases due to age-related changes in the lung tissue itself, a decrease in its elasticity, irreversible expansion of the alveoli. All this prevents the transfer of oxygen from the lungs to the blood and impairs the oxygen supply to the body.

Lack of oxygen in tissues and cells (hypoxia) in some cases may be the result of circulatory disorders and blood composition. The cause of tissue hypoxia can be a decrease in the number of functioning capillaries, slowing down and frequent stops of capillary blood flow, etc.

Observations in the clinic have established that in people suffering from cardiovascular diseases - mi (ischemic heart disease, hypertension, etc.), respiratory failure, accompanied by a decrease in the amount of oxygen in the blood, is combined with an increased content of cholesterol and protein-fat complexes (lipoproteins ). From this it was concluded that the lack of oxygen in the body plays a role in the development of atherosclerosis. This conclusion was confirmed in the experiment. It turned out that the amount of oxygen in the tissues and organs of patients with atherosclerosis was significantly below the norm.

The habit of breathing through the mouth is harmful to health. It entails restriction of respiratory movements of the chest, violation of the rhythm of breathing, insufficient ventilation of the lungs. Difficulty in nasal breathing associated with some pathological processes in the nose and nasopharynx, especially common in children, sometimes leads to serious disorders of mental and physical development. In children with adenoid growths in the nasopharynx, which impede nasal breathing, general weakness, pallor, reduced resistance to infections appear, and mental development is sometimes disturbed. With a prolonged absence of nasal breathing in children, underdevelopment of the chest and its muscles is observed.

Physiologically correct nasal breathing is an essential condition for maintaining health. In view of the importance of this issue, let us dwell on it in more detail.

In the nasal cavity, the regulation of humidity and temperature of the air entering the body is carried out. So, in cold weather, the temperature of the outside air in the nasal passages rises, at a high temperature of the external environment, depending on the degree of its humidity, more or less significant heat transfer occurs due to evaporation from the nasal mucosa and nasopharynx.

If the inhaled air is too dry, then, passing through the nose, it is moistened due to the release of fluid from the goblet cells of the mucous membrane and numerous glands.

In the nasal cavity, the air flow is freed from various impurities contained in the atmosphere. There are special points in the nose where dust particles and microbes are constantly “trapped”.

Quite large particles are retained in the nasal cavity - more than 50 microns in size. Smaller particles (from 30 to 50 microns) penetrate the trachea, even smaller particles (10-30 microns) reach large and medium bronchi, particles with a diameter of 3-10 microns enter the smallest bronchi (bronchioles), and finally, the smallest (1-3 microns) - reach the alveoli. Therefore, the finer the dust particles, the deeper they can penetrate the respiratory tract.

Dust that has entered the bronchi is retained by the mucus that covers their surface, and is brought out for about an hour. Mucus covering the surface of the nasal cavity and bronchi acts as a constantly renewing movable filter and is an important barrier that protects the body from exposure to microbes, dust and gases that enter the respiratory tract.

This barrier is especially important for residents of large cities, since the concentration of dust particles in urban air is very high. A large amount of carbon dioxide, carbon monoxide, sulfur oxides, as well as dust and ash (millions of tons per year) is released into the atmosphere of cities. An average of a thousand liters of air passes through the lungs during the day, and if the airways did not have the ability to self-cleanse, they would be completely clogged within a few days.

In the purification of the bronchi and lungs from foreign particles, in addition to tracheobronchial mucus, other mechanisms also take part. So, for example, the removal of particles is facilitated by the very movement of air during exhalation. This mechanism is especially intense during forced expiration and coughing.

Of great importance for the implementation of the antimicrobial barrier function of the nasopharynx and bronchi are substances secreted by the nasal mucosa, as well as specific antibodies in the nasal cavity. Therefore, in healthy people, pathogenic microorganisms, as a rule, do not penetrate into the trachea and bronchi. That small number of microbes that nevertheless gets there is quickly removed due to a kind of protective device - the ciliated epithelium lining the surface of the respiratory tract, starting from the nose and down to the smallest bronchioles.

On the free surface of epithelial cells, facing the lumen of the respiratory tract, there is a large number of constantly fluctuating (ciliated) hairs - cilia. All cilia on the epithelial cells of the respiratory tract are closely linked to each other. Their movements are coordinated and resemble a grain field disturbed by the wind. Despite their small size, ciliated hairs can move relatively large particles weighing 5-10 mg.

If the integrity of the ciliated epithelium is violated due to injury or medicinal substances that have entered directly into the respiratory tract, foreign particles and bacteria are not removed in the damaged areas. In these places, the resistance of the mucous membrane to infection is sharply reduced, conditions for the disease are created. From the mucus secreted by goblet cells, plugs are formed that clog the lumen of the bronchi. This can lead to inflammatory processes in non-ventilated areas of the lungs.

Respiratory tract diseases often occur as a result of damage to the mucous membrane by foreign impurities in the inhaled air. Tobacco smoke has a particularly harmful effect on the bronchi and lungs. It contains many toxic substances, the most famous of which is nicotine. In addition, tobacco smoke has a harmful effect on the respiratory organs: it worsens the conditions for cleansing the respiratory tract from foreign particles and bacteria, as it delays the movement of mucus in the bronchi and trachea. So, in non-smokers, the speed of mucus movement is mm per 1 min, while in smokers it is less than 3 mm per 1 min. This disrupts the removal of foreign particles and microbes to the outside and creates conditions for infection of the respiratory tract.

Tobacco smoke has a very significant negative effect on alveolar macrophages. It inhibits their movement, capture and digestion of bacteria (i.e. inhibits phagocytosis). The toxicity of tobacco smoke is also expressed in direct damage to the structure of macrophages, a change in the properties of their secretion, which not only ceases to protect the lung tissue from harmful effects, but also itself begins to contribute to the development of pathological processes in the lungs. This explains the occurrence of emphysema and pneumosclerosis in long-term smokers. Intensive smoking significantly aggravates the course of acute respiratory diseases and contributes to their transition to chronic inflammatory processes.

In addition, tobacco smoke contains substances that promote the development of malignant tumors (carcinogens). Therefore, smokers develop cancerous tumors in the respiratory tract much more often than non-smokers.

Psychogenic respiratory disorders

The vast majority of questions from readers of our resource addressed to our specialists contain complaints of a feeling of shortness of breath, a lump in the throat, a feeling of lack of air, a feeling of stopping breathing, pain in the heart or chest, a feeling of tightness in the chest and associated feelings of fear and anxiety

In most cases, these symptoms are not associated with either lung disease or heart disease and are a manifestation of hyperventilation syndrome, a very common autonomic disorder that affects 10 to 15% of the adult population. Hyperventilation syndrome is one of the most common forms of vegetative dystonia (VSD).

Symptoms of hyperventilation syndrome are often interpreted as symptoms of asthma, bronchitis, respiratory infections, angina pectoris, goiter, etc., but in most cases (more than 95%) they are in no way associated with diseases of the lungs, heart, thyroid gland, etc.

Hyperventilation syndrome is closely related to Panic attacks and Anxiety disorders. In this article, we will try to explain what is the essence of hyperventilation syndrome, what are its causes, what are its symptoms and signs, and how is it diagnosed and treated.

How is respiration regulated and what is the importance of respiration in the human body?

The somatic system includes bones and muscles and ensures the movement of a person in space. The vegetative system is a life support system, it includes all the internal organs necessary to maintain human life (lungs, heart, stomach, intestines, liver, pancreas, kidneys, etc.).

Like the whole body, the human nervous system can also be conditionally divided into two parts: autonomic and somatic. The somatic part of the nervous system is responsible for what we feel and what we can control: it provides coordination of movements, sensitivity and is the carrier of most of the human psyche. The vegetative part of the nervous system regulates hidden processes that are not subject to our consciousness (for example, it controls metabolism or the work of internal organs).

As a rule, a person can easily control the work of the somatic nervous system: we (can easily make the body move) and practically cannot control the functions of the autonomic nervous system (for example, most people cannot control the work of the heart, intestines, kidneys and other internal organs).

Breathing is the only vegetative function (life support function) subject to the will of man. Anyone can hold their breath for a while or, on the contrary, make it more frequent. The ability to control breathing comes from the fact that the respiratory function is under the simultaneous control of both the autonomic and somatic nervous systems. This feature of the respiratory system makes it extremely sensitive to the influence of the somatic nervous system and the psyche, as well as various factors (stress, fear, overwork) that affect the psyche.

The regulation of the breathing process is carried out at two levels: conscious and unconscious (automatic). The conscious mechanism for controlling breathing is activated during speech, or various activities that require a special mode of breathing (for example, while playing wind instruments or blowing flowed). The unconscious (automatic) breathing control system works when a person's attention is not focused on breathing and is busy with something else, as well as during sleep. The presence of an automatic breathing control system gives a person the opportunity to switch to other activities at any time without the risk of suffocation.

As you know, during breathing, a person releases carbon dioxide from the body and absorbs oxygen. In the blood, carbon dioxide is in the form of carbonic acid, which makes the blood acidic. The acidity of the blood of a healthy person is maintained within very narrow limits due to the automatic operation of the respiratory system (if there is a lot of carbon dioxide in the blood, a person breathes more often, if there is little, then less often). An incorrect breathing pattern (too fast, or vice versa, too shallow breathing), characteristic of hyperventilation syndrome, leads to a change in blood acidity. A change in the acidity of the blood against the background of improper breathing gives rise to a number of metabolic changes throughout the body, and it is these metabolic changes that underlie the appearance of some of the symptoms of hyperventilation syndrome, which will be discussed below.

Thus, breathing is the only possibility for a person to consciously influence the metabolism in the body. Due to the fact that the vast majority of people do not know what the effect of breathing on metabolism is and how to “breathe properly” in order for this effect to be favorable, various changes in breathing (including those with hyperventilation syndrome) only disrupt metabolism and harm body.

What is hyperventilation syndrome?

Hyperventilation syndrome (HVS) is a condition in which, under the influence of mental factors, the normal breathing control program is disrupted.

For the first time, respiratory disorders characteristic of hyperventilation syndrome were described in the middle of the 19th century in soldiers who took part in hostilities (at that time, HVS was called the "soldier's heart"). At the very beginning, a strong association was noted between the occurrence of hyperventilation syndrome with high levels of stress.

At the beginning of the twentieth century, HVS was studied in more detail and is currently considered one of the most common forms of vegetovascular dystonia (VSD, neurocirculatory dystonia). In patients with VVD, in addition to the symptoms of HVS, other symptoms characteristic of a disorder in the work of the autonomic nervous system can be observed.

What are the main reasons for the development of respiratory disorders in hyperventilation syndrome?

At the end of the twentieth century, it was proved that the main cause of all the symptoms of HVS (shortness of breath, a feeling of a coma in the throat, sore throat, annoying coughing, a feeling of inability to breathe, a feeling of chest tightness, pain in the chest and in the heart area, etc.) are psychological stress, anxiety, excitement and depression. As mentioned above, the function of breathing is influenced by the somatic nervous system and the psyche and therefore reacts to any changes that occur in these systems (mainly stress and anxiety).

Another reason for the occurrence of HVS is the tendency of some people to imitate the symptoms of certain diseases (for example, cough, sore throat) and to unconsciously fix these symptoms in their behavior.

The development of HVS in adulthood can be facilitated by monitoring patients with dyspnea in childhood. This fact may seem unlikely to many, but numerous observations have proven the ability of a person’s memory (especially in the case of impressionable people or people with artistic inclinations) to firmly fix certain events (for example, perceptions of sick relatives or their own illness) and subsequently try to reproduce them in real life. life after many years.

In case of hyperventilation syndrome, disruption of the normal breathing program (change in the frequency and depth of breathing) leads to a change in blood acidity and the concentration of various minerals in the blood (calcium, magnesium), which in turn causes such symptoms of HVA as tremors, goosebumps, convulsions, pain in the heart area, a feeling of muscle stiffness, dizziness, etc.

Symptoms and signs of hyperventilation syndrome.

Different Types of Breathing Disorder

Panic attacks and respiratory symptoms

• strong heart beats
• sweating
• chills
• shortness of breath, choking (feeling short of breath)
• pain and discomfort in the left side of the chest
• nausea
• dizziness
• a feeling of unreality of the surrounding world or one's own self
• fear of going crazy
• fear of dying
• tingling or numbness in the legs or arms
• flushes of heat and cold.

Anxiety disorders and respiratory symptoms

Anxiety disorder is a condition, the main symptom of which is a feeling of intense internal anxiety. The feeling of anxiety in an anxiety disorder is usually unjustified and not associated with the presence of a real external threat. Severe internal restlessness in an anxiety disorder often accompanies shortness of breath and a feeling of shortness of breath.

• constant or intermittent feeling of shortness of breath
• a feeling of not being able to take a deep breath or that "air is not getting into the lungs"
• feeling of difficulty breathing or tightness in the chest
• annoying dry cough, frequent sighs, sniffling, yawning.

Emotional disorders in GVS:

• internal feeling of fear and tension
• a sense of imminent disaster
• fear of death
• fear of open or closed spaces, fear of large crowds of people
• depression

Muscular disorders in HVS:

• feeling of numbness or tingling in the fingers or feet
• spasms or cramps in the muscles of the legs and arms
• feeling of tightness in the arms or muscles around the mouth
• pain in the heart or chest

Principles of development of symptoms of HVS

Very often, this may be a hidden or not fully realized concern about the patient's state of health, a past illness (or illness of relatives or friends), conflict situations in the family or at work, which patients tend to hide or unconsciously reduce their significance.

Under the influence of a mental stress factor, the work of the respiratory center changes: breathing becomes more frequent, more superficial, more restless. A long-term change in the rhythm and quality of breathing leads to a change in the internal environment of the body and to the development of muscle symptoms of HVS. The appearance of muscle symptoms of HVS, as a rule, increases the stress and anxiety of patients and thus closes the vicious circle of the development of this disease.

Respiratory disorders with GVS

• Pain in the heart or chest, short-term increase in blood pressure
• Intermittent nausea, vomiting, intolerance to certain foods, episodes of constipation or diarrhea, abdominal pain, irritable bowel syndrome
• Feeling of unreality of the surrounding world, dizziness, feeling close to fainting
• Prolonged fever up to 5 C without other signs of infection.

Hyperventilation syndrome and lung diseases: asthma, chronic bronchitis

According to modern statistics, about 80% of patients with bronchial asthma also suffer from HVA. In this case, the starting point in the development of HVS is exactly asthma and the patient's fear of the symptoms of this disease. The appearance of HVA against the background of asthma is characterized by an increase in dyspnea attacks, a significant increase in the patient's need for medications, the appearance of atypical attacks (dyspnea attacks develop without contact with an allergen, at an unusual time), and a decrease in the effectiveness of treatment.

All patients with asthma should carefully monitor their external respiration during and in between attacks in order to be able to distinguish between an asthma attack and an HVA attack.

Modern methods of diagnostics and treatment of respiratory disorders in HVS

The minimum examination plan for suspected HVS includes:

The state of affairs in the diagnosis of HVS is often complicated by the patients themselves. Many of them, paradoxically, in no way want to accept that the symptoms they experience are not a sign of a serious illness (asthma, cancer, goiter, angina pectoris) and come from the stress of a breakdown in the breathing control program. In experienced physicians' assumption that they are ill with HVS, such patients see a hint that they are 'faking the disease'. As a rule, such patients find some benefit in their morbid condition (liberation from certain duties, attention and care from relatives) and therefore it is so difficult to part with the idea of ​​a “serious illness”. Meanwhile, the patient's attachment to the idea of ​​a "serious illness" is the most significant obstacle to the effective treatment of HVS.

Express DHW diagnostics

To confirm the diagnosis of HVS and treatment, you should contact a neurologist.

Treatment of hyperventilation syndrome

Changing the patient's attitude towards his disease

Respiratory gymnastics in the treatment of respiratory disorders in HVS

During severe attacks of shortness of breath or the appearance of a feeling of lack of air, breathing into a paper or plastic bag is recommended: the edges of the bag are tightly pressed against the nose, cheeks and chin, the patient inhales and exhales air into the bag for several minutes. Breathing into a bag increases the concentration of carbon dioxide in the blood and very quickly eliminates the symptoms of an attack of GVS.

For the prevention of HVS or in situations that can provoke symptoms of HVS, “belly breathing” is recommended - the patient tries to breathe, raising and lowering the stomach due to diaphragm movements, while exhalation should be at least 2 times longer than inhalation.

Breathing should be rare, no more than 8-10 breaths per minute. Breathing exercises should be carried out in a calm, peaceful atmosphere, against the backdrop of positive thoughts and emotions. The duration of the exercises gradually increase the dominut.

Psychotherapeutic treatment is extremely effective for GVS. During psychotherapy sessions, a psychotherapist helps patients to realize the inner cause of their illness and get rid of it.

In the treatment of HVS, drugs from the group of antidepressants (Amitriptyline, Paroxetine) and anxiolytics (Alprazolam, Clonazepam) are highly effective. Drug treatment of HVS is carried out under the supervision of a neurologist. The duration of treatment is from 2-3 months to a year.

As a rule, drug treatment of HVA is highly effective and, in combination with breathing exercises and psychotherapy, guarantees the cure of patients with HVA in the vast majority of cases.

Tell your friends about the article or feed it to the printer

Respiratory disorders

General information

Breathing is a set of physiological processes that provide oxygen to human tissues and organs. Also, in the process of breathing, oxygen is oxidized and excreted from the body in the process of metabolism of carbon dioxide and partially water. The respiratory system includes: nasal cavity, larynx, bronchi, lungs. Breathing consists of their stages:

• external respiration (provides gas exchange between the lungs and the external environment);
• gas exchange between alveolar air and venous blood;
• transport of gases through the blood;
• gas exchange between arterial blood and tissues;
• tissue respiration.

Violations in these processes can occur due to the disease. Serious breathing disorders can be caused by such diseases:

External signs of respiratory failure make it possible to roughly assess the severity of the patient's condition, determine the prognosis of the disease, as well as the localization of damage.

Causes and symptoms of respiratory failure

Breathing problems can be caused by a variety of factors. The first thing you should pay attention to is the frequency of breathing. Excessively rapid or slow breathing indicates problems in the system. Also important is the rhythm of breathing. Rhythm disturbances lead to the fact that the time intervals between inhalations and exhalations are different. Also, sometimes breathing can stop for a few seconds or minutes, and then it appears again. Lack of consciousness can also be associated with problems in the airways. Doctors are guided by the following indicators:

• Noisy breathing;
• apnea (stop breathing);
• violation of the rhythm / depth;
• Biot's breath;
• Cheyne-Stokes breathing;
• Kussmaul breathing;
• tychipnea.

Consider the above factors of respiratory failure in more detail. Noisy breathing is a disorder in which breath sounds can be heard from a distance. There are violations due to a decrease in airway patency. It can be caused by diseases, external factors, rhythm and depth disturbances. Noisy breathing occurs in the following cases:

• Damage to the upper respiratory tract (inspiratory dyspnea);
• swelling or inflammation in the upper airways (stiff breathing);
• bronchial asthma (wheezing, expiratory dyspnea).

When breathing stops, disturbances are caused by hyperventilation of the lungs during deep breathing. Sleep apnea causes a decrease in the level of carbon dioxide in the blood, upsetting the balance of carbon dioxide and oxygen. As a result, the airways narrow, the movement of air becomes difficult. In severe cases, there is:

• tachycardia;
• lowering blood pressure;
• loss of consciousness;
• fibrillation.

In critical cases, cardiac arrest is possible, since respiratory arrest is always fatal to the body. Doctors also pay attention when examining the depth and rhythm of breathing. These disorders can be caused by:

• metabolic products (slags, toxins);
• oxygen starvation;
• craniocerebral injuries;
• bleeding in the brain (stroke);
• viral infections.

Damage to the central nervous system causes Biot's respiration. Damage to the nervous system is associated with stress, poisoning, impaired cerebral circulation. May be caused by encephalomyelitis of viral origin (tuberculous meningitis). Biot's breathing is characterized by the alternation of long pauses in breathing and normal uniform respiratory movements without rhythm disturbance.

An excess of carbon dioxide in the blood and a decrease in the work of the respiratory center causes Cheyne-Stokes respiration. With this form of breathing, the respiratory movements gradually increase in frequency and deepen to a maximum, and then pass to more superficial breathing with a pause at the end of the "wave". Such "wave" breathing is repeated in cycles and can be caused by the following disorders:

• vasospasm;
• strokes;
• hemorrhages in the brain;
• diabetic coma;
• intoxication of the body;
• atherosclerosis;
• exacerbation of bronchial asthma (attacks of suffocation).

In children of primary school age, such disorders are more common and usually disappear with age. Also among the causes may be traumatic brain injury and heart failure.

The pathological form of breathing with rare rhythmic inhalations and exhalations is called Kussmaul breathing. Doctors diagnose this type of breathing in patients with impaired consciousness. Also, a similar symptom causes dehydration.

The type of shortness of breath tachypnea causes insufficient ventilation of the lungs and is characterized by an accelerated rhythm. It is observed in people with strong nervous tension and after hard physical work. Usually passes quickly, but may be one of the symptoms of the disease.

Treatment

Depending on the nature of the disorder, it makes sense to contact the appropriate specialist. Since breathing problems can be associated with many diseases, if you suspect asthma, contact an allergist. With intoxication of the body, a toxicologist will help.

A neurologist will help restore a normal breathing rhythm after shock conditions and severe stress. With past infections, it makes sense to contact an infectious disease specialist. For a general consultation with mild breathing problems, a traumatologist, endocrinologist, okncologist, and somnologist can help. In case of severe respiratory disorders, it is necessary to call an ambulance without delay.

Not enough air: causes of breathing difficulties - cardiogenic, pulmonary, psychogenic, others

Breathing is a natural physiological act that occurs constantly and which most of us do not pay attention to, because the body itself regulates the depth and frequency of respiratory movements depending on the situation. The feeling that there is not enough air, perhaps, is familiar to everyone. It can appear after a quick jog, climbing stairs to a high floor, with strong excitement, but a healthy body quickly copes with such shortness of breath, bringing breathing back to normal.

If short-term shortness of breath after exercise does not cause serious concern, quickly disappearing during rest, then a prolonged or sudden onset of a sharp difficulty in breathing can signal a serious pathology, often requiring immediate treatment. An acute shortage of air when the airways are closed by a foreign body, pulmonary edema, an asthmatic attack can cost a life, so any respiratory disorder requires clarification of its cause and timely treatment.

In the process of breathing and providing tissues with oxygen, not only the respiratory system is involved, although its role, of course, is paramount. It is impossible to imagine breathing without the proper functioning of the muscular frame of the chest and diaphragm, the heart and blood vessels, and the brain. Breathing is influenced by the composition of the blood, hormonal status, activity of the nerve centers of the brain and many external causes - sports training, rich food, emotions.

The body successfully adjusts to fluctuations in the concentration of gases in the blood and tissues, increasing, if necessary, the frequency of respiratory movements. With a lack of oxygen or increased needs in it, breathing quickens. Acidosis, which accompanies a number of infectious diseases, fever, tumors, provokes an increase in breathing to remove excess carbon dioxide from the blood and normalize its composition. These mechanisms turn on themselves, without our will and efforts, but in some cases they become pathological.

Any respiratory disorder, even if its cause seems obvious and harmless, requires examination and a differentiated approach to treatment, therefore, if you feel that there is not enough air, it is better to immediately go to a general practitioner, cardiologist, neurologist, psychotherapist.

Causes and types of respiratory failure

When it is difficult for a person to breathe and there is not enough air, they speak of shortness of breath. This sign is considered an adaptive act in response to an existing pathology or reflects the natural physiological process of adaptation to changing external conditions. In some cases, it becomes difficult to breathe, but an unpleasant feeling of lack of air does not occur, since hypoxia is eliminated by an increased frequency of respiratory movements - in case of carbon monoxide poisoning, work in breathing apparatus, a sharp rise to a height.

Shortness of breath is inspiratory and expiratory. In the first case, there is not enough air when inhaling, in the second - when exhaling, but a mixed type is also possible, when it is difficult to both inhale and exhale.

Shortness of breath does not always accompany the disease, it is physiological, and this is a completely natural condition. The causes of physiological shortness of breath are:

• Physical exercise;
• Excitement, strong emotional experiences;
• Being in a stuffy, poorly ventilated room, in the highlands.

Physiological increase in breathing occurs reflexively and passes after a short time. People with poor physical condition who have a sedentary "office" job experience shortness of breath in response to physical effort more often than those who regularly visit the gym, pool or just take daily walks. As general physical development improves, shortness of breath occurs less frequently.

Pathological shortness of breath can develop acutely or disturb constantly, even at rest, significantly aggravated by the slightest physical effort. A person suffocates when the airways are quickly closed by a foreign body, swelling of the tissues of the larynx, lungs and other serious conditions. When breathing in this case, the body does not receive the necessary even minimal amount of oxygen, and other severe disorders are added to shortness of breath.

The main pathological reasons for which it is difficult to breathe are:

• Diseases of the respiratory system - pulmonary dyspnea;
• Pathology of the heart and blood vessels - cardiac dyspnea;
• Violations of the nervous regulation of the act of breathing - shortness of breath of the central type;
• Violation of the gas composition of the blood - hematogenous shortness of breath.

cardiac causes

Heart disease is one of the most common reasons why it becomes difficult to breathe. The patient complains that he does not have enough air and presses in the chest, notes the appearance of edema on the legs, cyanosis of the skin, fatigue, etc. Usually, patients whose breathing is disturbed against the background of changes in the heart have already been examined and are even taking appropriate drugs, but shortness of breath can not only persist, but in some cases is aggravated.

With a pathology of the heart, there is not enough air when inhaling, that is, inspiratory dyspnea. It accompanies heart failure, can persist even at rest in its severe stages, is aggravated at night when the patient lies.

The most common causes of cardiac dyspnea are:

1. Cardiac ischemia;
2. arrhythmias;
3. Cardiomyopathy and myocardial dystrophy;
4. Defects - congenital lead to shortness of breath in childhood and even the neonatal period;
5. Inflammatory processes in the myocardium, pericarditis;
6. Heart failure.

The occurrence of breathing difficulties in cardiac pathology is most often associated with the progression of heart failure, in which either there is no adequate cardiac output and tissues suffer from hypoxia, or congestion occurs in the lungs due to failure of the left ventricular myocardium (cardiac asthma).

In addition to shortness of breath, often combined with a dry, painful cough, people with cardiac pathology have other characteristic complaints that somewhat facilitate diagnosis - pain in the heart area, “evening” edema, cyanosis of the skin, interruptions in the heart. It becomes more difficult to breathe in the supine position, so most patients even sleep half-sitting, thus reducing the flow of venous blood from the legs to the heart and the manifestations of shortness of breath.

symptoms of heart failure

With an attack of cardiac asthma, which can quickly turn into alveolar pulmonary edema, the patient literally suffocates - the respiratory rate exceeds 20 per minute, the face turns blue, the cervical veins swell, the sputum becomes foamy. Pulmonary edema requires emergency care.

Treatment of cardiac dyspnea depends on the underlying cause that caused it. An adult patient with heart failure is prescribed diuretics (furosemide, veroshpiron, diacarb), ACE inhibitors (lisinopril, enalapril, etc.), beta-blockers and antiarrhythmics, cardiac glycosides, oxygen therapy.

Children are shown diuretics (diacarb), and drugs of other groups are strictly dosed due to possible side effects and contraindications in childhood. Congenital malformations, in which the child begins to suffocate from the very first months of life, may require urgent surgical correction and even heart transplantation.

Pulmonary causes

Lung pathology is the second reason leading to difficulty in breathing, while both inhalation and exhalation are possible. Pulmonary pathology with respiratory failure is:

• Chronic obstructive diseases - asthma, bronchitis, pneumosclerosis, pneumoconiosis, pulmonary emphysema;
• Pneumo- and hydrothorax;
• tumors;
• Foreign bodies of the respiratory tract;
• Thromboembolism in the branches of the pulmonary arteries.

Chronic inflammatory and sclerotic changes in the lung parenchyma greatly contribute to respiratory failure. They are aggravated by smoking, poor environmental conditions, recurrent infections of the respiratory system. Shortness of breath at first worries during physical exertion, gradually becoming permanent, as the disease passes into a more severe and irreversible stage of the course.

With pathology of the lungs, the gas composition of the blood is disturbed, there is a lack of oxygen, which, first of all, is not enough for the head and brain. Severe hypoxia provokes metabolic disorders in the nervous tissue and the development of encephalopathy.

Patients with bronchial asthma are well aware of how breathing is disturbed during an attack: it becomes very difficult to exhale, discomfort and even pain in the chest appear, arrhythmia is possible, sputum is coughed up with difficulty and is extremely scarce, the cervical veins swell. Patients with this shortness of breath sit with their hands on their knees - this position reduces venous return and stress on the heart, alleviating the condition. Most often it is difficult to breathe and there is not enough air for such patients at night or in the early morning hours.

In a severe asthma attack, the patient suffocates, the skin becomes bluish, panic and some disorientation are possible, and status asthmaticus may be accompanied by convulsions and loss of consciousness.

With respiratory disorders due to chronic pulmonary pathology, the appearance of the patient changes: the chest becomes barrel-shaped, the spaces between the ribs increase, the cervical veins are large and dilated, as well as the peripheral veins of the extremities. The expansion of the right half of the heart against the background of sclerotic processes in the lungs leads to its insufficiency, and shortness of breath becomes mixed and more severe, that is, not only the lungs cannot cope with breathing, but the heart cannot provide adequate blood flow, overflowing with blood the venous part of the systemic circulation.

There is not enough air also in case of pneumonia, pneumothorax, hemothorax. With inflammation of the lung parenchyma, it becomes not only difficult to breathe, the temperature also rises, there are obvious signs of intoxication on the face, and coughing is accompanied by sputum production.

An extremely serious cause of sudden respiratory failure is the entry of a foreign body into the respiratory tract. It can be a piece of food or a small part of a toy that the baby accidentally inhales while playing. The victim with a foreign body begins to suffocate, turns blue, quickly loses consciousness, cardiac arrest is possible if help does not arrive in time.

Thromboembolism of the pulmonary vessels can also lead to sudden and rapidly increasing shortness of breath, cough. It occurs more often than a person suffering from pathology of the vessels of the legs, heart, destructive processes in the pancreas. With thromboembolism, the condition can be extremely severe with an increase in asphyxia, blue skin, rapid cessation of breathing and heartbeat.

In some cases, severe shortness of breath is caused by allergies and Quincke's edema, which are also accompanied by stenosis of the lumen of the larynx. The cause may be a food allergen, a wasp sting, inhalation of plant pollen, a drug. In these cases, both the child and the adult require emergency medical care to stop the allergic reaction, and in case of asphyxia, a tracheostomy and mechanical ventilation may be required.

Treatment of pulmonary dyspnea should be differentiated. If the cause of everything is a foreign body, then it must be removed as soon as possible, with allergic edema, the child and adult are shown the introduction of antihistamines, glucocorticoid hormones, adrenaline. In case of asphyxia, a tracheo- or conicotomy is performed.

In bronchial asthma, treatment is multistage, including beta-agonists (salbutamol) in sprays, anticholinergics (ipratropium bromide), methylxanthines (eufillin), glucocorticosteroids (triamcinolone, prednisolone).

Acute and chronic inflammatory processes require antibacterial and detoxification therapy, and compression of the lungs with pneumo- or hydrothorax, impaired airway patency by a tumor is an indication for surgery (puncture of the pleural cavity, thoracotomy, removal of part of the lung, etc.).

Cerebral causes

In some cases, breathing difficulties are associated with brain damage, because the most important nerve centers that regulate the activity of the lungs, blood vessels, and heart are located there. Shortness of breath of this type is characteristic of structural damage to the brain tissue - trauma, neoplasm, stroke, edema, encephalitis, etc.

Respiratory function disorders in brain pathology are very diverse: it is possible both to slow down breathing and to increase it, the appearance of different types of pathological breathing. Many patients with severe brain pathology are on artificial lung ventilation, as they simply cannot breathe on their own.

The toxic effect of the waste products of microbes, fever leads to an increase in hypoxia and acidification of the internal environment of the body, which causes shortness of breath - the patient breathes often and noisily. Thus, the body seeks to quickly get rid of excess carbon dioxide and provide tissues with oxygen.

A relatively harmless cause of cerebral dyspnea can be considered functional disorders in the activity of the brain and peripheral nervous system - autonomic dysfunction, neurosis, hysteria. In these cases, shortness of breath is of a “nervous” nature, and in some cases this is noticeable to the naked eye, even to a non-specialist.

With vegetative dystonia, neurotic disorders and banal hysteria, the patient seems to lack air, he makes frequent respiratory movements, while he can scream, cry and behave extremely defiantly. A person during a crisis may even complain that he is suffocating, but there are no physical signs of asphyxia - he does not turn blue, and the internal organs continue to work correctly.

Respiratory disorders in neurosis and other disorders of the psyche and emotional sphere are safely removed with sedatives, but often doctors encounter patients in whom such nervous shortness of breath becomes permanent, the patient concentrates on this symptom, sighs often and breathes rapidly during stress or emotional outburst.

Treatment of cerebral dyspnea is carried out by resuscitators, therapists, psychiatrists. In severe brain damage with the impossibility of independent breathing, the patient is being artificially ventilated. In the case of a tumor, it must be removed, and neuroses and hysterical forms of difficulty in breathing must be stopped with sedatives, tranquilizers and neuroleptics in severe cases.

Hematogenous causes

Hematogenous shortness of breath occurs when the chemical composition of the blood is disturbed, when the concentration of carbon dioxide increases in it and acidosis develops due to the circulation of acidic metabolic products. Such a respiratory disorder manifests itself in anemia of various origins, malignant tumors, severe renal failure, diabetic coma, and severe intoxication.

With hematogenous shortness of breath, the patient complains that he often lacks air, but the process of inhalation and exhalation is not disturbed, the lungs and heart do not have obvious organic changes. A detailed examination shows that the cause of frequent breathing, in which the feeling that there is not enough air, is shifts in the electrolyte and gas composition of the blood.

Treatment of anemia involves the appointment of iron preparations, vitamins, rational nutrition, blood transfusion, depending on the cause. In case of renal, hepatic insufficiency, detoxification therapy, hemodialysis, infusion therapy are carried out.

Other causes of difficulty breathing

Many are familiar with the feeling when, for no apparent reason, one cannot breathe without a sharp pain in the chest or back. Most are immediately frightened, thinking about a heart attack and clutching at validol, but the reason may be different - osteochondrosis, herniated disc, intercostal neuralgia.

With intercostal neuralgia, the patient feels severe pain in half of the chest, aggravated by movement and inhalation, especially impressionable patients can panic, breathe quickly and shallowly. With osteochondrosis, it is difficult to inhale, and constant pain in the spine can provoke chronic shortness of breath, which can be difficult to distinguish from shortness of breath in pulmonary or cardiac pathologies.

Treatment of breathing difficulties in diseases of the musculoskeletal system includes exercise therapy, physiotherapy, massage, drug support in the form of anti-inflammatory drugs, analgesics.

Many expectant mothers complain that as the pregnancy progresses, it becomes more difficult for them to breathe. This symptom may well fit into the norm, because the growing uterus and fetus raise the diaphragm and reduce the expansion of the lungs, hormonal changes and the formation of the placenta contribute to an increase in the number of respiratory movements to provide the tissues of both organisms with oxygen.

However, during pregnancy, breathing should be carefully assessed so as not to miss a serious pathology behind its seemingly natural increase, which can be anemia, thromboembolic syndrome, progression of heart failure with a defect in a woman, etc.

One of the most dangerous reasons why a woman can begin to choke during pregnancy is pulmonary embolism. This condition is a threat to life, accompanied by a sharp increase in breathing, which becomes noisy and ineffective. Possible asphyxia and death without emergency care.

Thus, having considered only the most common causes of difficulty breathing, it becomes clear that this symptom can indicate dysfunction of almost all organs or systems of the body, and in some cases it is difficult to isolate the main pathogenic factor. Patients who find it difficult to breathe need a thorough examination, and if the patient is suffocating, urgent qualified help is needed.

Any case of shortness of breath requires a trip to the doctor to find out its cause, self-medication in this case is unacceptable and can lead to very serious consequences. This is especially true of respiratory disorders in children, pregnant women and sudden attacks of shortness of breath in people of any age.

Rapid breathing is a symptom that develops in a person with a variety of diseases. In this case, the frequency of respiratory movements increases to 60 or more per minute. This phenomenon is also called tachypnea. In adults, rapid breathing is not accompanied by a violation of its rhythm or the appearance of other clinical signs. With this symptom, only the frequency increases and the depth of inspiration decreases. Newborns can also experience a similar condition - transient tachypnea.

Human breathing depends on:

• age;
• body weight;
• individual anatomical features;
• conditions (rest, sleep, high physical activity, pregnancy, fever, etc.);
• the presence of chronic diseases, severe pathologies.

Normally, the frequency of respiratory movements during wakefulness for an adult is 16–20 per minute, while for a child it is up to 40.

Tachypnea develops when the oxygen content in the blood decreases and the amount of carbon dioxide increases. There is an excitation of the respiratory center in the medulla oblongata. At the same time, the number of nerve impulses to the muscles of the chest increases. The resulting high respiratory rate can also be due to the presence of a number of diseases or psycho-emotional states.

Diseases that cause rapid breathing:

• bronchial asthma;
• chronic bronchial obstruction;
• pneumonia;
• exudative pleurisy;
• pneumothorax (or open);
• myocardial infarction;
• cardiac ischemia;
• increased thyroid function (hyperthyroidism);
• brain tumors;
• Tietze syndrome and rib pathology.

Other reasons:

• pulmonary embolism;
• fever;
• sharp pain;
• heart defects;
• chest trauma;
• hysteria, panic attack, stress, shock;
• mountain sickness;
• medications;
• drug overdose;
• acidosis in metabolic disorders, including ketoacidosis in diabetes;
• anemia;
• damage to the central nervous system.

Types and symptoms

Tachypnea is divided into physiological and pathological. Increased breathing is considered normal during sports and physical activity. A high frequency of respiratory movements during illness is already a sign of pathology. Tachypnea often turns into shortness of breath. At the same time, breathing ceases to be superficial, the inhalation deepens.

If tachypnea progresses to dyspnoea that occurs only when lying on one side, heart disease can be suspected. Increased breathing at rest may indicate pulmonary thrombosis. In the supine position, shortness of breath appears with airway obstruction.

Pathological rapid breathing, if untreated, often leads to hyperventilation, i.e., the oxygen content in the blood of a person begins to exceed the norm. The following symptoms appear:

• dizziness;
• weakness;
• darkening in the eyes;
• spasms of the muscles of the extremities;
• tingling sensation in the fingertips and around the mouth.

Very often, tachypnea occurs with ARVI, acute respiratory infections, influenza. In this case, increased breathing is accompanied by the following symptoms: fever, chills, cough, runny nose and others.

Also, one of the most common options for the appearance of tachypnea is nervous excitement during stress or panic. It is difficult for a person to breathe, speak, there is a feeling of chills.

Sometimes tachypnea can be a sign of a developing dangerous condition or a complication of a serious illness. If a person has a regular increase in breathing, along with the appearance of weakness, chills, chest pain, dry mouth, high fever and other symptoms, you should definitely consult a doctor.

Transient tachypnea

Transient tachypnea is an increase in breathing that develops in newborns in the first hours of life. The child is breathing heavily and often, with wheezing. The skin from a lack of oxygen in the blood acquires a blue tint.

Transient tachypnea occurs more often in children born at term by caesarean section. Fluid in the lungs at birth is absorbed slowly, which causes rapid breathing. Tachypnea in newborns does not require treatment. The child recovers within 1 to 3 days due to the natural disappearance of the cause. To maintain the normal state of the child, additional oxygen supply is needed.

One of the main complaints most often voiced by patients is shortness of breath. This subjective feeling forces the patient to go to the clinic, call an ambulance and may even be an indication for emergency hospitalization. So what is shortness of breath and what are the main causes that cause it? You will find answers to these questions in this article. So…

What is shortness of breath

In chronic heart disease, shortness of breath first occurs after exercise, and eventually begins to disturb the patient at rest.

As mentioned above, shortness of breath (or dyspnea) is a subjective sensation of a person, an acute, subacute or chronic feeling of lack of air, manifested by tightness in the chest, clinically - an increase in the respiratory rate over 18 per minute and an increase in its depth.

A healthy person who is at rest does not pay attention to his breathing. With moderate physical exertion, the frequency and depth of breathing change - the person is aware of this, but this state does not cause him discomfort, besides, the respiratory rate returns to normal within a few minutes after the load is stopped. If shortness of breath with moderate exertion becomes more pronounced, or appears when a person performs elementary actions (when tying shoelaces, walking around the house), or, even worse, does not go away at rest, we are talking about pathological shortness of breath, indicating a particular disease .

Classification of dyspnea

If the patient is concerned about difficulty in inhaling, such shortness of breath is called inspiratory. It appears when the lumen of the trachea and large bronchi narrows (for example, in patients with bronchial asthma or as a result of compression of the bronchus from the outside - with pneumothorax, pleurisy, etc.).

If discomfort occurs during expiration, such shortness of breath is called expiratory. It occurs due to narrowing of the lumen of the small bronchi and is a sign of chronic obstructive pulmonary disease or emphysema.

There are a number of reasons that cause mixed shortness of breath - with a violation of both inhalation and exhalation. The main among them are lung diseases in the late, advanced stages.

There are 5 degrees of severity of shortness of breath, determined on the basis of patient complaints - the MRC scale (Medical Research Council Dyspnea Scale).

Severity	Symptoms
0 - no	Shortness of breath does not bother, except for a very heavy load
1 - light	Shortness of breath occurs only when walking fast or when climbing a hill
2 - medium	Shortness of breath leads to a slower pace of walking compared to healthy people of the same age, the patient is forced to stop while walking to catch his breath.
3 - heavy	The patient stops every few minutes (approximately 100 m) to catch his breath.
4 - extremely severe	Shortness of breath occurs with the slightest exertion or even at rest. Due to shortness of breath, the patient is forced to stay at home all the time.

Causes of shortness of breath

The main causes of shortness of breath can be divided into 4 groups:

1. Respiratory failure due to:
   • violation of bronchial patency;
   • diffuse diseases of the tissue (parenchyma) of the lungs;
   • diseases of the vessels of the lungs;
   • diseases of the respiratory muscles or chest.
2. Heart failure.
3. Hyperventilation syndrome (with neurocirculatory dystonia and neuroses).
4. Metabolic disorders.

Shortness of breath with lung pathology

This symptom is observed in all diseases of the bronchi and lungs. Depending on the pathology, shortness of breath can occur acutely (pleurisy, pneumothorax) or disturb the patient for many weeks, months and years ().

Shortness of breath in COPD is due to narrowing of the airway lumen, the accumulation of viscous secretions in them. It is permanent, expiratory in nature and, in the absence of adequate treatment, becomes more and more pronounced. Often combined with a cough, followed by sputum discharge.

In bronchial asthma, shortness of breath manifests itself in the form of sudden attacks of suffocation. It has an expiratory character - a light short breath is followed by a noisy, labored exhalation. When you inhale special medicines that expand the bronchi, breathing quickly normalizes. Asphyxiation attacks usually occur after contact with allergens - by inhaling them or eating them. In especially severe cases, the attack is not stopped by bronchomimetics - the patient's condition progressively worsens, he loses consciousness. This is an extremely life-threatening condition that requires emergency medical attention.

Accompanies shortness of breath and acute infectious diseases - bronchitis and. Its severity depends on the severity of the course of the underlying disease and the extent of the process. In addition to shortness of breath, the patient is worried about a number of other symptoms:

• temperature increase from subfebrile to febrile digits;
• weakness, lethargy, sweating and other symptoms of intoxication;
• unproductive (dry) or productive (with phlegm) cough;
• chest pain.

With timely treatment of bronchitis and pneumonia, their symptoms stop within a few days and recovery occurs. In severe cases of pneumonia, cardiac failure joins respiratory failure - shortness of breath increases significantly and some other characteristic symptoms appear.

Lung tumors in the early stages are asymptomatic. If a recently arisen tumor was not detected by chance (during prophylactic fluorography or as an accidental finding in the process of diagnosing non-pulmonary diseases), it gradually grows and, when it reaches a sufficiently large size, causes certain symptoms:

• at first non-intense, but gradually increasing constant shortness of breath;
• hacking cough with a minimum of sputum;
• hemoptysis;
• chest pain;
• weight loss, weakness, pallor of the patient.

Treatment of lung tumors may include surgery to remove the tumor, chemotherapy and / or radiation therapy, and other modern treatment methods.

The greatest threat to the life of the patient is borne by such conditions manifested by shortness of breath, such as pulmonary embolism, or PE, local airway obstruction and toxic pulmonary edema.

PE is a condition in which one or more branches of the pulmonary artery are clogged with blood clots, as a result of which part of the lungs is excluded from the act of breathing. The clinical manifestations of this pathology depend on the extent of the lung lesion. Usually it is manifested by sudden shortness of breath, disturbing the patient with moderate or slight physical exertion or even at rest, a feeling of suffocation, tightness and chest pain, similar to that with, often hemoptysis. The diagnosis is confirmed by corresponding changes in the ECG, chest x-ray, and angiopulmography.

Airway obstruction is also manifested by the symptom complex of suffocation. Shortness of breath is inspiratory in nature, breathing is heard at a distance - noisy, stridor. A frequent companion of shortness of breath in this pathology is a painful cough, especially when changing the position of the body. The diagnosis is made on the basis of spirometry, bronchoscopy, x-ray or tomography.

Airway obstruction can be caused by:

• violation of the patency of the trachea or bronchi due to compression of this organ from the outside (aortic aneurysm, goiter);
• damage to the trachea or bronchi by a tumor (cancer, papillomas);
• ingress (aspiration) of a foreign body;
• formation of cicatricial stenosis;
• chronic inflammation leading to destruction and fibrosis of the cartilaginous tissue of the trachea (with rheumatic diseases - systemic lupus erythematosus,).

Therapy with bronchodilators in this pathology is ineffective. The main role in the treatment belongs to adequate therapy of the underlying disease and mechanical restoration of airway patency.

It can occur against the background of an infectious disease, accompanied by severe intoxication, or due to exposure to the respiratory tract of toxic substances. At the first stage, this condition is manifested only by gradually increasing shortness of breath and rapid breathing. After some time, shortness of breath is replaced by painful suffocation, accompanied by bubbling breathing. The leading direction of treatment is detoxification.

The following lung diseases are less common with shortness of breath:

• pneumothorax - an acute condition in which air enters the pleural cavity and lingers there, squeezing the lung and preventing the act of breathing; occurs due to injuries or infectious processes in the lungs; requires urgent surgical care;
• - a serious infectious disease caused by Mycobacterium tuberculosis; requires long-term specific treatment;
• actinomycosis of the lungs - a disease caused by fungi;
• emphysema - a disease in which the alveoli are stretched and lose the ability to normal gas exchange; develops as an independent form or accompanies other chronic respiratory diseases;
• silicosis - a group of occupational lung diseases resulting from the deposition of dust particles in the lung tissue; recovery is impossible, the patient is prescribed supportive symptomatic therapy;
• , defects of the thoracic vertebrae - in these conditions, the shape of the chest is disturbed, which makes breathing difficult and causes shortness of breath.

Shortness of breath in the pathology of the cardiovascular system

Persons suffering from one of the main complaints note shortness of breath. In the early stages of the disease, shortness of breath is perceived by patients as a feeling of lack of air during physical exertion, but over time this feeling is caused by less and less exertion, in advanced stages it does not leave the patient even at rest. In addition, advanced stages of heart disease are characterized by paroxysmal nocturnal dyspnea - an attack of suffocation that develops at night, leading to the awakening of the patient. This condition is also known as . Its cause is stagnation in the lungs of fluid.

Shortness of breath in neurotic disorders

Three-quarters of neurologists and psychiatrists complain of shortness of breath of one degree or another. The feeling of lack of air, the impossibility of breathing deeply, often accompanied by anxiety, fear of death from suffocation, a feeling of a “shutter”, an obstruction in the chest that prevents a full breath - the complaints of patients are very diverse. Typically, such patients are easily excitable, acutely responsive to stress people, often with hypochondriacal inclinations. Psychogenic breathing disorders often manifest against the background of anxiety and fear, depressed mood, after experienced nervous overexcitation. There are even attacks of false asthma - suddenly developing attacks of psychogenic shortness of breath. A clinical feature of the psychogenic features of breathing is its noise design - frequent sighs, groans, groans.

Treatment of shortness of breath in neurotic and neurosis-like disorders is carried out by neuropathologists and psychiatrists.

Shortness of breath with anemia

With anemia, the organs and tissues of the patient's body experience oxygen starvation, in order to compensate for which, the lungs try, as it were, to pump more air into themselves.

Anemia is a group of diseases characterized by changes in the composition of the blood, namely, a decrease in the content of hemoglobin and red blood cells in it. Since the transport of oxygen from the lungs directly to organs and tissues is carried out precisely with the help of hemoglobin, when its amount decreases, the body begins to experience oxygen starvation - hypoxia. Of course, he tries to compensate for this state, roughly speaking, to pump more oxygen into the blood, as a result of which the frequency and depth of breaths increase, i.e. shortness of breath occurs. There are different types of anemia and they occur due to different reasons:

• insufficient intake of iron with food (in vegetarians, for example);
• chronic bleeding (with peptic ulcer, uterine leiomyoma);
• after recent severe infectious or somatic diseases;
• with congenital metabolic disorders;
• as a symptom of oncological diseases, in particular blood cancer.

In addition to shortness of breath with anemia, the patient complains of:

• severe weakness, loss of strength;
• decreased sleep quality, decreased appetite;
• dizziness, headaches, decreased performance, impaired concentration, memory.

Persons suffering from anemia are characterized by pallor of the skin, in some types of the disease - its yellow tint, or jaundice.

It is easy to diagnose - it is enough to pass a general blood test. If there are changes in it, indicating anemia, a number of examinations, both laboratory and instrumental, will be prescribed to clarify the diagnosis and identify the causes of the disease. Treatment is prescribed by a hematologist.

Shortness of breath in diseases of the endocrine system

Persons suffering from diseases such as obesity and diabetes also often complain of shortness of breath.

With thyrotoxicosis, a condition characterized by excessive production of thyroid hormones, all metabolic processes in the body increase sharply - at the same time, it experiences an increased need for oxygen. In addition, an excess of hormones causes an increase in the number of heartbeats, as a result of which the heart loses the ability to fully pump blood to tissues and organs - they lack oxygen, which the body tries to compensate for - shortness of breath occurs.

An excess amount of adipose tissue in the body during obesity makes it difficult for the respiratory muscles, heart, lungs, as a result of which the tissues and organs do not receive enough blood and experience a lack of oxygen.

With diabetes, sooner or later the vascular system of the body is affected, as a result of which all organs are in a state of chronic oxygen starvation. In addition, kidneys are also affected over time - diabetic nephropathy develops, which in turn provokes anemia, as a result of which hypoxia is further enhanced.

Shortness of breath in pregnant women

During pregnancy, the respiratory and cardiovascular systems of a woman's body experience increased stress. This load is due to an increased volume of circulating blood, compression from the bottom of the diaphragm by an enlarged uterus (as a result of which the chest organs become cramped and respiratory movements and heart contractions are somewhat difficult), the need for oxygen is not only for the mother, but also for the growing embryo. All these physiological changes lead to the fact that during pregnancy, many women experience shortness of breath. In this case, the respiratory rate does not exceed 22-24 per minute, it becomes more frequent during physical exertion and stress. With the progression of pregnancy, shortness of breath also progresses. In addition, expectant mothers often suffer from anemia, as a result of which shortness of breath increases even more.

If the respiratory rate exceeds the above figures, shortness of breath does not go away or does not significantly decrease at rest, the pregnant woman should definitely consult with an obstetrician-gynecologist or therapist.

Shortness of breath in children

The respiratory rate in children of different ages is different. Dyspnea should be suspected if:

• in a child of 0–6 months, the number of respiratory movements (RR) is more than 60 per minute;
• in a child of 6–12 months, the respiratory rate is over 50 per minute;
• in a child older than 1 year, the respiratory rate is over 40 per minute;
• in a child older than 5 years, the respiratory rate is over 25 per minute;
• a child of 10–14 years old has a respiratory rate of over 20 per minute.

During emotional arousal, during physical exertion, crying, feeding, the respiratory rate is always higher, but if the respiratory rate significantly exceeds the norm and slowly recovers at rest, the pediatrician should be informed about this.

Most often, shortness of breath in children occurs with the following pathological conditions:

• respiratory distress syndrome of the newborn (often recorded in premature babies whose mothers suffer from diabetes mellitus, cardiovascular disorders, diseases of the genital area; intrauterine hypoxia, asphyxia contribute to it; clinically manifested by shortness of breath with a respiratory rate of over 60 per minute, a blue tint of the skin pallor, chest rigidity is also noted; treatment should be started as early as possible - the most modern method is the introduction of pulmonary surfactant into the trachea of ​​a newborn in the first minutes of his life);
• acute stenosing laryngotracheitis, or false croup (a feature of the structure of the larynx in children is its small lumen, which, with inflammatory changes in the mucous membrane of this organ, can lead to disruption of the passage of air through it; usually, false croup develops at night - swelling increases in the vocal cords, leading to severe inspiratory dyspnea and suffocation; in this condition, it is necessary to provide the child with fresh air and immediately call an ambulance);
• congenital heart defects (due to intrauterine development disorders, a child develops pathological communications between the main vessels or cavities of the heart, leading to a mixture of venous and arterial blood; as a result, the organs and tissues of the body receive blood that is not saturated with oxygen and experience hypoxia; depending on the severity defect shows dynamic observation and / or surgical treatment);
• viral and bacterial bronchitis, pneumonia, bronchial asthma, allergies;
• anemia.

In conclusion, it should be noted that only a specialist can determine the reliable cause of shortness of breath, therefore, if this complaint occurs, you should not self-medicate - the most correct decision would be to consult a doctor.

Which doctor to contact

If the diagnosis is still unknown to the patient, it is best to contact a general practitioner (pediatrician for children). After the examination, the doctor will be able to establish a presumptive diagnosis, if necessary, refer the patient to a specialized specialist. If shortness of breath is associated with lung pathology, it is necessary to consult a pulmonologist, in case of heart disease, a cardiologist. Anemia is treated by a hematologist, diseases of the endocrine glands - by an endocrinologist, pathology of the nervous system - by a neurologist, mental disorders accompanied by shortness of breath - by a psychiatrist.

Tachypnea - rapid shallow breathing, which is not accompanied by a violation of the respiratory rhythm. At rest, the respiratory rate with tachypnea exceeds 20 breaths per minute in an adult, 25 in children of one year of age and 40 in newborns.

ICD-10	R06.0
ICD-9	786.06

Tachypnea occurs with physical exertion, viral diseases, nervous excitement, poisoning, and elevated body temperature, and can also be a symptom of other diseases and conditions.

General information

The frequency of respiratory movements (RR) is the number of inhalation-exhalation cycles in a certain unit of time (usually the number of cycles per minute is counted). NPV is one of the main and oldest biological signs (biomarkers) that are used to determine the state of the entire human body.

A number of factors affect a person's respiratory rate:

• age;
• physical activity;
• health status;
• congenital features, etc.

In a state of physiological rest, the respiratory rate of an adult healthy awake person is 16-20 respiratory movements, and in a newborn it is 40-45. With age, the NPV in children decreases.

Physical activity, emotional arousal and heavy food intake cause a physiological increase in respiratory rate, and in a sleeping person, the respiratory rate decreases to 12-14 respiratory movements per minute.

Forms

Tachypnea can be:

• physiological (occurs during physical exertion, pregnancy, nervous excitement);
• pathological (caused by various diseases of the respiratory system, viral diseases, etc.).

Transient tachypnea of ​​newborns is also distinguished, which occurs in the first hours of life due to the preservation of an excess amount of intrauterine fluid in the lungs.

Reasons for development

Tachypnea occurs when:

• excitation of the respiratory center;
• pathology of the central nervous system (meningitis, traumatic brain injury);
• reflex reactions caused by sharp pain, pulmonary embolism, a decrease in the depth of breathing (occurs as a result of restriction of respiratory movements during pleurisy, chest injuries, or with a significant decrease in lung capacity).

Tachypnea develops when:

• Spasm of the bronchi or bronchiolitis (diffuse inflammation of the bronchial mucosa) as a result of a violation of the normal flow of air into the alveoli.
• Pneumonia (viral and lobar), pulmonary tuberculosis, atelectasis (caused by a decrease in the respiratory surface of the lungs).
• Exudative pleurisy, pneumothorax, hydrothorax, mediastinal tumors as a result of lung compression.
• Tumors that compress or clog the main bronchus.
• Blockage of the pulmonary trunk by a thrombus or other intravascular substrate (pulmonary infarction).
• Emphysema of the lung, which manifests itself in a pronounced form and proceeds against the background of cardiovascular pathology.
• Dry pleurisy, acute myositis, diaphragmatitis, intercostal neuralgia, fracture of the ribs or the presence of metastases of a malignant tumor in this area as a result of insufficient depth of breathing (associated with the desire to avoid sharp pains in the chest).
• Ascites, flatulence, in late pregnancy (develops due to increased intra-abdominal pressure and a high level of standing diaphragm).

Tachypnea is also seen in:

• fever
• hysteria ("dog breathing", in which the respiratory rate reaches 60-80 per minute);
• diseases of the cardiovascular system;
• chronic obstructive pulmonary diseases;
• anemia;
• diabetic ketoacidosis and other pathological conditions.

Tachypnea after surgery may occur as a side effect of anesthesia.

Tachypnea in newborns usually develops during delivery by caesarean section (20-25% of the total number of children born by caesarean section). In general, transient tachypnea is observed in 1-2% of the total number of newborns.

Normally, approximately 2 days before delivery and during physiological childbirth, intrauterine fluid from the lungs is gradually absorbed into the blood of the fetus. Caesarean section (especially planned) weakens this process, and in the newborn, intrauterine fluid is stored in the lungs in excess. This provokes swelling of the lung tissue and a decrease in the ability to provide oxygen to the body, resulting in the development of tachypnea.

Tachypnea in children can also be caused by:

• acute asphyxia in childbirth;
• excessive drug therapy of the mother during childbirth (excessive use of oxytocin, etc.);
• mother has diabetes.

Symptoms

Tachypnea is manifested by increased respiratory movements and shallow breathing, which is not accompanied by a violation of the respiratory rhythm. Clinical signs of shortness of breath are not observed.

Treatment

Transient and physiological tachypnea do not need treatment and pass on their own, and with pathological causes of an increase in respiratory rate, it is necessary to eliminate the underlying disease.

Any changes in the child's breathing immediately become noticeable to parents. Especially if the frequency and nature of breathing changes, extraneous noises appear. We will talk about why this can happen and what to do in each specific situation in this article.

Peculiarities

Children breathe differently than adults. Firstly, in babies, breathing is more superficial, shallow. The volume of air inhaled will increase as the child grows, in babies it is very small. Secondly, it is more frequent, because the volume of air is still small.

The airways in children are narrower, they have a certain deficit of elastic tissue.

This often leads to a violation of the excretory function of the bronchi. With a cold or a viral infection in the nasopharynx, larynx, and bronchi, active immune processes begin to fight the invading virus. Mucus is produced, the task of which is to help the body cope with the disease, “bind” and immobilize alien “guests”, stop their progress.

Due to the narrowness and inelasticity of the respiratory tract, the outflow of mucus can be difficult. Most often, problems with the respiratory system in childhood are experienced by children who were born prematurely. Due to the weakness of the entire nervous system in general and the respiratory system in particular, they have a significantly higher risk of developing serious pathologies - bronchitis, pneumonia.

Babies breathe mainly with the “belly”, that is, at an early age, due to the high location of the diaphragm, abdominal breathing prevails.

At the age of 4, chest breathing begins to form. By age 10, most girls are breastfeeding and most boys are diaphragmatic (abdominal) breathing. A child's need for oxygen is much higher than the needs of an adult, because babies are actively growing, moving, they have much more transformations and changes in their bodies. To provide all organs and systems with oxygen, the baby needs to breathe more often and more actively, for this there should be no pathological changes in his bronchi, tracheas and lungs.

Any, even insignificant, at first glance, reason (stuffy nose, sore throat, tickling) can complicate children's breathing. During illness, it is not so much the abundance of bronchial mucus that is dangerous, but its ability to quickly thicken. If, with a blocked nose, the baby breathed through his mouth at night, then with a high degree of probability, the next day the mucus will begin to thicken and dry out.

Not only the disease can disturb the child's external breathing, but also the quality of the air that he breathes. If the climate in the apartment is too hot and dry, if the parents turn on the heater in the children's bedroom, then there will be many more problems with breathing. Too humid air will also not benefit the baby.

Oxygen deficiency in children develops faster than in adults, and this does not necessarily require the presence of some serious illness.

Sometimes there is enough slight swelling, slight stenosis, and now hypoxia develops in the little one. Absolutely all departments of the children's respiratory system have significant differences from the adult. This explains why children under 10 years of age are most likely to suffer from respiratory ailments. After 10 years, the incidence decreases, with the exception of chronic pathologies.

The main breathing problems in children are accompanied by several symptoms that are understandable to every parent:

• the child's breathing became hard, noisy;
• the baby breathes heavily - inhalations or exhalations are given with visible difficulty;
• the respiratory rate has changed - the child began to breathe less often or more often;
• wheezing appeared.

The reasons for these changes may be different. And only a doctor in tandem with a specialist in laboratory diagnostics can establish the true ones. We will try to tell in general terms what reasons most often underlie changes in breathing in a child.

Varieties

Depending on the nature, experts distinguish several types of shortness of breath.

hard breathing

Harsh breathing in the medical understanding of this phenomenon is such respiratory movements in which inhalation is clearly audible, but exhalation is not. It should be noted that hard breathing is a physiological norm for young children. Therefore, if the child does not have a cough, runny nose or other symptoms of the disease, then you should not worry. The baby is breathing within the normal range.

Rigidity depends on age - the younger the toddler, the harder his breath. This is due to the underdevelopment of the alveoli and muscle weakness. The baby usually breathes noisily, and this is quite normal. In most children, breathing softens by the age of 4, in some it can remain quite hard until 10-11 years. However, after this age, the breathing of a healthy child always softens.

If a child has an exhalation noise accompanied by a cough and other symptoms of the disease, then we can talk about a large list of possible ailments.

Most often, such breathing accompanies bronchitis and bronchopneumonia. If the exhalation is heard as clearly as the inhalation, then you should definitely consult a doctor. Such harsh breathing will not be the norm.

Harsh breathing with a wet cough is characteristic of the recovery period after an acute respiratory viral infection. As a residual phenomenon, such breathing indicates that not all excess sputum has left the bronchi. If there is no fever, runny nose and other symptoms, and hard breathing is accompanied by a dry and unproductive cough, Maybe it's an allergic reaction to some antigen. With influenza and SARS at the very initial stage, breathing can also become hard, but at the same time, a sharp increase in temperature, liquid transparent discharge from the nose, and possibly redness of the throat and tonsils will be the obligatory accompanying symptoms.

Hard breath

Difficulty breathing is usually difficult. Such difficult breathing causes the greatest concern among parents, and this is not at all in vain, because normally, in a healthy child, the breath should be audible, but light, it should be given to the child without difficulty. In 90% of all cases of difficulty breathing when inhaling, the cause lies in a viral infection. These are all familiar influenza viruses and various acute respiratory viral infections. Sometimes heavy breathing accompanies such serious diseases as scarlet fever, diphtheria, measles and rubella. But in this case, changes in inspiration will not be the first sign of the disease.

Usually, heavy breathing does not develop immediately, but as the infectious disease develops.

With influenza, it can appear on the second or third day, with diphtheria - on the second, with scarlet fever - by the end of the first day. Separately, it is worth mentioning such a cause of difficult breathing as croup. It can be true (for diphtheria) and false (for all other infections). Intermittent breathing in this case is explained by the presence of stenosis of the larynx in the region of the vocal folds and in nearby tissues. The larynx narrows, and depending on the degree of croup (how narrowed the larynx) determines how difficult it will be to inhale.

Heavy shortness of breath is usually accompanied by shortness of breath. It can be observed both under load and at rest. The voice becomes hoarse, and sometimes disappears altogether. If the child is convulsive, jerky breathing, while breathing is clearly difficult, well audible, when trying to inhale, the skin above the collarbone sinks a little, you should immediately call an ambulance.

Croup is extremely dangerous, it can lead to the development of instant respiratory failure, suffocation.

It is possible to help a child only within the limits of first aid - open all the windows, provide fresh air (and do not be afraid that it is winter outside!), put the child on his back, try to calm him down, since excessive excitement makes the breathing process even more difficult and exacerbates the situation. All this is done from that period of time, while the ambulance brigade is going to the baby.

Of course, it is useful to be able to intubate the trachea with improvised means at home, in case of suffocation of a child, this will help save his life. But not every father or mother will be able, having overcome fear, to make an incision in the trachea with a kitchen knife and insert a spout from a porcelain teapot into it. This is how life-saving intubation is done.

Heavy breathing along with cough in the absence of fever and signs of a viral disease may indicate asthma.

General lethargy, lack of appetite, shallow and shallow breaths, pain when trying to breathe deeper can indicate the onset of a disease such as bronchiolitis.

Rapid breathing

The change in respiratory rate is usually in favor of acceleration. Rapid breathing is always a clear symptom of a lack of oxygen in the child's body. In the language of medical terminology, rapid breathing is called "tachypnea." A failure in respiratory function can occur at any time, sometimes parents may notice that a baby or a newborn often breathes in a dream, while the breathing itself is shallow, it looks like what happens in a dog that is “out of breath”.

Any mother can detect the problem without much difficulty. However you should not try to independently look for the cause of tachypnea, this is the task of specialists.

The technique for counting the respiration rate is quite simple.

It is enough for a mother to arm herself with a stopwatch and put her hand on the child’s chest or tummy (it depends on age, since abdominal breathing prevails at an early age, and at an older age it can change into chest breathing. You need to count how many times the child inhales (and the chest or stomach rises - drops) in 1 minute. Then you should check with the above age norms and draw a conclusion. If there is an excess, this is an alarming symptom of tachypnea, and you should consult a doctor.

Quite often, parents complain about frequent intermittent breathing in their baby, not being able to distinguish tachypnea from banal shortness of breath. To do this in the meantime is quite simple. You should carefully observe whether the baby's inhalations and exhalations are always rhythmic. If rapid breathing is rhythmic, then we are talking about tachypnea. If it slows down and then accelerates, the child breathes unevenly, then we should talk about the presence of shortness of breath.

The causes of rapid breathing in children are often neurological or psychological in nature.

Severe stress, which the baby cannot express in words due to age and insufficient vocabulary and figurative thinking, still needs to be released. In most cases, children begin to breathe faster. This is considered physiological tachypnea, there is no particular danger of violation. The neurological nature of tachypnea should be considered first of all, remembering what events preceded the change in the nature of inhalations and exhalations, where the baby was, who he met, whether he had a strong fright, resentment, hysteria.

The second most common cause of rapid breathing is in respiratory diseases, primarily in bronchial asthma. Such periods of increased breaths are sometimes harbingers of periods of difficult breathing, episodes of respiratory failure, characteristic of asthma. Frequent fractional breaths often accompany chronic respiratory ailments, such as chronic bronchitis. However, the increase does not occur during remission, but during exacerbations. And along with this symptom, the baby has other symptoms - cough, fever (not always!), decreased appetite and general activity, weakness, fatigue.

The most serious reason for frequent inhalations and exhalations lies in in diseases of the cardiovascular system. It happens that it is possible to detect pathologies from the side of the heart only after the parents bring the baby to an appointment about increased breathing. That is why, in case of violation of the frequency of breaths, it is important to examine the child in a medical institution, and not to self-medicate.

Hoarseness

Bad breath with wheezing always indicates that there is an obstruction in the airways for the passage of the air stream. A foreign body, which the child inadvertently inhaled, and dried bronchial mucus, if the baby was treated for cough incorrectly, and narrowing of any part of the respiratory tract, the so-called stenosis, can also stand in the way of air.

Wheezing is so varied that you need to try to give a correct description of what parents hear in the performance of their own child.

Wheezing is described by duration, tonality, by coincidence with inhalation or exhalation, by the number of tones. The task is not easy, but if you successfully cope with it, then you can understand what exactly the child is sick with.

The fact is that wheezing for different diseases is quite unique, peculiar. And they actually have a lot to say. So, wheezing (dry wheezing) can indicate a narrowing of the airway, and wet wheezing (noisy gurgling accompaniment of the breathing process) can indicate the presence of fluid in the airways.

If the obstruction has arisen in a bronchus with a wide diameter, the wheezing tone is lower, bassy, ​​deaf. If the bronchi are thin, then the tone will be high, with a whistle on exhalation or inhalation. With inflammation of the lungs and other pathological conditions that lead to changes in tissues, wheezing is noisier, louder. If there are no severe inflammations, then the child wheezes quieter, muffled, sometimes barely distinguishable. If the child wheezes, as if sobbing, this always indicates the presence of excess moisture in the airways. Experienced doctors can diagnose the nature of wheezing by ear using a phonendoscope and percussion.

It happens that wheezing is not pathological. Sometimes they can be seen in an infant up to a year old, both in a state of activity and at rest. The baby breathes with a bubbling "accompaniment", and also noticeably "grunts" at night. This is due to the congenital individual narrowness of the respiratory tract. Such wheezing should not disturb parents if there are no accompanying painful symptoms. As the child grows, the airways will grow and expand, and the problem will disappear by itself.

In all other situations, wheezing is always an alarming sign that definitely requires examination by a doctor.

Wet rales, gurgling in varying degrees of severity may accompany:

• bronchial asthma;
• problems of the cardiovascular system, heart defects;
• lung diseases, including edema and tumors;
• acute renal failure;
• chronic respiratory diseases - bronchitis, obstructive bronchitis;
• SARS and influenza;
• tuberculosis.

Dry whistling or barking rales are more often characteristic of bronchiolitis, pneumonia, laryngitis, pharyngitis, and may even indicate the presence of a foreign body in the bronchi. In making the correct diagnosis, the method of listening to wheezing - auscultation - helps. Every pediatrician owns this method, and therefore a child with wheezing should definitely be shown to a pediatrician in order to establish a possible pathology in time and start treatment.

Treatment

After the diagnosis is made, the doctor prescribes the appropriate treatment.

Hard breathing therapy

If there is no temperature and, except for the rigidity of breathing, there are no other complaints, then the child does not need to be treated. It is enough to provide him with a normal motor regime, it is very important that excess bronchial mucus come out as quickly as possible. It is useful to walk on the street, play outdoor and active games in the fresh air. Usually breathing returns to normal within a few days.

If hard breathing is accompanied by a cough or fever, it is imperative to show the child to a pediatrician to rule out respiratory diseases.

If the disease is detected, the treatment will be aimed at stimulating the discharge of bronchial secretions. To do this, the baby is prescribed mucolytic drugs, heavy drinking, vibration massage.

For information on how vibration massage is done, see the following video.

Harsh breathing with a cough, but without respiratory symptoms and temperature, requires a mandatory consultation with an allergist. Perhaps the cause of the allergy can be eliminated by simple household actions - wet cleaning, ventilation, elimination of all chlorine-based household chemicals, use of hypoallergenic baby washing powder when washing clothes and linen. If this does not work, then the doctor will prescribe antihistamines with a calcium preparation.

Measures for heavy breathing

Heavy breathing with a viral infection does not need special treatment, since the underlying disease needs to be treated. In some cases, antihistamines are added to standard prescriptions for influenza and SARS, since they help to relieve internal edema and make it easier for the child to breathe. With diphtheria croup, the child is hospitalized without fail, since he needs the prompt administration of anti-diphtheria serum. This can be done only in a hospital, where, if necessary, the baby will be provided with surgical assistance, the connection of a ventilator, the introduction of antitoxic solutions.

False croup, if it is not complicated, and the child is not breastfeeding, may be allowed to be treated at home.

For this, it is usually prescribed courses of inhalation with drugs. Moderate and severe forms of croup need inpatient treatment with the use of glucocorticosteroid hormones ("Prednisolone" or "Dexamethasone"). Treatment of asthma and bronchiolitis is also carried out under medical supervision. In severe form - in the hospital, in mild form - at home, subject to all the recommendations and prescriptions of the doctor.

Rhythm increase - what to do?

Treatment in case of transient tachypnea, which is caused by stress, fear or excessive sensibility of the child, is not required. It is enough to teach the child to cope with his emotions, and over time, when the nervous system gets stronger, attacks of frequent breathing will come to naught.

You can stop another attack with a paper bag. It is enough to invite the child to breathe into it, breathing in and out. In this case, you can not take air from the outside, you need to inhale only what is in the bag. Usually a few such breaths are quite enough for the attack to recede. The main thing, at the same time, is to calm down yourself and calm the child.

If the increase in the rhythm of inhalations and exhalations has pathological causes, the underlying disease should be treated. Child's cardiovascular problems are dealt with pulmonologist and cardiologist. Pediatrician can help you manage asthma ENT doctor, and sometimes an allergist.

Wheezing treatment

None of the doctors is engaged in the treatment of wheezing, since there is no need to treat them. The disease that caused their appearance should be treated, and not the consequence of this disease. If wheezing is accompanied by a dry cough, to alleviate the symptoms, along with the main treatment, the doctor may prescribe expectorant drugs that will help the dry cough to turn into a productive one with sputum as soon as possible.

If wheezing has caused stenosis, narrowing of the respiratory tract, the child may be prescribed drugs that relieve swelling - antihistamines, diuretics. With a decrease in edema, wheezing usually becomes quieter or disappears altogether.

Wheezing wheezing that accompanies staccato and labored breathing is always a sign that a child needs emergency medical attention.

Any combination of the nature and tone of wheezing against a high temperature is also a reason to hospitalize the child as soon as possible and entrust his treatment to professionals.