Airway obstruction in children what. Airway obstruction

A syndrome of obstruction of the respiratory tract, observed at any level, from the pharynx to the bronchioles, is called obstruction respiratory tract. In most cases, the condition is due to the complete closure or reduction of the lumen of the larynx, which becomes possible for the following reasons:

• Entry into the respiratory tract of a foreign body;
• Allergic, infectious and inflammatory diseases - bacterial tracheitis, Ludwig's angina, fungal infection, pharyngeal and peritonsillar abscess, laryngotracheobronchitis and diphtheria;
• Adenoids and post-intubation edema;
• Burns and injuries of the respiratory tract;
• Systemic disorders, tumors and cysts of the larynx;
• Hypertrophic tonsillitis;
• Neurological damage and post-tracheostomy stenosis;
• Volumetric processes in the areas located near the airways and larynx.

Airway obstruction can also be caused by congenital diseases, which include:

• Anomalies of the craniofacial region;
• Hypocalcemia and tracheoesophageal fistula;
• Laryngomalacia and laringocele;
• neurological disorders;
• Subglottic stenosis and vascular ring;
• birth trauma;
• Tracheomalacia and cystohygroma.

Allocate obstruction of the upper and lower respiratory tract, as well as two of their forms - fulminant (acute) and chronic. Also in medicine, it is customary to separate the stages of airway obstruction, namely:

• Compensation;
• subcompensation;
• Decompensation;
• Terminal stage of asphyxia.

Airway obstruction and hypoventilation (impaired breathing) most often occurs in patients at night. Hypoventilation increases as obstruction increases.

In patients or victims who are in a coma, obstruction can be triggered by blocking the airways with a sunken tongue.

Symptoms of airway obstruction

Upper airway obstruction usually occurs in neonates and children before school age due to the anatomical and physiological characteristics of the respiratory system. This condition manifests itself with the following symptoms:

• arterial hypotension;
• Strengthened work of the respiratory apparatus;
• Increased blood pressure and inspiratory dyspnea;
• Lack of cyanosis at rest, perioral or diffuse cyanosis appears during exercise;
• Coma and convulsions;
• Tachycardia and bradycardia;
• increased sweating;
• Lethargy and severe pallor;
• Inspiration paradox.

Lower airway obstruction is also most common in young children, and this condition is manifested by the following symptoms:

• The inability of the patient to breathe air;
• Appearance loud sound, rough noise or whistling during inspiration;
• Cough;
• Slow heart rate;
• Blueing of the skin;
• swelling of the lungs;
• Stopping breathing.

With obstruction of the respiratory tract by a foreign body, the development of aphonia, cyanosis, and acute respiratory failure is observed. At the same time, the patient cannot speak, cough, breathe, he often clutches his throat, convulsions may begin, and asphyxia may develop. If the patient is not given timely emergency help, he loses consciousness, and then sudden death occurs.

Treatment of airway obstruction

If the first symptoms of obstruction are detected, the patient must be urgently taken to the department. intensive care. Often on prehospital stage first aid is required. If airway obstruction is observed in a child, he should not be left alone, it is important to calm the baby and take it in his arms, since fear, screaming and anxiety can increase the effects of stenosis. First aid directly depends on the cause of the condition, as well as on the severity of the obstruction.

If the respiratory tract is present foreign body, mucus, vomit or liquid, it is necessary, provided that the patient is conscious, ask him to try to cough well. In cases where the patient cannot cough or such manipulation does not help, it is possible to apply the Heimlich maneuver at the prehospital stage to eliminate complete obstruction of the airways by a foreign body. The method of admission, if the patient is conscious, consists in the following actions:

• It is necessary to stand behind the patient, wrap his arms around him and press his palms on his stomach, at a level above the navel;
• Sharply compress the chest with quick jerks 4-5 times;
• Then, slowly continue to compress the chest until the foreign body comes out, and the patient begins to breathe normally.

If the patient is unconscious, the Heimlich maneuver is performed as follows:

• The patient is laid on his back on the floor;
• The person providing first aid sits on the hips of the victim, puts one palm in the supra-umbilical region of the patient;
• He puts the second palm on the first, then presses 5 times with quick jerky movements on the stomach;
• Then it is necessary to open the victim's mouth and try to remove the foreign body with a bent index finger.

If the victim shows symptoms of increasing airway obstruction and hypoventilation, gradually leading to cardiac arrest, it is necessary to provide emergency resuscitation measures, which cannot be carried out without special medical equipment.

General principles for the treatment of airway obstruction in children in medical institution, depending on the stage of the syndrome, are:

• Measures aimed at restoring obstruction - reducing or eliminating spasm and swelling of the mucous membrane of the respiratory tract;
• Elimination of obstruction - the release of the lumen of the larynx from the pathological secret;
• Correction of metabolic disorders;
• Antibacterial therapy;
• tracheal intubation;
• Artificial ventilation of the lungs.

Airway obstruction is a condition in which a patient develops obstruction of the respiratory tract at the level from the pharynx to the bronchioles. The victim must be given first medical care and transported to the intensive care unit as soon as possible.

Video from YouTube on the topic of the article:

Airway obstruction in children is a congenital or acquired syndrome of airway obstruction that can develop at any of its levels, from the entrance to the trachea to the bronchioles. In most cases, airway obstruction is characterized by complete or partial closure of the lumen of the larynx, which makes it impossible for the child to fully breathe. In children this pathology is quite common, as it is caused not only due to the development of a strong inflammatory process, but also due to mechanical damage trachea with foreign objects.

There are several negative factors at once, the presence of which can lead to the closure of the respiratory tract in a child. Some of them are associated with the emergence of an extensive infectious disease larynx, trachea and bronchioles, and others are acquired by children due to non-compliance with safety rules while playing with small parts of various toys and due to oversight on the part of parents.

In general, allocate the following reasons development of airway obstruction in children:

Classification

According to the type of development of pathology, obstruction is divided into two types:

Airway obstruction in children is classified according to the form of the course clinical picture, namely:

1. Acute. It develops at lightning speed upon contact of the respiratory mucosa with an external or internal stimulus. This form obstruction is observed when it enters the larynx or trachea foreign objects, an asthma attack, or anaphylactic shock due to extensive allergic reaction for a medicinal product.
2. Chronic. Common in children who suffer from inflammatory disease bodies respiratory system. With untimely medical care, or the failure of therapy, the mucous membrane and tissues of the larynx, trachea or bronchi gradually swell, narrow the respiratory lumen and make it impossible for the full functioning of the body. Chronic airway obstruction in children is still observed after acid burns, when injured tissues continue to change throughout later life.

Each type of pathology of the respiratory system is successfully treated in case of timely seeking medical help.

Depending on the severity of the disease and the cause of its development, traditional medications in the form of antibiotics, anti-inflammatory, vasodilators or antihistamines. As a last resort treatment is used surgical intervention with a full surgical operation to restore normal operation respiratory canal, regardless of the location of the altered tissue.

Stages of obstruction

After examining a child who complains of worsening breathing or suffocation, the doctor finds out possible cause the appearance of these symptoms. Next, determine the severity of the disease. In general, in medicine, the following stages of airway obstruction in children are distinguished:

• compensatory (the child is able to breathe on his own, but this process is slightly complicated);
• subcompensatory (spontaneous breathing is present, but there are clear signs lack of oxygen);
• decompensation (the respiratory lumen is partially or completely narrowed and doctors have to transfer the child to artificial ventilation lungs);
• complete asphyxia (the onset of death due to suffocation and the impossibility of further oxygen supply to the lungs).

Each of these stages requires medical staff specific actions to prevent further development the child has hypoventilation (impaired air circulation in the lungs). Accordingly, the manifestation of hypoventilation increases in proportion to the increase in airway obstruction.

In children who are in a state of coma or unconscious, the onset of obstruction is possible through the entry of the tongue into the cavity of the larynx.

Symptoms

The manifestation of airway obstruction in most cases is observed in newborns and children who have not yet reached school age. This is due to the peculiarities of the structure of their respiratory organs, as well as weak immune system at all its levels. The narrowing of the lumen of the respiratory canal in a child is expressed in the form of the following symptoms:

• redness of the face with a bluish tint around the eyes, lips and in the area of ​​\u200b\u200bthe wings of the nose;
• rapid and shallow breathing;
• convulsions;
• loss of consciousness;
• increased sweating with normal temperature in room;
• inhibited reaction to external stimuli;
• numbness of the upper and lower extremities;
• dizziness;
• cough;
• slowdown heart rate and pulse;
• stop breathing.

Even if the child has one of these signs of airway obstruction, it is urgent to call an ambulance. Until the doctor arrives, the child needs to be turned over on his stomach so that his body and head are slightly bent forward.

Treatment of airway obstruction

Therapy disease state respiratory organs of the child is performed in a hospital. The type of treatment is determined directly by the doctor who examines the patient. If the obstruction was caused by foreign elements, then they try to remove them with the help of medical equipment. Carry out if necessary surgical operation. All measures are taken to free the respiratory canal and restore stable air circulation with blood filling with oxygen.

Allergic airway obstruction and mucosal edema are treated antihistamines, which can be administered to the patient as an intramuscular or intravenous injection. The further use of medicines of this category in the form of tablets for the prevention of the next attacks of suffocation is not excluded. For the period of removal of the allergic reaction, the child is injected intravenously with Eufillin, which is considered a potent vasodilator that can restore the respiratory lumen even with diphtheria edema of the larynx.

Inflammatory obstruction is treated with the use of antibacterial and anti-inflammatory drugs. These can be injections and tablets that destroy pathogenic bacteria that have accumulated on the mucous membrane of the upper and lower respiratory tract. As the child recovers and the concentration of infection in the body decreases, the degree of manifestation of obstruction decreases proportionally and the child begins to breathe on his own.

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

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

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

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

The main symptoms of obstructive bronchitis

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

What is dangerous obstructive bronchitis

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

When emergency hospitalization is required

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

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

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

Treatment of obstructive bronchitis

Mode

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

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

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

Diet

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

Home hygiene and other features of caring for a sick child

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

Avoid contact of the child with synthetic detergents and protect him from secondhand smoke.

Medical treatment

Antibiotics and antivirals

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

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

Fenspiride (Erespal)

Erespal - modern drug, which has anti-inflammatory activity, reduces excessive sputum production and promotes the removal bronchial obstruction. Its appointment from the first days of the disease reduces the likelihood of complications, speeds up the treatment process.

Antiallergic drugs

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

Hormones

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

Other drugs

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

Physiotherapy and warming treatments

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

Massage and therapeutic gymnastics

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

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

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

What else do you need to know

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

The hallmarks of a foreign body obstruction are:

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

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

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

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

Prevention of obstructive bronchitis

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

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

Content

Disease of the mucous membranes of the upper respiratory tract occurs in every fifth child under three years of age. Obstruction is narrowing or blockage of the airway due to increased secretion, edema, thickening and spasm of the walls. Bronchitis in children is dangerous for its consequences. In severe cases, hospitalization is required.

The mechanism of development of inflammatory lesions of the bronchi

The pathology of the upper respiratory tract has the following pathogenesis:

1. Pathogenic microorganisms (bacteria, viruses, fungi) get on the mucous membranes of the bronchi.
2. Inflammation develops.
3. Damaged cells produce histamine, which increases vascular permeability.
4. There is swelling, spasms of smooth muscles.
5. Active production of bronchial secretions with increased viscosity begins.
6. The ciliated epithelium ceases to function in the previous mode.

The subsequent development of obstructive bronchitis has the following mechanism:

1. There is accumulation and stagnation of mucus.
2. This contributes to the reproduction of the pathogen in the bronchial tree.
3. The coughing function is impaired.
4. The airways become clogged with mucus.
5. Due to the decrease in the lumen, the patency of the bronchi is sharply reduced (obstruction develops).
6. There is an attack of suffocation, bronchospasm.

Pathogens and risk factors

Bronchial obstruction in children can be caused by such microorganisms:

• influenza virus;
• mold bending;
• cytomegalovirus;
• mycoplasmas;
• chlamydia;
• enteroviruses;
• tuberculosis, Pseudomonas aeruginosa;
• Proteus;
• herpes virus;
• golden staphylococcus aureus;
• legionella;
• rhinovirus;
• streptococcus;
• Pneumococcus.

The appearance of an obstructive form of bronchitis is provoked by:

• weakness of the respiratory muscles;
• allergic reaction to food, medicines, dust;
• underdevelopment of the immune system;
• entry into the respiratory tract of foreign objects;
• smoke inhalation;
• tumors;
• tonsillitis;
• SARS;
• helminthic invasions;
• hypothermia;
• fungus indoors;
• viral infections;
• frequent crying;
• difficult childbirth;
• early transition to artificial mixtures;
• air pollution.

Why is airway obstruction dangerous in children?

Inflammatory processes in the bronchi with bronchial obstruction syndrome can lead to:

• inflammation of the lungs;
• chronic bronchitis;
• respiratory failure;
• hypoxia;
• cor pulmonale;
• bronchial asthma;
• sinusitis;
• otitis;
• emphysema of the lungs (expansion of the air space);
• respiratory arrest;
• lethal outcome.

Classification of the disease in pediatrics

Obstructive inflammation in children is distinguished by origin. Primary - the infection affects the bronchial tree, secondary - the result of a complication of other inflammatory processes. Given the etiology, the disease is:

• irritative (caused by the action chemical substances, toxins);
• bacterial;
• fungal;
• allergic;
• asthmatic;
• viral;
• mixed (influence of several factors).

Bronchitis of obstructive type according to the nature of the course can be acute, chronic and recurrent, in duration - limited, diffuse (common). Type of disease according to the type of inflammatory process in the tissues:

• fibrous;
• catarrhal;
• purulent;
• bronchiolitis;
• necrotic;
• ulcerative;
• catarrhal-purulent;
• hemorrhagic.

How does obstructive bronchitis manifest in a child?

AT childhood the disease has the following clinical picture:

• pallor or cyanosis of the skin;
• noisy and wheezing breathing;
• poor discharge of mucus;
• prolonged exhalation;
• unproductive dry cough;
• difficulty breathing;
• dyspnea;
• chest pains.

Symptoms at the onset of the disease respiratory infection – subfebrile temperature body, drowsiness, nausea, sore throat, runny nose. Signs of obstructive bronchitis in children:

• cough that causes vomiting;
• cervical lymphadenitis (inflammation of the lymph nodes);
• increased heart rate;
• an increase in the size of the chest;
• wheezing that can be heard at a distance;
• superficial rapid breathing (tachypnea).

Acute bronchiolitis in newborns

Pathology in infants is provoked by underdeveloped immunity and unformed bronchi. Premature babies often get sick. The inflammation leads to spastic bronchitis and acute respiratory failure (bronchiolitis). Diseases in a newborn occur for the following reasons:

• action of microorganisms by airborne droplets(viruses, bacterial flora; fungi);
• inhalation of polluted air, tobacco smoke;
• consequence of antibiotic therapy;
• complication of pathologies of the respiratory system.

Acute bronchiolitis is accompanied by the following clinical picture:

• blue nasolabial triangle and skin;
• hoarse breathing;
• refusal to feed;
• dyspnea;
• drowsiness;
• constant crying;
• oxygen starvation (asphyxia);
• sinking of the fontanel;
• rapid breathing;
• weight reduction.

Diagnostics

If an obstructive form of bronchitis is suspected, the examination begins with auscultation (listening). If necessary, the pediatrician invites children's doctors to consult:

• pulmonologist;
• allergist-immunologist;
• otolaryngologist.

To diagnose bronchitis in children, prescribe:

• blood test - general, biochemical analysis and composition of gases;
• allergy tests;
• bakposev sputum to determine the pathogen;
• cytological examination of mucus;
• PCR (polymerase chain reaction) - detection of a microorganism by its DNA;
• chest x-ray;
• spirometry - determination of ventilation functions external respiration(FVD);
• bronchoscopy;
• computed tomography.

How to treat bronchitis in a child

• semi-bed mode;
• hypoallergenic diet;
• wet cleaning, airing the room;
• frequent warm drinking;
• room humidification;
• taking medication prescribed by a doctor;
• inhalation;
• hot foot baths;
• breathing exercises;
• vibration massage.

Acute obstructive bronchitis in children in severe form and illness in newborns require hospitalization. For treatment use:

• oxygen therapy;
• removal of sputum by electric suction;
• alkaline inhalations;
• antibiotics - Amoxiclav, Flemoxin Solutab;
• antiviral - Grippferon, Arbidol;
• mucolytics - Ambroxol, Bronchobos;
• bronchial dilators Pulmicort, Berodual;
• expectorant - Bronchicum, Gerbion.

Tactics of treatment in young children

Oxygen therapy is used to eliminate oxygen deficiency in infants. Medicines are given to babies in the form of a suspension or by inhalation, they are prescribed:

• antibiotics - Augmentin, Suprax;
• antiviral drops Grippferon, suppositories Genferon;
• antipyretic candles - Paracetamol;
• mucolytics (thinning phlegm) Lazolvan, Bromhexine;
• breathing exercises;
• rinsing the nose with saline;
• vibration massage.

Therapy of bronchitis in children older than 3 years

The goal of treating obstructive bronchitis in children is to eliminate the cause of inflammation, relieve coughing and breathing. A child older than three years is prescribed:

• antiviral drugs - syrup Orviem, pills Kagocel;
• antibiotics - Macropen, Cefalexin;
• mucolytics - Mukosol, Ambrobene;
• expectorant - Dr. Theiss, Bronchicum;
• to relieve bronchospasm - Salbutamol, Troventol.

The treatment regimen for obstructive bronchitis involves the use of:

• inhalation with saline, mineral water"Borjomi";
• bronchial drainage;
• antipyretics - syrup Efferalgan, suppositories Viburkol;
• antihistamines - Suprastin, Claritin.

Treatment of obstructive bronchitis in children according to Komarovsky

A well-known pediatrician with the appearance of a cough, difficulty breathing in a child advises to be sure to undergo a diagnosis, to identify the causative agent of the disease. Dr. Komarovsky recommends:

1. Humidify indoor air.
2. Maintain the temperature in the room 18-20.
3. To walk outside.

Tips for taking medications and performing medical procedures:

1. Give your child plenty of fluids (water, fruit drinks, alkaline mineral water).
2. Use antibiotics only when bacterial cause illness.
3. Use expectorants prescribed by a pediatrician.
4. At acute form bronchitis do not massage.
5. Hot steam inhalations are prohibited.

Folk remedies for bronchial obstruction in a child

Treatment with the use of herbal ingredients requires coordination with the pediatrician. These methods are for children over three years of age. Decoction of sage with milk:

1. Pour a glass of milk.
2. Pour in three tablespoons of herbs.
3. Boil 15 minutes.
4. Remove and hold for an hour.
5. Give 100 ml 4 times a day.
6. Duration - until relief of symptoms.

Obstructive cough in a child is treated with wraps:

1. Preheat sunflower oil- 300 ml.
2. Soak a towel on them.
3. Place warm on your baby's chest.
4. From above - cellophane, pajamas and a blanket.
5. Leave overnight.
6. Conduct a seven-day course of treatment.

Compress with butter and honey for better expectoration:

1. Mix the components - 50 g each.
2. Melt over low heat, cool.
3. Spread the warm mixture on your baby's chest and back.
4. Wrap with towel and cellophane.
5. Leave the compress until the morning.
6. The course is 7 days in a row.

Forecast and prevention of bronchitis

Timely diagnosis and proper therapy help to completely cure the disease. Frequent infections, allergies, the action of provoking factors cause recurrent obstructive bronchitis in half of the children. The disease threatens to degenerate into bronchial asthma.

• Get vaccinated.
• Use hardening methods to increase immunity.
• Travel with a child to the sea.
• Avoid contact with patients.
• Visit a pediatrician for dispensary observation.
• Treat colds and inflammations in time.
• Breastfeed the newborn.
• Avoid hypothermia.
• Follow the daily routine.
• Clear the baby's nose of mucus.
• Take vitamins.

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- this is inflammation of the bronchial tree due to bronchial edema, hypersecretion of mucus and the development of bronchospasm, i.e., a violation of bronchial patency. There are forms of obstructive bronchitis:

• Acute obstructive bronchitis(phenomena of bronchial obstruction persist for no more than 10 days)
• Protracted obstructive bronchitis(phenomena of bronchial obstruction persist for more than 10 days) often occurs in children with a burdened premorbid background, chronic ENT pathology, vitamin D deficiency, asthenia.
• Recurrent (continuously recurrent) obstructive bronchitis(the phenomena of bronchial obstruction are observed 3 or more times a year), can lead to the formation of bronchial asthma.

The mechanism of development of obstructive bronchitis

Causes of obstructive bronchitis The most common cause of obstructive bronchitis in children of the first 3 years is viral infection(up to 70% of all cases). Despite the fact that in children older than 3 years the frequency of viral bronchitis decreases, given reason remains in the lead. Obstructive bronchitis of infectious origin can be caused by various respiratory viruses:

• respiratory syncytial viruses;
• parainfluenza virus of the third type;
• influenza virus;
• rhinovirus;
• adenovirus;

Bacterial agents:

• haemophilus influenza;
• Streptococcus pneumoniae;
• Moraxella catarrhali
• DNA persistent infectious agents - chlamydia, mycoplasmas.

An important role in the development of obstructive bronchitis in children is played by an allergic factor, especially in children with early age suffering food allergy and atopic dermatitis.

Risk factors leading to the development of obstructive bronchitis

• Physiological features of the structure of the respiratory tract (narrowness of the respiratory tract, insufficient activity of local immunity, poor development of the respiratory muscles, high viscosity of bronchial mucus, etc.)
• Pathological conditions women during pregnancy (toxicosis, preeclampsia, threatened miscarriage, intrauterine infection)
• Smoking and alcohol abuse during pregnancy
• Burdened hereditary allergic anamnesis;
• birth defects development of the bronchial tree;
• Prematurity (especially children born with extremely low weight and low body at 22-30 weeks gestation); light weight s; hypovitaminosis D.
• Anomalies of the constitution (exudative-catarrhal diathesis, lymphatic diathesis).
• Acute respiratory diseases transferred by a child in the first six months of life; artificial feeding(early introduction of mixtures or complete replacement breastfeeding from the first days of life).

Symptoms of obstructive bronchitis

• Cough. It can be exhausting, obsessive, unproductive. Often the child coughs with attacks. The cough may get worse with physical activity.
• Noisy or wheezing breathing. Even at a distance, wheezing and whistling in the chest can be heard.
• Dyspnea. The baby begins to breathe more often, anxiety appears. The symptom can be checked at home. For this, one should calculate respiratory movements, which are performed by the chest in one minute, with a hand on the chest. Increased shortness of breath is an unfavorable symptom. It may indicate the development of respiratory failure, and requires the prompt intervention of emergency and ambulance specialists.
• Temperature increase. It can rise up to 37-39 degrees. Against the background of an increase in temperature, shortness of breath and anxiety in young children may increase.
• Violation of the general condition. Young children refuse breastfeeding, act up, decreases them physical activity, there is drowsiness and general weakness.
• On thedisruption of nasal breathing and redness of the oropharynx. Occurs in viral and bacterial infections.

Diagnosis of obstructive bronchitis.

Diagnosis of obstructive bronchitis is based on the data of anamnesis, examination of the child, data of laboratory-instrumental and functional examination methods that are carried out by a pediatrician and a pediatric pulmonologist. Physical studies:

• cough
• the appearance of a box percussion sound.
• hard breathing; prolonged exhalation
• whistling dry rales (their tone and number may vary).
• measuring the level of oxygen in the blood, will reveal the phenomenon of respiratory failure.

Laboratory examination methods:

• Clinical blood test (allows you to clarify the signs of inflammation)
• In case of recurrent obstructive bronchitis, allergological tests (level of general and specific IgE), skin prick tests (uninformative in children under 3 years old, high risk of false positive and false negative results).
• PCR and serological testing for infections.

Instrumental examinations:

X-ray of the lungs makes it possible to identify signs of hyperventilation: increased transparency of the lung tissue, horizontal arrangement of the ribs, low standing of the dome of the diaphragm. X-rays may be performed in children with suspected:

• pneumonia
• foreign body (history, weakening of breathing on one side, unilateral wheezing), aspiration (frequent regurgitation, vomiting, children with aggravated premorbid background with swallowing disorders)
• squeezing process in the mediastinum (persistent metallic cough).

Functional examination methods Spirometry is the measurement of the volume of external respiration, which includes the measurement of volume and speed indicators. It is not carried out in children under 5-6 years of age due to their inability to produce a full forced exhalation. With recurrent obstructive bronchitis, spirometry with medicinal (bronchodilators) drugs is also performed to exclude bronchial asthma.

Treatment of acute obstructive bronchitis in children

Treatment of obstructive bronchitis in most cases is possible at home. Hospitalization is subject to children under 1 year of age, as well as with moderate and severe course, phenomena and respiratory failure. Do not self-medicate your child, seek qualified help from a specialist. A properly selected treatment complex will simultaneously help get rid of coughing attacks, relieve spasm, normalize temperature, and also reduce the risk of developing chronic disease respiratory tract in your child. For successful treatment obstructive bronchitis it is necessary: ​​Compliance with the medical and protective regimen

• peace;
• air humidification in the apartment;
• plentiful alkaline and warm drink;
• dairy-vegetarian diet.

To relieve cough and relieve bronchospasm

• Mucolytics, mucoregulators, expectorants
• Inhalation therapy bronchodilators
• Inhaled corticosteroid therapy

Caution should be exercised in the use of antitussive drugs. A direct contraindication for their use is the combination wet cough and bronchospasm.
To improve sputum discharge help:

• Postural drainage (positional massage) is a complex of manipulations: patting, stroking and tapping at a certain drainage position of the body.
• Vibration massage chest. Vibration effect on tissues, provided with the help of special vibration massagers, reduces the inflammatory process
• Breathing exercises
• Antipyretic drugs
• Anticongestants (possibly combined), to reduce swelling of the nasal mucosa and improve nasal breathing.
• Antibiotics

In the treatment of obstructive bronchitis in children, they are prescribed in case of accession bacterial infection; persistent bronchial obstruction, with a persistent increase in temperature for more than 3 days, and symptoms of intoxication, pronounced inflammatory changes in the blood test.

ethnoscience

Treatment of obstructive bronchitis folk remedies no evidence-based treatment results. And the use of mustard plasters, applications with honey, as well as inhalations with herbs and essential extracts for a warming purpose can increase the phenomena of bronchial obstruction. Complications of the disease:

• Pneumonia, bronchopneumonia
• Chronicization of the inflammatory process
• Bronchial asthma

Prevention of obstructive bronchitis:

• Timely treatment and prevention of acute respiratory diseases.
• Vaccination against influenza, Haemophilus influenzae, pneumococcal infection. Premature babies are also vaccinated against respiratory sentience infection.
• Sanitation of foci of chronic inflammation in the oropharynx and nasopharynx.
• Stop smoking during pregnancy, in the presence of the child.
• Carrying out community activities. Spa treatment.

Elimination of allergic background, reduction of allergy readiness.