Acute obstructive bronchitis in children is characterized. All causes of frequent bronchitis in a child

Obstructive bronchitis is one of the most dangerous diseases. In terms of severity, it is in second place after. Most often, the disease affects children under the age of 6-7 years. This is due to the fact that babies have very narrow gaps in the bronchi.

The inflammatory process provokes the accumulation of a large amount of mucus in the bronchial canals, which leads to a thickening of the mucous membrane and clogs the bronchi.

general description

Obstructive bronchitis is a severe spasm of the bronchi that prevents the release of the resulting mucus. Accompanied by high temperature. It is most dangerous for children under the age of 1-2 years, because they do not have a cough reflex, which contributes to the discharge of sputum. With a strong attack of coughing, the child may even suffocate.

For obstruction the mucous membrane of the bronchi grows, clogs the respiratory channels. Phlegm and mucus accumulate in them, making it difficult to breathe. The accumulation of sputum causes severe inflammation, swelling of the bronchi, which leads to severe oxygen starvation.

Causes of what is dangerous

In addition to hereditary anomalies of the esophagus, diseases of the gastrointestinal tract and nasopharynx, there are many causes of bronchitis. The disease can be caused by:

prone to bronchial obstruction premature babies, immunocompromised. Risk factors - genetic predisposition (, rickets, cystic fibrosis, congenital lung hypoplasia, etc.), passive smoking, polluted atmosphere. Obstructive bronchitis can occur against the background of any cold or hypothermia. Untreated, diseases of the nervous system lead to obstruction.

Consequences of obstructive bronchitis:

Classification

There are three forms of obstructive bronchitis: acute, chronic and allergic.

acute form occurs as a result of a viral infection. The first signs of the disease can be noticed within a few days after the onset of SARS or influenza. There is a strong cough with wheezing, shortness of breath.

Chronic or recurrent obstructive bronchitis is the result of an untreated acute form. It is characterized by morning bouts of coughing, sweating, fatigue, low temperature. The disease can occur several times a year, be provoked by hypothermia.

allergic form obstructive bronchitis in children is paroxysmal in nature, occurs with close contact with the allergen. Often accompanied by a runny nose, lacrimation, but does not cause fever.

Any kind of bronchial obstruction is dangerous, it proceeds in a very severe form, especially at the age of 2 years. It is necessary to treat this disease only in a hospital, so as not to cause serious complications.

Specific and non-specific signs

With obstructive bronchitis, the following primary symptoms develop:

Secondary signs:

The danger lies in the rapid progression of the disease, the rapid swelling of the bronchi, which leads to oxygen starvation.

How to recognize the disease

Infants suffer from obstruction of the small branches of the bronchi (bronchioles). Obstructive bronchitis in children under one year old called bronchiolitis. The very first symptoms of the disease are fever, runny nose, paroxysmal cough, suffocation. There is a strong swelling of the mucosa, which prevents the discharge of sputum. The child constantly cries, cannot sleep. The disease develops very quickly, often leading to serious complications.

For children aged 1 to 4 years obstructive bronchitis is more often diagnosed. It usually appears after a viral infection and is caused by bronchospasm. At an early stage of the disease, coughing can be rare, weak.

If the disease is not treated in time, then after 3-4 days there are severe attacks of coughing, wheezing, fever, heavy, rapid, wheezing breathing, difficulty in exhaling, and swelling of the chest. Additional symptoms are runny nose and sore throat. The cough is worse at night.

In children 4-6 years old obstructive bronchitis is treated faster. Thanks to the development of the respiratory muscles, the cough becomes productive, the baby can get rid of sputum on his own. The recovery process is also accelerated by the fact that more serious drugs can be prescribed at this age.

If at least some of these symptoms are detected, it is urgent to call a doctor. In no case should you self-medicate, use "proven" folk remedies without consulting a specialist.

Children under 2 years of age with signs of obstruction are subject to immediate hospitalization.

Diagnostic measures

Obstructive bronchitis is diagnosed by a doctor based on examining and listening to the lungs. Assigned. and talk about a serious inflammatory process.

To confirm the diagnosis and rule out pneumonia, x-ray is prescribed. If the pulmonary pattern is enhanced, but there are no foci of infiltration, darkening, then obstructive bronchitis is diagnosed.

How is the treatment going and what to do if it happens at night - read the article on our website.

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How and what to treat

Treatment of acute obstructive up to a year is carried out only in a hospital. 2 years and older can be treated at home provided that the condition of the child is satisfactory, does not cause concern. The doctor should draw up a treatment plan.

Mandatory procedures:

• inhalation with saline;
• washing the nasopharynx;
• physiotherapy;
• massage;
• diet;
• plentiful warm drink.

How to massage with obstructive bronchitis in children, watch the video:

If bronchitis is of an infectious origin or the disease is severe, with a prolonged high temperature, then antibiotics. Used to relieve bronchospasm antispasmodics(No-shpa or Papaverine).

In case of obstructive bronchitis, in no case should you take antitussive drugs: only expectorants, thinning sputum (based on ambroxol) are used.

In severe cases, a doctor may prescribe hormone therapy, sometimes with intravenous administration of Eufilin. Antiviral drugs are effective, for example, Erespal, immunomodulators (, Interferon,). With severe allergy symptoms, antihistamines are used.

Mandatory conditions:

• maintaining high humidity in the room;
• regular ventilation;
• adherence to a hypoallergenic milk and vegetable diet;
• daily wet cleaning of the room;
• frequent and plentiful drinking (non-acidic fruit drinks, teas, mineral water without gas).

With obstructive bronchitis in children do not use warming ointments, mustard plasters and essential oils, at high temperature do not make compresses and warming up. Before starting treatment with folk remedies, you need to consult with your doctor and make sure that the child does not have allergies. Call your pediatrician right away and listen to what Dr. Komarovsky says on this topic.

Forecast and preventive measures

With proper and timely treatment, obstructive bronchitis completely disappears and does not recur. But the disease can be recurrent and can lead to serious consequences.

At risk are children prone to allergies, with elevated levels of immunoglobulin in the blood. With frequent relapses, obstructive bronchitis develops into asthma.

Preventive measures:

It is very important to observe the correct indoor temperature conditions (18-21C) and humidity (at least 65%). Avoid contact with allergens, do not take the child to crowded places during epidemics, protect from inhaling tobacco smoke, walk more often in the fresh air (preferably in a forest or near a pond).

By following these recommendations, you can maintain the health of the baby, prevent the onset of the disease and the complications it causes. If it was not possible to avoid the disease, then it is necessary to consult a doctor who will determine how to cure obstructive bronchitis in your child.

Need strictly follow the instructions of the pediatrician and do not try to cure the disease on your own. this is dangerous. In case of a severe course, you should not refuse hospitalization.

In contact with

The human respiratory system consists of many interconnected structures. Through them, air enters the body, warms up, is distributed and converted by the lungs into oxygen, which enriches the blood. The bronchi are a transport system for air that has entered them from the trachea. It consists of numerous tubes of different diameters through which the air flow is cleaned, warmed and distributed through the alveoli.

If the bronchial tubes become inflamed, then their lumen is filled with sputum. The volume of penetrating air decreases, lung function is impaired, and the body begins to experience oxygen starvation. This disease is called obstructive bronchitis (not to be confused with the word "obstructive").

Causes of obstructive bronchitis in children

Children are especially susceptible to this disease, because their airways are not yet fully formed. Obstructive bronchitis in babies can appear for many reasons. All factors that cause the disease can be divided into three groups:

• infections that provoke inflammation of the bronchi;
• allergic reactions;
• organic pathologies of development.

The infectious factor of the onset of the disease is the most common. Pathogens that cause obstructive bronchitis in children:

• viruses - influenza, parainfluenza, rhinovirus, cytomegalovirus, adenovirus, respiratory syncytial virus;
• bacteria - streptococci, pneumococci, chlamydia, mycoplasmas;
• helminths that have penetrated the bronchi during migration in the body (roundworms);
• molds, candidiasis.

The leader among the pathogens that cause bronchitis are a variety of viral infections. Among children under 3 years old, the abstract frequency of the viral nature of bronchitis reaches 90%. After 3 years, this reason recedes, but still remains dominant. In recent years, cases of bacterial infection of the bronchi, especially mycoplasma and chlamydia, have become more frequent. These pathogens not only cause acute bronchitis in children, but also contribute to its transition to a chronic form.

Young children are more likely to develop obstructive bronchitis than adolescents and adults. This is due to the anatomical features of their respiratory system:

• children's bronchi are not yet fully formed and have a narrow lumen;
• the immune system in the formation stage is not able to provide full protection;
• respiratory muscles are weaker than in adolescents;
• the skeleton of the bronchi is underdeveloped;
• high viscosity of sputum;
• prolonged stay on the back during sleep.

Provoking factors

The occurrence of frequent respiratory diseases, turning into bronchitis, is facilitated by factors unfavorable for children:

• pathological course of pregnancy in the mother;
• hereditary predisposition to allergies;
• congenital pathologies of the bronchi;
• prematurity or underweight;
• vitamin D deficiency;
• acute respiratory infections in the first year of life;
• artificial feeding;
• non-compliance of living conditions with sanitary standards;
• polluted air, smoking parents.

The mechanism of the development of the disease

Obstructive bronchitis develops in children according to the following scheme:

The main symptoms of the disease

Initially, the disease proceeds according to the general picture of SARS or influenza. Signs of acute bronchial obstruction may appear already on the first day, more often after 2-3 days.

Symptoms that indicate that a child develops obstructive bronchitis:

• changes in breathing (leading symptom) - noise, whistling when inhaling, increased frequency (up to 50-60 breaths per minute), shortness of breath;
• cough dry, sometimes paroxysmal, more often at night, sputum, if it departs, then with difficulty and in meager amounts;
• heat;
• headache;
• babies may vomit;
• pain is felt between the shoulder blades;
• stuffy nose, red throat;
• in newborns, the tips of the nose, ears, lips and nails turn blue;
• lack of appetite;
• sometimes loss of consciousness.

Traditional treatment regimen

Obstructive bronchitis is treated both in the hospital and at home on an outpatient basis. The general rule is the medical control over the patient's condition and the obligatory visit to the doctor when the first symptoms of the disease appear. Otherwise, when trying to self-medicate, the disease quickly turns into pneumonia and severe consequences develop, sometimes with a threat to the life of the child.

Parents need to remember that obstructive bronchitis is inextricably linked with a violation of the function of breathing and providing the whole body with oxygen, so the disease is a threat to all the vital organs of the child. The doctor decides whether to place the baby in a clinic or outpatient treatment, based on the history.

Hospitalization is mandatory for suspected obstructive bronchitis in such clinical cases:

• Children under 1.5 years old. If the child is 2 years old, then the issue of hospitalization is at the discretion of the doctor. As a rule, therapists for babies 2-3 years old insist on placing patients in the clinic.
• The rapid development of the disease, the lack of progress in treatment for 4-6 hours.
• Severe course of the disease.
• Insufficient breathing, the child suffocates.
• Increasing hypoxia.

If the doctor has decided to treat at home, then the parents must ensure such care for the sick child, which will create favorable conditions for a quick recovery of health.

Half bed rest

At the beginning of the disease, when the body temperature is high, strict bed rest and rest are necessary to mobilize the patient's immune forces. After normalization of the temperature, the child should not stay in bed all the time, since a long stay in the supine position has a bad effect on the respiratory function. The child can sit in bed, walk around the apartment. Active games are excluded. In the future, walks in the fresh air are recommended.

Food

You should carefully consider the diet of the baby. It is necessary, on the one hand, not to overload the stomach of a weakened organism, and on the other hand, to ensure sufficient caloric intake. Reduce the amount of solid food taken by a third. Increase the amount of liquid by 1.5 times. Provide plenty of warm fluids. The liquid must have an alkaline reaction (mineral waters of Essentuki, Borjomi). Eliminate all foods that can cause allergies. Food should be light, but high-calorie, high in vitamins and minerals. A lactic acid diet, soups, cereals would be ideal.

Ensuring indoor air quality

Children with bronchitis are extremely sensitive to air humidity and oxygen saturation. Parents need to ventilate the room daily to ensure the flow of oxygen. In case of insufficient humidity, a special device should be installed to generate moist air, wet cleaning should be carried out daily, the floor and objects can be sprayed with water. To disinfect the room, you should use special hypoallergenic products.

Inhalations for bronchial cleansing and physiotherapy

Inhalations should be done at intervals established by the attending pediatrician. For inhalation, it is better to use a steam inhaler or nebulizer. Physical solution is mixed with mineral alkaline water, herbal decoctions, medicated bronchodilators.

Physiotherapy, massage and gymnastics restore the balance of inhaled and exhaled air, increase blood flow to the respiratory tract.

Medical therapy

Treatment of obstructive bronchitis is complex. The doctor prescribes several drugs of different effects. You should not stop taking any of the prescribed medications, especially antibiotics, on your own, even if it seems that the child is already healthy. Untreated obstructive bronchitis becomes chronic. After recovery, prophylaxis should be observed to avoid symptoms of recurrent bronchitis.

Medical treatment

Treatment of obstructive bronchitis is complex. It aims to achieve several goals:

• removal of obstruction and restoration of bronchial patency;
• normalization of secretomotor function, sputum thinning and expectoration;
• suppression of pathogenic infection and elimination of the inflammatory process;
• restoration of respiratory function in full;
• elimination of the consequences of the disease for the body as a whole.

Antitussive drugs in the treatment of obstructive bronchitis are not used, since their combination with bronchospasm negatively affects the general condition of the patient. Drug therapy includes the use of drugs from the following groups:

• antipyretic - only with hytherthermia;
• decongestants - for the relief of a runny nose;
• bronchodilators - to expand the lumen of the bronchi;
• mucolytics - to thin sputum;
• secretory means - for effective expectoration;
• glucocorticosteroid hormones - in case of a severe course of the disease;
• antibiotics are antimicrobials.

Antibiotics are not always prescribed. Indications for their use are:

• age up to a year;
• bacterial rather than viral nature of the infection;
• the temperature lasts more than 3 days;
• bronchospasm is stable;
• signs of general intoxication;
• inflammatory signs in the general blood test.

Treatment with folk remedies

Inhalations

Traditional medicine, just like professional medicine, offers an effective method of getting rid of bronchial obstruction - inhalation. All familiar steam inhalations (under the covers over the kettle) are not effective for obstructive bronchitis. Inhalations using drugs and alkaline solutions should be done using an inhaler or nebulizer. Well relieve spasm such folk remedies for inhalation:

• sea ​​salt - 3 tablespoons per 1 liter of water;
• adding a small amount of crushed onion or garlic to the solution;
• essential oils of lavender, eucalyptus, juniper;
• decoctions of mint, sage, eucalyptus.

Infusions and decoctions

Infusions and decoctions according to folk recipes are used as an expectorant. If the child is not allergic to honey, then adding honey to medicinal decoctions will increase the effectiveness of the treatment.

• Milk with sage. Boil 3 tablespoons of dry sage herb in 1 liter of milk for 15 minutes, and then let the decoction infuse for an hour. Dissolve 3 tablespoons of honey in the resulting infusion. Drink every hour for 100 g.
• Carrot juice with honey. Mix freshly squeezed juice with honey in equal parts and drink a teaspoon 5-6 times a day.
• Infusions of various compositions are prepared as follows. 1 tablespoon of vegetable raw materials is poured into a glass of boiling water, allowed to brew for 15-30 minutes, honey is added and the child is offered to drink the decoction.

For the treatment of bronchitis with decoctions and infusions, people use mixtures of medicinal plants:

• raspberry, linden, black elderberry;
• medicinal chamomile, linden, black elderberry, mint;
• licorice root, plantain herb and coltsfoot;
• elecampane.

Compresses

Traditional medicine suggests the use of compresses and rubbing.

It is important to know that the well-known mustard plasters for obstructive bronchitis are categorically contraindicated. Mustard vapors can cause severe bronchospasm in the patient.

Compresses from vegetable and butter oils will have a positive warming effect. Oil compresses are applied all night before bed. To do this, you can use vegetable oil or a mixture of butter and honey. Warmed oil is applied to the chest and back of the baby, wrapped in a terry towel, wrapped with plastic wrap on top. In this form, the patient is put to sleep.

Massage and gymnastics

To effectively remove sputum, a special postural massage is used. The child should be laid on the stomach so that the head is slightly lower than the level of the legs. This will ensure blood flow to the massage area. The edge of the palm makes light taps on the back of the baby. Such bronchial drainage helps to separate sputum well.

Special breathing exercises restore lung function. It is usually carried out in the office of physiotherapy exercises. At home, simply inflating a balloon is effective. This procedure improves ventilation of the lungs.

Forecasts

Modern medicine copes well with childhood obstructive bronchitis. In all cases, doctors manage to cure the disease. When seeking medical help on time, following all the doctor's prescriptions and timely treatment, the prognosis is positive. A complication such as bronchial asthma occurs in no more than 2% of patients.

It should be noted that the recovery period is important for preschool children. This is due to the fact that the anatomical features of children of this age and insufficient immunity predispose to re-disease during the year. Preventive measures to prevent relapse are very important for a cured child.

Preventive measures

To prevent the acute form of the disease from recurring, it is necessary to prevent obstructive bronchitis in children:

• avoid viral infections, contact with patients, crowded places;
• get vaccinated against influenza and other viruses on time;
• consult an allergist and provide the child with a hypoallergenic environment and nutrition;
• constantly monitor the cleanliness and humidity of the air in the child's room, often ventilate the room;
• healthy sleep, long walks in the air, a balanced diet and hardening will ensure a quick restoration of immunity;
• spa treatment is useful for rehabilitation after illness;
• do not ignore the dispensary observation of a pediatrician;
• with frequent recurrences of obstructive bronchitis, you need to undergo an examination and get advice from a pulmonologist;
• according to the doctor's prescription, immunomodulators can be used.

The term obstructive in modern medical practice means damage to the upper respiratory tract. The mucous membranes of the bronchial tree and trachea are involved in the pathological process. In most cases, the disease proceeds in an acute form and takes on the features of a chronic one. With obstructive symptoms, symptoms characteristic of bronchial asthma may occur. In most cases, the development of pathology can be provoked by viral and bacterial infections.

And now let's dwell on this in more detail.

What is obstructive bronchitis?

The term bronchi means an extensive network of tubes of different diameters. Their main task is to pass air. Oxygen penetrates to the lungs, overcoming the larynx and bronchi. With the penetration of infection in the bronchi, an inflammatory process develops, the process of air circulation is disturbed, and the movement of air to the lungs becomes difficult. Obstructive can be considered as an acute form of pathology that occurs with symptoms of bronchial obstruction. It is important to remember that it is a pathology that has a predisposition to chronicity, therefore, worthy attention should be paid to its treatment. If simple rules are not followed, the pathological process may be aggravated. Chronization is quite dangerous and not pleasant. A chronic diagnosis increases the risk of developing various pathologies of the upper and lower respiratory tract, against which the entire immune system suffers.

A feature of obstructive is a pronounced narrowing of the bronchi, namely, obstruction. This condition can manifest itself as a result of various provoking factors. Violation makes it impossible to breathe, coughing occurs when inhaling.

A feature of the inflammatory process is the rapid deterioration of the clinical picture of the disease. The symptoms are growing rapidly. A characteristic manifestation is a dry, hacking cough, which leads to various sleep disorders.

By the term obstruction, physicians mean the closure of the lumen between the bronchi. - an inflammatory process that occurs in the mucous membranes and muscle walls of organs. The middle bronchi and bronchioles are often involved in the pathological process. Against the background of the inflammatory process, their complete or partial blockage occurs.

The mechanism of development of obstructive in a child can be represented as follows:

• a viral infection occurs;
• pathogenic microorganisms penetrate the nasopharynx;
• a runny nose is manifested, acting as a natural immune reaction;
• the pathological process extends to the throat;
• the upper respiratory tract is involved in the inflammatory process.

The complexity of the treatment of bronchitis lies in the fact that such a disease is often provoked by particularly resistant microorganisms that have overcome the natural barriers of the body. After active pathogens enter the mucous membranes of the bronchus, a local reaction appears, the bronchioles begin the process of producing a viscous mucous secretion, which becomes the cause of obstruction.

The main purpose of the bronchi is to protect the lungs from infection. The main bactericidal substance in this case is the mucous secretion. The purification process proceeds according to the required scheme, if the secret has a liquid consistency. As a result of various factors, the density of mucus may change, and this condition is negative. The reason for the thickening of mucus may be as follows:

• increase in body temperature of the child;
• contact with dust and allergens;
• insufficient air humidity;
• non-compliance with the drinking regime.

If the mucus becomes dry, it becomes an ideal breeding ground for infection. Mucous masses in this state are not excreted, but remain in the bronchi. Untimely treatment of obstructive disease can cause the development of bronchial asthma.

A lump of dried mucus in this case is the main cause of obstruction, because it blocks the lumen of the bronchi of various diameters. Against the background of such a violation, confident prerequisites for development are created due to a violation of the processes of natural ventilation of the lungs.

Symptoms of obstructive bronchitis in children

A distinctive feature of chronic inflammation is long-term. Dry, hacking cough, which may persist in the absence of other symptoms. At the same time, the general condition of the child remains unchanged, there is no decrease in activity. The danger of pathology is that a prolonged cough can cause bronchial hypertrophy, which manifests itself due to strong physical activity.

Causes and prevention of obstructive bronchitis

Obstructive - a condition in which bronchospasm is traced. Against the background of such a disease, the mucus accumulated inside cannot come out and provokes various respiratory disorders.

The list of the main reasons that can provoke the development of a child can be presented as follows:

• allergic inflammation of the bronchi;
• the introduction of viruses;
• hypothermia of the body;
• severe overheating;
• second hand smoke;
• living in a region with an unfavorable ecological situation;
• constant crying that interferes with normal breathing;
• received birth injuries;
• health disorders manifested during the neonatal period;
• increased air humidity in the living room;
• the formation of fungus in a residential area.

Parents should remember that a cough that lasts more than 3 days is a reason to contact a pediatrician. It is impossible to ignore such a symptom, it may indicate the development of a child. Such a disease is treatable and well corrected, provided timely access to a specialist.

Currently, there is no active vaccine that provides prevention of development in a child. The simplest and most effective method of preventing the onset of the disease is the right lifestyle. The main forces should be coordinated on the activation of the protective properties of the immune system. Simple rules will help ensure the restoration of protective properties:

1. The child should walk daily in the fresh air.
2. The benefit will be feasible physical activity, excluding overwork of the body.
3. The child's menu should include fruits and vegetables.
4. Useful annual vacation at sea and in the mountains. The duration of climate change should be at least 21 days.
5. The regular intake of complexes, which contain vitamins and trace elements, is shown.
6. Regular sanitation of the oral cavity, timely treatment of carious cavities, even in milk teeth.
7. Treatment and prevention of diseases of the ENT system.

Parents should remember that the manifestation of the disease always indicates that it is necessary to consult a doctor. Incomplete treatment significantly increases the likelihood of developing dangerous complications.

The first signs of obstructive bronchitis

Like any cold, it starts with a stuffy nose and cough. A feature is that with obstructive severe coughing attacks occur at night. Cough urges, despite the strength, do not provoke the excretion of sputum. The child is worried about severe pain in the retrosternal space. During the period of illness, children become restless, constantly act up, sleep is often disturbed, and nervous excitability increases.

The list of additional signs indicating the development of the disease can be presented as follows:

• an increase in the frequency of breaths, the manifestation of noise on inspiration;
• whistling breath;
• enlargement of the chest in size;
• manifestation of pallor of the skin;
• unproductive cough;
• manifestation of subfebrile body temperature;
• as the disease progresses, moist rales appear;
• manifestation of signs of bloating of the lungs on the radiograph;
• redness of the tonsils, their hypertrophy;
• enlargement of the lymph nodes.

In most cases, obstructive disease is diagnosed in children over the age of 2-3 years. At the initial stage of the development of the disease, the clinical picture is similar to the symptoms of a cold, so parents often ignore the need to seek medical help. Symptoms characteristic of obstruction appear 2-3 days after the onset of the disease, usually at the time when parents manage to reduce body temperature with the help of antipyretics.

Treatment of obstructive bronchitis in children

Treatment of obstructive in children under the age of 1 year is carried out in a hospital. Such a security measure is taken because of the high risks of developing dangerous complications.

Children over the age of one year can be treated at home.

• compliance with bed rest;
• daily walks in the fresh air;
• light, plant-based diet;
• plentiful drink;
• regular cleaning of the premises;
• air humidification.

If the treatment is carried out in a hospital, the chamber should be regularly quartzed.

To eliminate spasm, inhalations can be performed using such drugs:

• terbutaline;
• phenotorel.

At home, you can use a nebulizer.

If treatment with bronchodilators is ineffective, corticosteroids may be used. Mucolytics and broncholytics may be used to speed up sputum clearance. Alkaline inhalations using Borjomi water will benefit. Breathing exercises and drainage massage help to significantly speed up the process of removing mucus accumulated in the bronchi. The basics of drainage massage should be explained to parents by a specialist in exercise therapy. improper procedure increases the risk of complications.

Treatment with antibiotics is possible only if a secondary infection is attached. The most suitable means are selected individually. Dosages are selected depending on the type of infection and the severity of the patient's condition. The duration of the course of therapy is set individually.

The probability of a complete recovery without dangerous complications, provided that you seek medical help in a timely manner, reaches 100%. The reason for the development of the dangerous consequences of the disease is often the inattentive attitude of parents to the health of their own child. does not belong to the category of extremely dangerous diseases, subject to its timely treatment. Lack of treatment entails a chronic inflammatory process. The chronic course of the disease will cause the child to face a debilitating cough several times a year. It is quite difficult to get rid of chronic obstruction, and in advanced cases it is impossible, therefore it is better to pay attention in a timely manner to the treatment of pathology that occurs in an acute form.

This is inflammation in the membranes and muscular wall of the bronchi, accompanied by obstruction. So doctors call the closure of the lumen of a hollow organ. In this case, small and medium bronchi are closed, clogged. This does not happen by itself, but against the background of acute bronchitis.

The mechanism of obstruction will be more understandable if you know how inflammation of the lining and wall of the bronchi begins and develops. Most often (about 85% of cases) a child becomes infected with a viral infection. Viruses penetrate the nasopharynx, causing a runny nose as an immune response, from there to the larynx, where a local protective reaction occurs, as a result of which the throat turns red.

Particularly aggressive and tenacious viruses quickly overcome the two previous "posts" of immunity (nose and throat) and penetrate into the lower respiratory tract. The mucous membrane of the bronchi also meets uninvited "guests" with local immunity and begins to actively produce bronchial secretion- a special mucus that is able to bind and neutralize the activity of viral particles.

Bronchial task quite understandable - to prevent the penetration of viruses further - into the lungs. And their main weapon is mucus. And everything goes fine as long as this slime is liquid. If, under the influence of adverse factors (high body temperature of the child, dry or dusty air that he breathes, etc.) begins to thicken, dry out, then from a protective device it will immediately turn into an excellent environment for the reproduction of pathogenic microbes.

Staphylococci, pneumococci, other "cocci" and not only they will gladly take advantage of this. And then bronchitis will become complicated by a secondary bacterial infection. Dried mucus creates another big problem - it clogs small and medium-sized bronchi, pulmonary ventilation is disturbed, and excellent prerequisites for pneumonia are created.

It is this condition of bronchial obstruction that is understood by the concept of "obstructive bronchitis". It is always better to prevent this disease than to treat it later, but, alas, it is not always possible to prevent it. If such a diagnosis is established, this does not mean that you need to panic. This is a signal for immediate action.

First of all, you need to understand what kind of disease we are talking about, because obstructive bronchitis can be both acute and chronic. In children, in the overwhelming majority of cases, the first variant occurs, the chronic form is usually the lot of adults. A chronic illness can be discussed if an incessant wet cough accompanies the child without stopping for more than 3 months, and such periods have been observed for at least two years in a row.

Danger

Changes that occur in the bronchi can be reversible(bronchospasm, inflammation of the mucosa and submucosa), and can be classified as irreversible. Such dangerous transformations include narrowing of the lumen of the bronchi, prolapse of the membrane wall.

The most dangerous complications bronchial obstruction- this is pulmonary emphysema, cardiac pathologies, which are associated with an increase in the size of the organ due to increased blood pressure in the small circle (pulmonary), recurrent acute attacks of respiratory failure, bronchiectasis (a condition of pathological expansion of the bronchi).

The peculiarities of the structure of the respiratory organs of children are that their airways are narrow, sputum, even with a favorable course of the disease, is quite difficult to leave in a timely manner.

That is why it is very important not to self-medicate bronchitis in general, and if we are talking about an obstructive form, then only qualified doctors and modern medications will help to avoid dangerous consequences.

The reasons

Obstructive bronchitis most often develops against the background of acute viral bronchitis, which, in turn, is a fairly common consequence of infection with influenza, parainfluenza, measles and other viral agents that are active in the respiratory system.

With such a disease, bacterial complications that develop against the background of bronchial obstruction are not excluded. This will require a change in the approach to treatment and rehabilitation.

By themselves, bacterial lesions of the bronchi are quite rare. Such ailments are more severe than viral ones, but the prognosis is quite favorable, since antibiotics exist and are widely used in the 21st century, they quickly and effectively deal with pathogenic microbes that have settled in the shell or wall of the bronchi.

Sometimes obstructive bronchitis in children is caused by prolonged allergic or toxic exposure. This is the most dangerous form of obstruction, since with it there is a narrowing of the lumen, not even due to thick bronchial secretions, but to a greater extent due to swelling of the tissues.

Risk factors that provoke the development of obstructive bronchitis are as follows:

• inhalation of dust, tobacco smoke, gases, chlorine vapors and other chemicals;
• too dry air in the room where there is a child with ordinary acute bronchitis;

• improper treatment of acute bronchitis;
• general ill-being of the child - malnutrition, lack of vitamins, prolonged stress;

• frequent colds and other diseases that reduce the ability of the immune system to defend itself;
• chronic or prolonged runny nose, other nasal breathing disorders;
• the genetic predisposition of the child to allergies, especially to its respiratory manifestations.

The risk of obstruction in the most common acute catarrhal bronchitis increases several times if the parents do not immediately begin to take measures to create optimal conditions for a normal recovery.

If the baby continues to breathe dry air in the apartment, if heaters are turned on in his room, and he himself is wrapped in several warm clothes, there will be no sense in treating even very expensive and effective drugs. With a high degree of probability, thickening and drying of bronchial mucus will occur, obstruction will begin.

A prerequisite for preventing blockage of small and medium bronchi is humidified air in the room, coolness, ventilation and wet cleaning. More details about the required parameters - just below.

Symptoms and signs

Obstructive bronchitis is not often an independent disease, it is usually a complication of acute bronchitis or a viral disease. Therefore, the symptoms at the initial stage will completely repeat the clinical picture of a particular disease. With the flu, you will first have a fever, sore muscles and throat, headaches, and only then signs indicating bronchitis.

With allergies, the symptoms will also not appear immediately, but after a sufficiently long exposure to allergens. In all cases, obstructive bronchial disease has its own distinctive features. signs that allow you to suspect an ailment and make the necessary diagnosis in time:

• Body temperature is usually not high, more often it remains within subfebrile values ​​- 37.0-37.9 degrees.
• May experience mild sore throat, slight redness of the mucous membranes. This symptom is optional.
• The main symptom is cough. It appears almost immediately with the onset of respiratory manifestations and for the first 3-5 days is dry and barking in nature. Its intensity at night increases markedly. After a few days, a dry cough turns into a productive wet, accompanied by expectoration of sputum.

• Obstruction may indicate the appearance of severe shortness of breath The child has even from minor physical exertion or, in general, at rest.
• Often with an obstructive form of the disease, a child develops wheezing dry rales when breathing, their parents will be able to hear even without the appropriate medical education and special devices. Wheezing is very well audible.

• The child, due to a lack of oxygen, which is a consequence of a violation of pulmonary respiration, becomes lethargic, drowsy, apathetic. He sweats a lot even in the absence of high temperature. This condition is often referred to as "cold sweat".
• The sputum that the child coughs up with difficulty has a rich yellow color., sometimes it contains greenish or brown impurities, fragments of crusts of dried secretion.

Most symptoms disappear gradually with treatment. During the first week, fever and sore throat usually go away, but the cough can persist for about 3 more weeks. There are also more protracted conditions, but it depends on the individual characteristics of the body, on the state of immunity and the correctness of the selected treatment.

Diagnostics

Considering that obstructive bronchitis poses a serious danger to the child's body, parents must definitely call a doctor or visit a pediatrician at a polyclinic at their place of residence. First of all, the doctor will evaluate the totality of all symptoms and “listen” to the child with a phonendoscope. The obstructive form of the disease is characteristic and hard breathing, scattered wheezing. A sputum sample will be taken for analysis.

Using the bakposev method, it will be able to establish if there are bacterial or fungal lesions of the bronchi, this knowledge will help you choose a very specific antibiotic that is most effective against a particular microbe.

The doctor can give a referral for an X-ray of the lungs. An x-ray will rule out other possible lung problems - tuberculosis, emphysema, etc. X-rays are not prescribed for everyone. Bronchoscopy in the obstructive form of the disease is almost always prescribed. The procedure is quite simple, it includes the collection of mucus for analysis and examination of the condition of the bronchial mucosa.

A blood test will also be required. You will have to do a general analysis, a biochemical and a special type of analysis, which allows you to establish the degree of respiratory failure - a blood test for gas composition.

If viral bronchitis is difficult to cure, recurs, the doctor may prescribe an immunological study of blood and sputum to identify a specific pathogen virus. In most cases of uncomplicated bronchitis caused by SARS or influenza, such an analysis is not required, since most viral infections are successfully treated according to the standard scheme.

Treatment

Usually bronchitis is allowed to be treated at home. However, infants or newborns with such a diagnosis must be hospitalized.

Treatment of bronchitis complicated by obstruction is not included in the list of drugs in the prescription list. This is a whole range of activities that will fall on the shoulders of parents and in which pharmaceutical preparations are not at all the main thing. The main principle of the treatment of any bronchitis is the liquefaction and removal of sputum accumulated in the bronchi. If it is sufficiently liquid, then blockage will not occur, and if obstruction does occur, it can be dealt with with the same therapeutic approach.

First of all, using a special hygrometer device, you need to change the humidity in the apartment, if it is below 50%, then the air is too dry, and its inhalation leads to drying out of the bronchial secret. If the humidity is above 70% - the air is too humid, this creates additional risks with severe inflammation. The recommended mode is 50-70%. All grandmothers know how to create it.

To do this, mom needs to hang wet towels and sheets around the house and wet them again when they dry. Additionally, basins and containers with water are placed so that it can evaporate freely. Helps in this situation and an aquarium with fish.

However, there is a simpler and more accurate way to create optimal conditions for a child to recover quickly. A special device - a humidifier - can do everything for mom. They are ultrasonic, steam and "cold". Which one to choose is up to the parents. Many models are equipped with their own hygrometer and humidity sensor, as soon as the humidity reaches the set values, the device turns off.

The air temperature in the apartment should not be too high. The best values ​​​​are 18-20 degrees. It will seem to many mothers that it is cold, but in this situation it is better to dress the child warmer than usual, but do not violate the recommended room temperature, because it is these temperature indicators that are important for inhalation. It is necessary to dress a child with bronchitis wisely, since the disease is associated with excessive sweating. The baby should not sweat. After walking, be sure to take a warm shower and change the crumbs into clean clothes.

During treatment, this is especially important for obstructive bronchitis of allergic origin, it is important to remove from the child’s environment everything that is potentially dangerous in terms of the spread of allergens - limit contact with pets, remove dust accumulators from the child - carpets and soft toys. Wet cleaning should be done with ordinary water without the use of detergents, especially those based on chlorine. Wash baby clothes only with hypoallergenic baby detergent and be sure to additionally rinse with clean water.

Dilution of sputum contributes to drinking plenty of water.

The baby should be given as much juice, tea, water, fruit drinks and compotes as possible, avoiding carbonated drinks, too sour and too sweet drinks.

It is desirable that the temperature of the liquid be equal to body temperature, so the drink will be absorbed faster. You can additionally irrigate the nasal cavity with saline (1 teaspoon of salt per liter of boiled water) so that the nose is not blocked. With a runny nose, the baby breathes through the mouth and this additionally dries the mucous membranes.

At a temperature, bed rest should be provided. This is important at the initial stage of bronchitis. But as soon as the temperature has dropped and the cough has become wet, the child is recommended increased physical activity, because it helps to remove sputum.

You can and should take long walks on the street, play active games, do gymnastics in the fresh air.

During the acute period of the disease, it is better to make changes to the child's diet - to introduce a diet that excludes spicy and salty foods, so as not to further irritate the mucous membranes of the larynx.

Inhalations

At home, parents usually use steam inhalers and nebulizers for inhalation. The use of the former in obstructive bronchitis is not considered appropriate, since inhalation of steam moisturizes only the nasopharynx and larynx, steam particles simply do not reach the bronchi. Therapeutic inhalations using a nebulizer should be carried out only on the recommendation of a doctor and with the use of pharmaceutical drugs.

The nebulizer is designed in such a way that it disperses the liquid substance into smaller dispersed particles., which are able to reach the lower parts of the respiratory system - the bronchi and lungs. The course of such inhalations with the use of drugs such as Berodual allows you to cure obstruction much faster, because the particles of the drug go directly to the site of inflammation and act pointwise.

You should not pour mineral water, decoctions of chamomile or plantain into the nebulizer, since the device is intended for medicines. Inhalations should not be carried out during elevated temperatures. It is not recommended to carry out such procedures without special devices, since inhalation of vapors from hot potatoes under a blanket quite often leads to burns of the respiratory tract.

Medications

The main drugs in the treatment of obstructive bronchitis are mucolytic and expectorant drugs. They are necessary for thinning and removing sputum, and this, as we already know, is the main thing in the treatment of this disease.

It is very important to understand here that mucolytic drugs are not antitussives and it is wrong to ask the pharmacist for “something for coughing”.

"Cough" - these are antitussive drugs. They suppress the cough reflex by acting on the cough center in the brain. With bronchitis, coughing is very important and necessary, because without it, sputum removal will become impossible, there is no other way out for bronchial secretions. Reception of antitussive drugs is strictly contraindicated in bronchitis with obstruction.

Expectorant and mucolytic drugs allowed in childhood:

If the cause of bronchitis lies in viruses, the doctor may recommend antiviral drugs "Viferon", "Anaferon" and others at the initial stage of the disease. To use them or not is up to the parents. To date, official medicine has no evidence of the effectiveness of antiviral agents, and therefore no one can guarantee that they will somehow affect recovery. Even the pediatrician who prescribes them. The same applies to homeopathy. Syrups and tablets that belong to homeopathic medicines are not a medicine, they do not have proven effectiveness. Although they do not harm the child, that is why their doctors do not forbid taking even small ones.

With bacterial inflammation, in some cases (not always!) The doctor prescribes antibiotics. Children with obstructive bronchitis are usually recommended antimicrobials of the penicillin group, such as Amoxiclav, Amoxicillin. If penicillins do not cope with the task, the microbe is resistant to them, then the doctor may prescribe antibiotics of other groups - macrolides or cephalosporins. In difficult cases, Sumamed helps a lot.

With allergic lesions of the bronchi, treatment is best done in a hospital, since this condition is very dangerous and swelling can lead to suffocation. If the doctor allows you to be treated at home, then he will definitely prescribe antihistamines, such as Suprastin or Loratadin. Sometimes a child is shown therapy with hormonal drugs. The non-steroidal anti-inflammatory drug Ibuprofen has also shown itself to be effective; it is used at high temperatures as an antipyretic and gently relieves inflammation. Another non-hormonal anti-inflammatory drug that helps well with illness is Singulair.

Folk remedies

Treating a child with only folk remedies for obstructive bronchitis is not worth it, the price of a mistake and lost time may be too high. But some of the tools from the arsenal of our grandmothers may well help in the process of thinning sputum. These are, first of all, warm herbal decoctions. In parallel with the therapy prescribed by the doctor, the child can be given a decoction of chamomile, tea with raspberries or currants, a decoction of plantain, ginger water. All these measures should be included in the creation of a special, abundant drinking regime, which was mentioned above.

When it comes to alternative treatment, it is always easier to explain what cannot be done at home, because the list of what is possible is quite large.

With obstructive bronchitis, you can not:

• Rub the child's chest and back with badger or other fat especially in the presence of elevated temperatures. This leads to overheating, a violation of thermoregulation, and, accordingly, it contributes to the drying of the mucus, and not to its removal.
• At a temperature, rub the child with vodka or cool water, as this can lead to vasospasm.
• Do various warm compresses and body wraps if the child is likely to develop a bacterial complication, and there is almost always. The compresses and wraps themselves, according to most modern pediatricians, in no way affect the healing process, however, they create favorable conditions for the reproduction of bacteria, since microbes love heat in all its manifestations.
• Do not give your child, even drip, tinctures containing alcohol.
• All folk remedies based on the use of medicinal plants can be deadly for children with allergic obstruction, since the plants themselves are allergenic.

Breathing exercises and massage

Breathing exercises are very useful at the stage of recovery, when only a cough remains and it is important to get rid of it as soon as possible. The most rapid recovery of the affected mucous membranes of the bronchi is facilitated by exercises according to the Strelnikova method. It is based on a strong and intense inhalation through the nose and a relaxed exhalation through the mouth. During such rhythmic breathing, the child will perform certain exercises described in the method. It is best to conduct such classes in a playful way, in the fresh air, when the disease reaches the finish line.

Drainage massage helps well in the process of removing sputum in the second stage of the disease. It can be done even for babies. To do this, with your fingertips, you should make light tapping movements in the area of ​​\u200b\u200bthe ribs, chest and back. An older child should be placed on his knees face down so that the head is slightly lower than the priests, the chest, back and child are massaged with similar tapping movements, and then the child is asked to stand up and cough.

Prevention

There is no vaccine against bronchitis, but the right lifestyle will help reduce the likelihood of such a disease. The main preventive measure is to strengthen the immune system.

To do this, the child must walk a lot, breathe fresh air, play sports. Nutrition should include a sufficient amount of vitamins, trace elements.

It is important not to refuse age-appropriate preventive vaccinations, they significantly reduce the likelihood of contracting dangerous infectious diseases, a common complication of which is bronchitis. With the onset of a respiratory disease, it is important not to allow the mucus in the nose, larynx, and bronchi to dry out in order to avoid obstruction.

Any disease must be treated properly. For example, the use of antibiotics for a viral infection greatly increases the likelihood of complications, including bronchial obstruction.

Children with a tendency to recurrent respiratory diseases, frequent obstructive manifestations, it is important to visit a seaside resort at least once a year. In order not to make it worse, you need to choose the seas that are closer to your native region, since the peculiarities of the air in exotic countries can cause the baby to have a strong and painful acclimatization at sea and the healing vacation will turn into painful.