How does laryngotracheitis manifest in children? Treatment of laryngotracheitis in children at home

Laryngotracheitis can lead to narrowing and even complete closure of the lumen of the larynx. If children are not given first aid in time, the disease can be fatal.

Laryngotracheitis is an infectious disease of an inflammatory nature, the process of which involves two organs at once - the larynx and trachea. The causes of the disease can be viral or bacterial infections of the body:

1. Viral - influenza, scarlet fever, parainfluenza, acute respiratory infections, measles, chickenpox, rubella.
2. Bacterial - streptococci, mycobacterium tuberculosis, pneumococci, Treponema pallidum.

Also, laryngotracheitis can act as a complication of other inflammatory diseases of the upper respiratory tract (laryngitis, tonsillitis, sinusitis).

Pathogens can be transmitted from person to person through airborne droplets. For an organism with good immunity, laryngotracheitis is practically not contagious. But there are several factors that contribute to the development of the disease:

• general or local hypothermia;
• congestion in the lungs - emphysema, bronchial asthma, pneumosclerosis;
• chronic diseases - diabetes, glomerulonephritis, tuberculosis;
• mouth breathing due to rhinitis, adenoids, sinusitis;
• negative influence of inhaled air - too dry, hot, cold. The presence of harmful chemicals and dust in it;
• constant load on the vocal apparatus.

Laryngotracheitis can be acute or chronic. In children, an acute form is more often observed, which rarely becomes chronic, but causes a complication - laryngeal stenosis.

Risk factors for developing stenosis:

• age up to two years;
• male gender;
• the presence of exudative-catarrhal diathesis;
• allergy;
• burdensome obstetric history;
• the effect of negative factors during the neonatal period.

Symptoms of acute laryngotracheitis

Acute laryngotracheitis develops in children of a fairly early age, mainly from 6 months to 3 years. The incidence reaches its peak in the second year of life; single cases of infection are known in the first six months. The disease attacks boys more often, while girls get sick three times less often.

Laryngotracheitis in a child is usually manifested by three symptoms:

1. Voice change depends on how badly the infection has affected the vocal folds. But complete loss of voice is not typical for this disease.
2. A rough cough, reminiscent of barking - this cough occurs when air passes through a narrowed glottis.
3. Stenotic breathing is caused by swelling and spasm of the larynx, trachea and bronchi.

Symptoms in children can develop in three scenarios:

1. The disease begins unexpectedly, most often at night, during sleep. Attacks of stenotic breathing occur, but there are no signs of acute respiratory infections.
2. The attack also begins unexpectedly, but against the background of symptoms of a respiratory disease (cough, runny nose, fever).
3. Signs of the disease develop gradually, simultaneously with the symptoms of acute respiratory infections.

After a coughing attack, chest pain may remain. Children complain of unpleasant sensations in the throat (dryness, tickling, sensation of a foreign object).

During the examination, enlarged cervical lymph nodes can be detected. Percussion does not detect any changes. And upon auscultation, you will hear noisy breathing, sometimes moist rales.

If the disease develops according to the first type, the child’s condition is determined by the degree of narrowing of the larynx. During the second and third options, the negative impact of intoxication of the body should be taken into account.

The course of the disease can be continuous - symptoms increase until a certain time, and then the condition gradually improves. Or wavy - periods of improvement and deterioration alternate with each other.

After clinical recovery, residual cough may be observed periodically for several weeks.

Chronic laryngotracheitis

Chronic laryngotracheitis rarely develops in children. The symptoms are constant, but appear less pronounced. There is a periodic, slight increase in temperature. Under the influence of unfavorable factors, the process may go out of remission, in which case the clinical picture resembles the manifestations during the acute stage of the disease.

The chronic form is not as dangerous for children as the acute form, because it does not lead to acute laryngeal stenosis and asphyxia. But it can cause serious voice disorders.

Treatment

For mild forms, you can treat at home using cough syrup and other medications prescribed by your doctor. It is important to remember that the dosage of drugs depends on the age and weight of the baby, the concentration of the active substance and many other factors, so you should not self-medicate.

Therapy will depend on how narrowed the lumen of the larynx is. At the compensation stage they write out:

• interferons – Genferon, Roferon;
• antibiotics – Erythromycin, Ampicillin;
• antihistamines – Diphenhydramine, Diazolin;
• antitussives - most often in the form of syrup.

If the disease is accompanied by severe intoxication, especially in infants, then detoxification therapy is carried out.

Distractive procedures are used - hot foot baths, mustard plasters on the chest, inhalations with antiallergic and antispasmodic drugs.

If the disease is mild, then walking during illness will only be beneficial, but you need to pay great attention to the general condition of the baby.

After laryngotracheitis, you need to carefully protect the child from hypothermia, colds and contact with sick children, as this can provoke a relapse.

To treat a small child, it is best to use cough syrup, as it has a pleasant taste and is most often drunk by the baby voluntarily.

Help during a seizure

Sometimes it happens that parents do not pay attention to the symptoms for a long time and do not treat laryngotracheitis. Or the disease develops too rapidly. In this case, an attack of suffocation due to stenosis may take you by surprise. To save a child's life, you need to know how to provide emergency care.

1. Give the patient a sitting position; he can lean back slightly on a pillow.
2. Provide access to fresh air - unbutton clothes, open a window.
3. Pressing the root of the tongue with a spoon may help.
4. Do inhalations with medications, for example, cough syrup.
5. Take a hot foot bath. If this is not possible, then you can simply rub your feet.
6. Take an antiallergic drug.

Complications

In children, the disease can go almost unnoticed, but most often causes serious complications:

• bronchitis;
• bronchiolitis;
• pneumonia;
• false croup;
• hypoxia, asphyxia;
• benign tumors;
• cancerous formations;

Establishing diagnosis

Methods used to clarify the disease:

• laryngotracheoscopy;
• microlaryngoscopy;
• radiography;
• bacteriological analysis of secretions.

Expert opinion

The well-known doctor Komarovsky tells a lot of interesting things about the symptoms and treatment of laryngotracheitis in children in his videos. A large number of positive reviews about this person give reason to trust his words.

stenosing laryngotracheitis, acute stenosing laryngotracheitis (ASLT), croup, false croup, laryngeal stenosis

Laryngotracheitis is an inflammation of the larynx that develops against the background of ARVI. Main symptoms: hoarse voice, barking cough, difficulty breathing. Laryngotracheitis in children can be life-threatening due to age-related anatomical features of the larynx.

To understand what false croup is in children, it is necessary to understand which croup is called true. Only with diphtheria does true (diphtheria) croup occur in children, when dense films form in the throat that block breathing. This is a dangerous disease that requires immediate medical attention. Fortunately, true cereals are no longer found due to mass vaccination against diphtheria. Therefore, croup, which occurs as a complication of ARVI or influenza, is called false. It is less dangerous, but can also pose a threat to life due to suffocation.

When and at what age does it most often occur?

Laryngotracheitis, as a rule, occurs in winter, when viral infections are rampant and apartments have dry and warm air. The first attack of laryngeal stenosis usually occurs in children aged two and three years. Rarely diagnosed in infants under 4 months. After 4–5 years, the first attack of croup usually does not occur. False croup is most often caused by parainfluenza viruses.

Characteristic signs of the disease

What are the symptoms of laryngotracheitis in children?

• Typical signs of ARVI: fever, runny nose, cough.
• Changes in voice. Hoarseness and discomfort when speaking appear.
• Changes in cough pattern. It becomes dry, barking, similar to “crow cawing” (translated from English as croup - to croak).
• Labored breathing. The main symptom of croup. The cause of difficulty breathing is narrowing (stenosis) of the larynx due to inflammation. It is difficult for the child to breathe. With bronchitis and pneumonia, on the contrary, it is difficult to exhale.

Most cereals begin with laryngitis - inflammation of the laryngeal mucosa. However, with laryngitis there is never difficulty breathing. If it appears, it means that croup is developing. There are times when a doctor diagnoses a child with laryngitis during the day, and at night the child may be taken away by ambulance with an attack of croup. In this situation, the doctor cannot be blamed for incompetence. He can diagnose absolutely correctly. You need to know that mucus accumulates in the larynx at night, this leads to its narrowing, causing difficulty breathing.

What are the reasons

In some children, attacks of croup recur, in others they never occur. Why does this happen?

• In healthy and strong children, croup is more common. It would seem that the weak and frail should be more susceptible to the disease, but this is not so. Thin children get sick with croup less often. In obese children it occurs much more often, because there is more fatty tissue on the walls of the larynx, and the passage is initially narrowed.
• In loved ones, well-groomed and caressed croup is more common. There is also such an opinion. The more fuss and anxiety around a child about his health, the more often he gives cause for concern. Breathing problems indicate psychosomatic causes.
• Anatomical features of the larynx. Children's larynx is much narrower than adults'. Therefore, a few millimeters of mucus on the walls of the larynx can already make breathing difficult. An adult may only experience voice problems, while a child may experience suffocation. With age, the cereals go away.
• Frequent ARVI. Croup is not an independent disease, but a consequence. It occurs only against the background of ARVI as a complication.
• Tendency to allergies. Children with allergies suffer from stenosis more often. With allergies, all mucous membranes, including the walls of the larynx, swell. This provokes symptoms of croup in children.

External environmental conditions are important - indoor air parameters. As soon as a child falls ill with ARVI and has a barking cough and a hoarse voice, this is an immediate signal to make the air in the room clean, cool and humid (it is desirable that it always be like this). No medicines or inhalations will help if the air problem is not solved. According to statistics, 80% of cases of croup are stopped at home before the ambulance arrives, if the child is provided with proper care.

4 stages of croup

The clinical picture of acute stenosing laryngotracheitis in children may vary depending on the stage of the disease.

1. Satisfactory condition. Clear consciousness; agitation occurs periodically; breathing does not become faster; pulse is within normal limits; unexpressed cyanosis (blueness) around the mouth.
2. Moderate weight. Clear consciousness; constant agitation; the skin in the area of ​​the nasolabial triangle turns blue; breathing quickens.
3. Heavy. Confused consciousness; pronounced cyanosis of the facial skin; strong excitement; breathing and pulse increase significantly.
4. Extremely heavy. Loss of consciousness; breathing is intermittent, shallow; the pulse first increases significantly, then thread-like and slow; extensive cyanosis of all parts of the body.

A clear sign of deterioration is an increasing respiratory rate, cyanosis and agitation. Parents can identify these symptoms. Only a doctor can assess the degree of acute laryngotracheitis in children. This determines the tactics of providing medical care.

When is hospitalization required?

An emergency call for a child with an attack of acute laryngotracheitis is always required. Under what conditions is hospitalization required?

• Infants, especially low birth weight and premature babies, with the first stage of croup.
• Children over one year of age with second stage croup, if no improvement is observed.
• Children with the third and fourth stages of laryngotracheitis.
• Lack of effectiveness when using hormonal therapy.
• Laryngeal pathologies, congenital stenosis.

How to alleviate a child’s condition: 7 important steps

Emergency care for croup is not particularly difficult. It is important for parents to remain calm in this extreme situation and act according to a clear algorithm. What needs to be done?

1. Ensure maximum physical rest. At the moment of an attack, there is no need to do any procedures, ask the child to turn, bend, or move somewhere. Any movement will create additional difficulties for breathing.
2. Provide emotional calm. When a person begins to choke, a strong feeling of fear arises. To be more precise, it is the fear of death. The older the child, the greater the awareness and the greater the panic. Because of fear, spasms of the laryngeal muscles occur, which aggravates the condition. That's why it's so important to calm your baby down. You can explain what is happening to the body, why difficulty breathing occurs. Tell them that this will pass quickly.
3. Give an antipyretic. This must be done even at a temperature of 38°C. As the temperature rises, breathing quickens, the mucus in the larynx dries out, which leads to respiratory failure.
4. Distraction therapy. These are foot and hand baths, inhalations with mineral water and soda. Some sources recommend breathing over hot steam, which helps loosen phlegm and expectorate mucus. However, there is also the opposite opinion: under no circumstances should you breathe above the steam. Hot air can cause the dry mucus in the larynx to swell and further narrow the passage. You can and should breathe, but only with inhalations at room temperature. If the ultrasonic humidifier is working, the child can be seated nearby. You can also open the tap with water (room temperature) in the bathroom and sit your baby next to it.
5. Fresh air access. If there are increasing signs of laryngotracheitis in a child, you need to open the window or the door to the balcony in order to maximally refresh and humidify the air and reduce its temperature. Ideal parameters: temperature 18°C, humidity from 50 to 70%.
6. Drink plenty of fluids. It is necessary if the child has a fever and the body loses a lot of moisture. When it is lost, the mucus becomes thicker, making breathing difficult. You need to drink in small sips. It is better not to give juices, compotes, drinks that can irritate the mucous membranes. It is best to offer regular drinking water.
7. Vasoconstrictor nasal drops. With ARVI, a child's nose is often clogged, so he breathes through his mouth. During an attack of croup, you need to be given the opportunity to breathe through your nose as soon as possible, so vasoconstrictor nasal drops are used.

What not to do? Under no circumstances should you give expectorants for a barking cough. They will promote the production of sputum, and the child will not be able to cough it up due to a narrowing of the larynx. The first attack of croup can greatly frighten not only the baby, but also the parents. You must immediately call an ambulance and act correctly until it arrives.

Nebulizer therapy

For diseases of the ENT organs, a modern and safe method of treatment at home is used - nebulizer (inhalation) therapy. It involves inhalation of medications using a special chamber - a compressor or ultrasonic nebulizer. This device finely sprays the medicine, which quickly enters the respiratory tract and alleviates the patient’s condition. Well relieves attacks of bronchial asthma and croup. It is used in the treatment of acute and chronic bronchitis, pneumonia, allergies, tuberculosis and other respiratory diseases. What are the benefits of nebulizer therapy?

• fast action, minimum side effects, continuous supply of the drug;
• no need to make any effort when inhaling, take deep breaths;
• used at any age;
• safety compared to aerosol preparations with dispensers, which contain harmful solvent impurities.

If your child has frequent attacks of croup, it makes sense to purchase a nebulizer for home inhalation.

To carry out nebulizer therapy, medicinal solutions are used, which are produced in special containers. A saline solution is used along with the medication for nebulization. All medications for nebulizer therapy, their dosage is prescribed by the doctor. For laryngotracheitis in children, pulmicort is used - a special suspension. This is a hormonal (glucocorticoid) drug with a broad spectrum of action that relieves swelling and inflammation of the mucous membrane.

Principles of treatment of laryngotracheitis

Treatment of laryngotracheitis in children depends on the stage of the disease. It is carried out under the strict supervision of a doctor.

• Systemic glucocorticosteroids (GCS). In addition to nebulizer therapy, the doctor may prescribe parenteral (injection) administration of GCS. Hormonal drugs reduce swelling, relieve inflammation and reduce the formation of mucus in the larynx. However, in pediatric practice, GCS is used with great caution, because they have many side effects. The course of treatment lasts several days, the dose of GCS is gradually reduced.
• Antiviral drugs. Their use is advisable only in the first days of ARVI. The antiviral drug blocks the action of the virus and the spread of inflammation in the larynx.
• Antihistamines. To reduce swelling of the mucous membranes.
• Antibacterial drugs. Croup occurs against the background of acute respiratory viral infections, which are not treated with antibiotics. Therefore, it is difficult to prove their effectiveness in this case. An antibiotic for laryngotracheitis in children is used only when there is a suspicion or diagnosis of “mycoplasma respiratory infection”, and secondary bacterial infections are also associated. Macrolide antibiotics are most often used.
• Broncho- and mucolytic drugs. They are prescribed only when an attack of stenosis is stopped. Used to thin, release mucus and relieve cough.
• Cases of resuscitation. If all methods of conservative treatment do not provide relief, resuscitation measures are carried out - intubation and tracheotomy (insertion of a tube into the larynx and trachea).

How to treat laryngotracheitis in children? We must do everything possible to prevent its occurrence. Preventive measures for acute respiratory viral infections, the ability to recognize the signs of incipient croup and promptly provide emergency assistance in case of difficulty breathing are important. The treatment of laryngotracheitis is carried out by an otolaryngologist.

Print

In contact with

Classmates

Like any disease, acute laryngotracheitis has its own causes and symptoms. Treatment conditions depend on the severity of the disease. In some cases, a child can be treated at home, and sometimes medical attention is required. All this in order - in the article.

Acute laryngotracheitis in children is a viral disease caused by swelling and inflammation of the subglottic space of the larynx.

During the course of the disease, a narrowing of the upper respiratory tract occurs, which leads to difficult breathing and lack of air. The second name of the disease is false croup.

The disease is common in young children. The peak incidence occurs in the second year of a child’s life. Often in young children, acute laryngotracheitis develops into bronchitis or.

Acute laryngotracheitis is most often a consequence of disease in certain areas of the respiratory tract as a result of ARVI. Primary damage to the larynx, and subsequently the trachea, may cause irritants:

• viral,
• mechanical,
• bacterial.

Symptoms of acute laryngotracheitis can occur 4-5 days after suffering or untreated respiratory viral disease.

Laryngotracheitis develops rapidly. The mechanism of acute laryngotracheitis is as follows:

• as a result of swelling of the laryngeal mucosa, the lumen through which air flows freely narrows;
• often a parallel spasm of the laryngeal muscles occurs, which leads to stenosing laryngitis;
• a large amount of inseparable purulent secretion accumulates in the lungs and bronchi;
• as a result of the narrowing of space, a barking cough is formed;
• breathing becomes noisy and difficult;
• the usual structure of the voice is disrupted.

Symptoms

At the very beginning of the disease, the child may complain of a sore and sore throat. Acute laryngotracheitis manifests itself:

• increased temperature;
• general malaise;
• the appearance of hoarseness in the voice;
• heavy breathing - when inhaling, you can hear a characteristic “sawing” whistle.

Symptoms are accompanied by a feeling of nasal congestion and dry mouth. A cough with sputum appears. Difficulty breathing is usually absent, except in cases where the effect of the virus extends to the subglottic space.

Attacks of acute laryngotracheitis occur at night and in the evening. The severity of the course directly depends on the degree of swelling and narrowing of the lumen. The baby suddenly becomes restless and cries. Attacks of barking cough are repeated more and more often, inhalation and exhalation become noisy.

Typically, attacks of acute laryngotracheitis are blocked at home. At the same time, medical attention is urgently needed if a child has:

• severe shortness of breath;
• pale skin;
• cyanosis (“blueness”) of the nasolabial area;
• rapid breathing, accompanied by flaring of the wings of the nose.

Differentiation with other diseases

False croup or acute laryngotracheitis must be distinguished from a number of diseases with similar symptoms.

On a note! Only a pediatrician can determine the disease through a personal examination of the child’s larynx.

Acute laryngotracheitis is characterized by the following::

• the laryngeal mucosa is somewhat hyperemic (red throat);
• the lumens of the larynx and trachea contain viscous pus, separated in the form of crusts;
• under the vocal cords there are bright red inflamed ridges.

In addition, the suddenness of the appearance, the speed of completion and the preservation of the ability to speak are characteristic only of false croup.

Most often, acute laryngotracheitis is differentiated from the following diseases:

Treatment

Treatment of acute laryngotracheitis is based on three principles:

• relieving an attack of disease and airway obstruction;
• relief of coughing attacks, normalization of breathing;
• relief of the main symptoms of the disease, rehabilitation.

Since false croup is a viral disease, treatment with antibacterial drugs is unacceptable. The same applies to expectorant and bronchodilator medications. They will not help and will worsen the course of the disease.

Treatment for attacks of false croup can be carried out both at home and in an inpatient setting. It all depends on the severity of the disease.

At home

The disease (if it does not have signs of stenosis (narrowing) of the larynx) can be treated at home. Parents will be able to independently alleviate the baby’s condition with simple non-drug measures:

• provide cool, moist air. This is especially true for attacks, during which it is important to bring the child to an open window or balcony. In the summer, when it is hot outside, it is permissible to sit the baby for a while near an open refrigerator;
• air humidity– the main component of non-drug therapy. If there is no humidifier in the house, then wet sheets hung on radiators or doors will come to the rescue;
• steam inhalation in the bathroom. To do this, you need to turn on the hot water and wait for the sauna effect. In such a “steam room” the child must be strictly under the supervision of parents for at least 15 minutes.

Of the medications at home, it is possible to use only Pulmicort in a compressor nebulizer.

Important! The nebulizer must be of the compressor type.

In the hospital

Indications for hospitalization The following cases are considered:

• development of respiratory failure against the background of acute laryngotracheitis;
• complication of the disease with stenosis of 2 or 3 degrees.

In a hospital setting, treatment is carried out as follows: medicines, How:

• dexamethasone,
• Beclomethasone dipropionate in aerosol form.

If these drugs do not have the desired effect, doctors often decide to put the patient under an air tent. It creates a therapeutic microclimate with a certain air humidity.

On a note! This measure is more likely to be forced and emergency. Before this, tracheal intubation is necessary - an operation to install a temporary thermoplastic tube in the larynx.

Useful video

The Union of Pediatricians of Russia advises parents with acute laryngotracheitis:

Conclusion

1. Only a doctor can detect the presence of acute laryngotracheitis when examining a child’s larynx.
2. Laryngotracheitis cannot be treated with antibacterial, expectorant and bronchodilator drugs. They will not solve the problem and will worsen the course of the disease.
3. Treatment of attacks is carried out at home or in a hospital setting, depending on the severity of the disease.

In contact with

Since the child's immune system is not yet sufficiently developed, there is a high risk of developing various diseases. First of all, inflammatory reactions occur in the organs of the nasopharynx. One of the most common diseases is laryngotracheitis, a disease that causes inflammation of the pharynx and trachea. This disease is especially dangerous for young children, since it is in childhood that there is a high risk of developing false croup. Therefore, it is very important to understand how to treat laryngotracheitis in a child in order to prevent the development of complications.

Causes and symptoms

Often, laryngotracheitis is caused by a viral infection (parainfluenza, influenza, herpes). Among the main reasons contributing to the occurrence and development of the disease are:

• features of the anatomical and physiological structure of the nasopharynx organs under the age of five years (narrow larynx);
• colds; weakened immune system;
• hypothermia, often a small draft is enough;
• contact with a carrier of infection;
• loud and prolonged scream, overstrain of the vocal cords, mechanical damage to the larynx;
• inhalation of various substances that cause allergies (varnish, paint, wool, dust);
• high temperature (above 22 degrees), low humidity (less than 50%) and dusty air in the room where the patient is.

The likelihood of laryngotracheitis increases in the presence of chronic diseases of the nasopharynx, frequent nasal congestion, diseases of the teeth and gums.

Also, under the age of five years, the disease is often accompanied by signs of false croup, which is dangerous due to severe swelling of the pharynx and can cause suffocation. Therefore, in order to prevent a threat to the child’s life, you should know what symptoms appear with laryngotracheitis, and what treatment is required at different stages of the development of the disease.

There are several forms of the disease, each of which is characterized by certain symptoms and requires an individual approach:

• Catarrhal form- the safest type of laryngotracheitis. It is this form that most often occurs under the age of fourteen. The main symptoms of laryngotracheitis in this case are similar to the signs of most viral infections: sore throat, hoarseness, dry annoying cough, hyperthermia. However, if treated incorrectly or untimely, there is a high probability of developing stenosis, which is life-threatening.
• Hyperplastic form- a type of laryngotracheitis, which also often develops in children. The main difference between this form is the severe swelling of the pharyngeal mucosa, which can cause difficulty breathing.
• Hemorrhagic form is accompanied by hemorrhage in the laryngeal mucosa and often occurs due to the presence of certain provoking factors (disorders of the hematopoietic process, liver disease). The main signs in this case: dry mouth, attacks of suffocating cough, viscous secretion mixed with blood, sensation of a foreign object in the throat.

Laryngotracheitis is diagnosed in 30% of children under three years of age who first encountered a common respiratory viral infection. The risk of developing the disease is higher in those who suffer from allergies.

The main symptoms and signs of laryngotracheitis, which appear at any stage of the disease:

• runny nose, hyperthermia, general weakness - the main signs of acute respiratory disease;
• change in voice timbre, hoarseness;
• sore throat when swallowing;
• decreased appetite;
• dry, paroxysmal, barking cough;
• rapid or, on the contrary, difficulty breathing; dyspnea;
• in later stages of the disease, against the background of difficulty breathing, paleness of the skin and cyanosis of the nasolabial triangle may appear.

Important! If an infant falls ill with laryngotracheitis, the following signs will help diagnose the disease: lethargy, increased anxiety, moodiness, runny nose, loud, barking cough.

Treatment

It is necessary to treat laryngotracheitis in children comprehensively, carrying out procedures aimed at combating the cause of the disease, as well as eliminating and alleviating the main symptoms.

When treating laryngotracheitis in patients predisposed to allergies, it is necessary to limit the use of essential oils, carefully use infusions of medicinal herbs, and use only proven medications.

• Use of antiallergic drugs. The action of this class of drugs is aimed at reducing edema and preventing the development of stenosis. Also, most antihistamines have a sedative effect, which will help the child calm down and reduce muscle spasms. The choice and form of the drug depend on the age of the child. For example, you can use Fenistil, Zodak, Loratadine.
• Antitussive drugs for laryngotracheitis are used only when the disease is accompanied by a dry cough without sputum production. In order for the child to sleep peacefully at night and not wake up from attacks of suffocating cough, they use Stoptusin, Herbion with plantain.
• Mucolytic and expectorant drugs for productive cough to thin and improve mucus removal. In this case, breastfeeding, medications based on ambroxol (Ambroxol, Lazolvan), acetylcesteine ​​(ACC) are recommended.
• Using lozenges, lozenges based on medicinal herbs, antiseptic and analgesic sprays for laryngotracheitis will help reduce sore throat, moisturize the pharyngeal mucosa, and eliminate soreness.

Important! In children, medications in the form of sprays should be used with caution to avoid the development of bronchospasm.

• If the disease is accompanied by a significant increase in temperature (above 38 degrees), antipyretic drugs should be used in the form of suppositories or syrups based on paracetamol (Cefekon suppositories, Efferalgan syrup) or ibuprofen (Nurofen syrup, Ibufen).
• If laryngotracheitis is caused by a viral infection, then antiviral drugs are used, for example, Groprinosin, Amizon, interferon-based drugs (Laferobion).
• Antibiotics for laryngotracheitis in children are used in the following situations: when the disease is caused by a bacterial infection; with high intoxication of the body; to prevent complications due to the viral nature of the disease. Given the fact that laryngotracheitis is most often caused by viruses, the use of antibacterial drugs is usually not necessary. If there is a need to use antibiotics, then preference is given to penicillin drugs (Augmentin). Cephalosporins (Cefadox) and, in particularly severe cases, macrolides (Sumamed) are also used.

Physiotherapeutic treatment

Along with general recommendations for treatment and the use of standard medications, physiotherapeutic procedures are used in the complex therapy of laryngotracheitis to speed up the recovery process and alleviate the symptoms of the disease:

• warm compresses on the pharynx and trachea (heating pad with warm water), mustard plasters;
• inhalation over steam and using a nebulizer;
• electrophoresis, UHF, microwave therapy;
• massage;
• hot baths for lower and upper extremities.

Important! Foot baths and warm compresses should only be used at normal body temperature.

If steam inhalations are used in the treatment of laryngotracheitis, then the following basic recommendations must be followed:

For the convenience and safety of the inhalation procedure, as well as more effective delivery of drugs to the area of ​​inflammation, it is better to use a special device - a nebulizer. However, it should be remembered that most nebulizers cannot use herbal infusions and essential oils. Nebulizers use alkaline inhalations with mineral water (Borjomi, Polyana Kvasova), medications indicated to eliminate the symptoms of the disease in inhalation form (Lazolvan, Sinupret, Nebutamol).

Gargling with infusions and decoctions of various herbs, for the preparation of which chamomile and calendula flowers, and sage are most often used. This procedure reduces inflammation and pain. Rinsing is carried out three times a day until the symptoms of the disease completely disappear.

Most often, treatment of laryngotracheitis in children is carried out on an outpatient basis. However, you should know the situations when you need to seek urgent medical help. Most often, danger is caused by conditions complicated by severe swelling of the larynx. In this case, the disease is accompanied by:

• intermittent, uneven breathing;
• shortness of breath;
• difficulty breathing, noisy breathing;
• excessive excitability or, on the contrary, drowsiness;
• pallor and cyanosis of the skin.

In this case, there is a stenosing form of laryngotracheitis (false croup), which is dangerous due to the development of asphyxia. First aid for false croup:

• alkaline inhalations;
• hot baths for the upper and lower extremities;
• Humidify the air using a humidifier and frequent wet cleaning.

The respiratory tract is a kind of gateway through which viruses and bacteria enter our bodies. The uppermost section, the nasopharynx, is most often affected.

However, the childhood inflammatory process tends to descend into the underlying sections - into the larynx and then into the trachea.

The characteristics of children's immunity, as well as the relatively short length of the respiratory tract, make a child more predisposed to the disease than an adult. What is laryngotracheitis in children and how to treat it? Let’s take a closer look.

In contact with

Classmates

What is laryngotracheitis

Laryngotracheitis is an inflammatory process affecting both the larynx (larynx) and trachea.

The larynx begins after the pharynx and then passes into the trachea. The diseases of these parts of the upper respiratory tract are mainly to blame for viruses that enter the larynx from the pharynx and move lower into the trachea.

These can be any respiratory viruses, which are grouped under the group name ARVI, and in everyday life are called colds. The disease develops according to the following general scenario:

1. Once on the mucous membrane of the respiratory tract, viruses begin to suppress local immunity.

1. Bacteria take advantage of decreased immunity and begin to intensively colonize the mucous membrane of the respiratory tract.

1. The bacterial infection ultimately leads to purulent inflammation, cough with the release of mucopurulent sputum.

The mucous membrane of the larynx and trachea swells and turns red. These symptoms of laryngotracheitis in children are not visible without a special endoscopic device. However, the disease manifests itself with other obvious signs by which parents can differentiate inflammation of the larynx and trachea from, for example,.

Why does laryngotracheitis occur?

A key factor in airway inflammation is a decrease in local immunity. As shown above, it can be caused by viruses. But often the cause of laryngotracheitis in children is non-viral.

1. Bacterial laryngotracheitis due to decreased local immunity

Various bacteria surround us everywhere: some live on the skin, others are limited in the nose, mouth, and throat. The child's immunity is undeveloped and unstable. Weakened immunity of the upper respiratory tract provides pathogenic microbes with opportunities to spread.

The main factors weakening the immunity of the larynx and trachea:

• Hypothermia;
• inhaling cold air through the mouth (for example, when children play in winter);
• passive smoking (for example, when adults smoke in a room where children are).

2. Bacterial laryngotracheitis as a result of infection with pathogenic microbes

To start the inflammatory bacterial process it is necessary:

• Imbalance of the microflora of the upper respiratory tract;
• inability of the immune system to restore the balance of “forces”.

A factor that significantly disrupts the balance of attacking microbes and protective forces is an external source of bacterial infection - a sick person. When coughing and sneezing, pathogenic microorganisms are sprayed into the surrounding space in huge quantities. The child’s body cannot cope with such a bacterial “attack” and becomes ill.

3. Bacterial laryngotracheitis due to an infectious focus in a child

The source of infection can be not only the external environment and opportunistic microbes inhabiting the upper respiratory tract, but also existing infectious foci in the body:

• In nose();
• in the paranasal sinuses ();
• inflamed tonsils ();
• sore throat ().

All of these diseases can lead to the spread of infection down the respiratory tract.

4. Allergic laryngotracheitis

Swelling of the larynx due to a non-infectious nature. Occurs as an allergic reaction to exposure to, for example, aerosol medications.

Types of childhood laryngotracheitis

The disease manifests itself in two forms:

• Acute uncomplicated;
• complicated stenosis.

Treatment of laryngotracheitis in children does not fundamentally depend on the form. However, significant stenosis of the larynx or trachea always requires more radical remedies, involving the child being in a hospital.

Symptoms of laryngotracheitis in children

Inflammation of the larynx and trachea does not appear unexpectedly. Often it occurs as a continuation of the inflammatory process in the upper respiratory tract: in the throat and nose. The initial symptoms of laryngotracheitis in children are manifested by standard signs characteristic of rhinitis and pharyngitis:

• Runny nose, stuffiness;
• cough;
• sore throat, irritation, sore throat;
• elevated temperature.

Acute laryngotracheitis

The progression of infection down the respiratory tract shows additional symptoms of laryngotracheitis in children:

• The cough takes on a “dry” and harsh sound;
• change in voice, hoarseness;
• pain when coughing in the upper center of the chest;
• coughing attacks at night;
• cough when taking a deep breath;
• sputum separation;
• Over time it becomes purulent;
• elevated temperature.

Acute laryngotracheitis can be complicated by significant stenosis of the larynx.

Stenosing laryngotracheitis

Stenosis is a narrowing of the lumen of an organ, cavity, etc. To one degree or another, edema (swelling) of the mucous membrane and, therefore, slight stenosis occurs in any inflammatory process, including and. Such obvious symptoms of laryngotracheitis in children as a change in voice, hoarseness, and ringing of the sound of a cough are nothing more than the result of inflammatory swelling of the larynx and glottis.


However, in some cases the stenosis is so severe that such conditions are classified as stenotic laryngotracheitis. A strong narrowing of the lumen impedes the movement of air. General symptoms of laryngotracheitis in children are supplemented by the following:

• Noisy inhalation and exhalation;
• labored breathing;
• attacks of shortness of breath;
• increased heart rate.

In the extreme, the stenosis can be so strong that it blocks the access of air to the lungs and causes. However, this is an extremely rare development of symptoms of laryngotracheitis in children.

Diagnostic methods

Initial diagnosis involves:

• Inspection;
• listening to the lungs;
• analysis of the patient’s condition based on complaints about well-being.

In general, diagnosis is not difficult. In cases of frequently recurrent disease, an analysis of the throat microflora (throat swab) is required to prescribe more effective antibacterial therapy.

Treatment options for children

Treatment of laryngotracheitis in children at home includes:

• Immunomodeling therapy (for children from 3 years of age);
• antibiotic therapy;
• symptomatic therapy.

At home

How to treat laryngotracheitis in a child?

1. Immunostimulating therapy

Immunomodulatory therapy for the treatment of laryngotracheitis in children may include:

• Antiviral immunomodulators;
• antibacterial immunomodulators.

Drugs of the first group are aimed at increasing the overall immune response of the body by increasing the release of interferon. Such means that can be used by children from 3 years of age include:

• Arbidol;
• Cycloferon;
• Grippferon;
• Anaferon (for children).

Preparations of the second group contain deactivated parts of bacteria, which most often cause inflammatory processes in the respiratory tract. They increase the number of immunocompetent cells and activate the process of capturing and destroying bacteria. These are topical preparations:

• Imudon;
• IRS-19.

All immunomodulators are used frequently - up to 6 times a day for a week or until significant relief occurs.

2. Antibiotics for laryngotracheitis

Local administration of an antibiotic is effective - spray spraying into the mouth. The traditional treatment for laryngotracheitis in children is Bioparox aerosol. Children from 3 years of age are inhaled 1-2 sprays into the mouth 4 times a day. For the first time you should use it with caution, because... Bioparox, like all aerosols, can cause spasms of the respiratory tract in young children.

In case of severe inflammation and for the treatment of laryngotracheitis in children, general antibiotics may be prescribed:

• Protected penicillins (Augmentin, Amoxiclav, Flemoxin, etc.);
• macrolides (Azithromycin - suspension for children from 6 months);
• cephalosporins (Suprax, Zinatsev, Fortum, etc.).

Antibiotics, as a general rule, are not used for more than 7 days. Antibiotics are taken regularly, i.e. observing equal time intervals between doses.

3. Symptomatic therapy

To eliminate the painful symptoms of laryngotracheitis in children, use:

• To combat dry cough - Tussin, Tusuprex, etc.;
• to improve sputum discharge - Mucoltin, terpopsis preparations, Ambroxol, etc.;
• to relieve swelling, irritation, itching - Erius (syrup), Zyrtec, Xizal, etc.;

special instructions

For effective treatment of laryngotracheitis in children, it is important to provide the necessary external conditions:

• Make the child talk less;
• additionally humidify the air in the room (hang wet towels, place open containers of water);
• give more warm drinks - tea, milk with honey, compotes;
• In the absence of fever and during the recovery phase, heat on the neck and chest is recommended.

Emergency care for laryngotracheitis

If a child has stenosing laryngotracheitis, it is necessary to seek emergency medical help.


The scope of assistance that parents can provide is quite limited.

1. It is necessary to take 0.3-0.5 ml (depending on the age of the child) of naphthyzine solution (0.05%).

1. Add 2-5 ml (depending on age) of water to naphthyzin.

1. The child should be in a sitting position with his head thrown back.

1. The resulting solution is quickly injected using a syringe (without a needle) into one of the nasal passages.

1. If everything went well, the child should cough.

The procedure described above is a one-time procedure. If the baby does not cough after it, and there is not at least a slight relief in breathing, the procedure can be repeated again, but in a different nasal passage.

Also, in case of acute stenosing laryngotracheitis, it is recommended to give the child an antihistamine tablet.

For allergic laryngotracheitis

Stenosis in allergic laryngotracheitis can be very strong. All of the above about the stenotic form fully applies to swelling of the larynx and trachea of ​​non-inflammatory causes.

In this case, a glucocorticosteroid drug can be used. For laryngotracheitis in children, this remedy is effective in relieving excessive swelling of the airways. Initially, it was intended to relieve attacks during and during. Method of administration: inhalation.

Pulmicort is contraindicated for viral, bacterial and fungal infections of the respiratory tract. This drug is used exclusively for allergic edema of the larynx and trachea.

ethnoscience

Folk remedies for laryngotracheitis are inhalations that have a local symptomatic effect on the respiratory tract.

You can use a nebulizer or the traditional method of inhaling warm steam.

What can be inhaled:

• Sea salt solution;
• eucalyptus;
• potato steam;
• chamomile;
• sage.

The question of choosing from the given list is not fundamental. The main thing is that the inflamed mucous membrane of the larynx and trachea receives the necessary moisture.

For the treatment of laryngotracheitis in children, a pharmaceutical homeopathic remedy, Aflubin, may be recommended. Recommended dosage for children: 5 drops three times a day.

Laryngotracheitis in children under 1 year of age

Treatment of laryngotracheitis in infants is a big responsibility. Many drugs are undesirable or contraindicated. The situation is complicated by the fact that infants are very defenseless against bacteria and viruses. Inflammation always develops rapidly. Professional medical assistance is required.

What should not be done with laryngotracheitis

1. Hot inhalations should not be performed.

1. You should not give antibiotics without a doctor's prescription.

1. You should not go outside.

1. It is necessary to ventilate the living space.

Prevention methods

Measures to prevent laryngotracheitis involve, mainly, a natural improvement in the body’s protective functions:

• The child should spend more time outdoors;
• the child’s body should experience moderate daily physical activity;
• It’s good to go on vacation to the sea once a year;
• vegetables, fruits, and nuts should be included in the diet.

What to Avoid

• Hypothermia is a sure way to reduce immunity;
• staying in kindergarten during seasonal peaks of ARVI;
• smoking in the presence of a child.

Under what conditions is laryngotracheitis diagnosed? The answer is given by Dr. Komarovsky.

Conclusion

Laryngotracheitis is an inflammatory disease affecting two parts of the upper respiratory tract (larynx and trachea).

Pediatric laryngotracheitis has a predominantly bacterial cause.

Treatment of laryngotracheitis in children is immunomodulating, antibacterial.

Stenosing laryngotracheitis requires emergency first aid.

To prevent a child from being bothered by inflammation of the larynx and trachea, it is necessary to strengthen his immunity, organize a balanced diet, make sure that he does not get hypothermic and walks in the fresh air more often.

In contact with