Symptoms and treatment of obstructive bronchitis in children

Obstructive bronchitis in children

Everyone gets bronchitis - both babies and their parents. But in children it happens much more often. At the same time, the disease often gets a new name - obstructive bronchitis. What this means, is the ailment as dangerous as it seems and how to treat the child, we will try to tell in this article.

What it is

Obstructive bronchitis in children - This is an inflammation in the membranes and muscle 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 clear if you know how inflammation of the membrane and walls of the bronchi begins and develops. Most often (about 85% of cases), a child becomes infected with a viral infection. Viruses enter the nasopharynx, causing a runny nose in response to an immune response, from there into the larynx, where a local defense reaction occurs, as a result of which the throat turns red.

Particularly aggressive and tenacious viruses quickly overcome the two previous "fasting" 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 - special mucus that is able to bind and neutralize the activity of viral particles.

The task of the bronchi quite understandable - to prevent viruses from entering further - into the lungs. And their main weapon is slime. And everything is going great as long as this slime is liquid. If it begins to thicken, dry out under the influence of unfavorable factors (high body temperature of a child, dry or dusty air that he breathes, etc.), 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 willingly take advantage of this. And then bronchitis will become complicated by a secondary bacterial infection. Dried mucus creates another big problem - it clogs the bronchi of small and medium caliber, pulmonary ventilation is impaired, and excellent prerequisites for pneumonia are created.

It is this state of bronchial obstruction that is understood as “obstructive bronchitis”. It is always better to prevent this disease than to cure 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 figure out 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 option occurs, the chronic form is usually the lot of adults. A chronic ailment 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.

The danger

The changes that occur in the bronchi can be reversible (bronchospasm, inflammation of the mucous and submucous membranes), and can qualify 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 pathology, which are associated with an increase in organ size due to increased blood pressure in the small circle (pulmonary), recurrent acute attacks of respiratory failure, bronchiectasis (a state 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.

Causes

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 actively act in the respiratory relation.

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

By themselves, bacterial lesions of the bronchi are rare. Such ailments are more severe than viral ones, but the forecasts are 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 membrane 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 tissue edema.

The risk factors provoking 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 the child is with the usual acute bronchitis;

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

frequent colds and other diseases that reduce the ability of the immune system to defend itself;
chronic or lingering rhinitis, other disorders of nasal breathing;
the child's genetic predisposition to allergies, especially to its respiratory manifestations.

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

If the baby continues to breathe dry air in the apartment, if the heaters are turned on in his room, and he himself will be wrapped in several warm clothes, there will be no sense in treatment with even very expensive and effective drugs. With a high degree of probability, thickening and drying out 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. Read more about the required parameters below.

Symptoms and Signs

Obstructive bronchitis is not so often an independent disease, usually it is 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, fever, sore muscles and throat, headaches first appear, and only then signs indicating bronchitis.

With allergies, the symptoms will not appear immediately either, but after a sufficiently long exposure to allergens. In all cases, obstructive bronchial disease has its own distinctive signs that allow you to suspect an illness and timely carry out the necessary diagnostics:

Body temperature is usually not high, more often it remains within the subfebrile range - 37.0-37.9 degrees.
Minor sore throat may occur, 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 the first 3-5 days has a dry and barking character. Its intensity increases markedly at night. After a few days, a dry cough turns into a productive wet cough, accompanied by expectoration of sputum.

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

The child, due to a lack of oxygen, which is a consequence of impaired pulmonary breathing, becomes lethargic, drowsy, apathetic. He sweats a lot even in the absence of a 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 greenish or brown impurities, fragments of crusts of dried secretion are discernible in it.

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

Diagnostics

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

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

The doctor can refer you for a chest x-ray. An X-ray will help exclude other possible problems with the lungs - tuberculosis, emphysema, etc. X-rays are not prescribed for everyone. Bronchoscopy for obstructive disease is almost always prescribed. The procedure is quite simple, it includes taking mucus for analysis and examining the state of the bronchial mucosa.

A blood test will also be required. We'll have to do a general analysis, biochemical and a special type of analysis that 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 pathogenic virus. In most cases of uncomplicated bronchitis caused by ARVI 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, a baby or newborn with such a diagnosis is necessarily hospitalized.

Treatment of bronchitis complicated by obstruction is not on the list of drugs on the prescription sheet. This is a whole range of measures 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 dilution and removal of sputum accumulated in the bronchi. If it is liquid enough, then there will be no blockage, and if the obstruction does happen, you can cope with it with the same therapeutic approach.

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

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

However, there is an easier and more accurate way to create optimal conditions for your child for a quick recovery. For mom everything can be done by a special device - a humidifier. 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 these are the temperature indicators that are important for inhalation. Dressing a child with bronchitis should be wisely, since the disease is associated with increased sweating. The kid shouldn't sweat. After walking, you must definitely take a warm shower and dress your baby in clean clothes.

When treating, it is especially important for obstructive bronchitis of allergic origin, it is important to eliminate from the child's environment everything that is potentially dangerous from the point of view of the spread of allergens - to limit contact with pets, remove dust accumulators from the child - carpets and soft toys. Do wet cleaning with plain water without the use of detergents, especially chlorine-based ones. Wash baby clothes only with hypoallergenic baby washing powder and be sure to additionally rinse with clean water.

Drinking plenty of fluids helps to dilute sputum.

The kid 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 is 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 the temperature, you need to ensure bed rest. This is important in the early stages of bronchitis. But as soon as the temperature dropped and the cough became wet, increased physical activity is recommended for the child, because it helps to drain sputum.

You can and should walk outside for a long time, play active games, do gymnastics in the fresh air.

During the acute period of the disease, it is better to make changes in 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.

To these recommendations, depending on the type of bronchitis and its origin, add some medicines, procedures, physiotherapy.

Inhalation

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

The nebulizer is designed in such a way that it scatters 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 drug particles go directly to the site of inflammation and act pointwise.

Do not pour mineral water, chamomile or plantain decoctions into the nebulizer, since the device is designed for medicines. Inhalation should not be carried out during an elevated temperature. 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.

Medicines

The main drugs in the treatment of obstructive bronchitis are mucolytic and expectorant drugs... They are necessary to liquefy and drain sputum, and this, as we already know, is the main thing in the treatment of this ailment.

It is very important to understand that mucolytic agents are not antitussives and it is wrong to ask the pharmacist to give "something for a cough".

"Cough suppressants" are antitussive drugs. They suppress the cough reflex by acting on the cough center in the brain. With bronchitis, cough is very important and necessary, since without it, sputum abstraction will become impossible, bronchial secretion has no other way out. Reception of antitussives is categorically contraindicated in bronchitis with obstruction.

Expectorant and mucolytic drugs allowed in childhood:

"ACC";
Bromhexine;
"Mukaltin";
Alteika syrup;
Codelak Broncho;
"Gerbion";
"Lazolvan".

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

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

In case of allergic lesions of the bronchi, treatment is best carried out in a hospital setting, since this condition is very dangerous and edema 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 hormonal therapy is indicated for a child. The non-steroidal anti-inflammatory drug "Ibuprofen" has also proved 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 an illness is "Singular".

Folk remedies

It is not worth treating a child only with folk remedies for obstructive bronchitis, the price of a mistake and lost time may be too high. But some of the tools from our grandmothers' arsenal 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, and ginger water. All these measures should be included in the creation of a special, plentiful 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 can be done is quite large.

With obstructive bronchitis, you cannot:

Rub the baby's chest and back with badger or other fat, especially against a background of elevated temperature. This leads to overheating, impaired thermoregulation, and, accordingly, contributes to the drying of mucus, and not its removal.
Rub the child with vodka at a temperature or cool water, as this can lead to vasospasm.
Do various warming compresses and wraps, if the child has a chance of developing a bacterial complication, and there is almost always. The compresses and wraps themselves, according to most modern pediatricians, do not in any way affect the healing process, however, they create favorable conditions for the multiplication of bacteria, since microbes love heat in all its manifestations.
You can not give the child, even drip, tinctures containing alcohol.
All folk remedies herbal medicinal products can be fatal to children with allergic obstruction, since the plants themselves are allergenic.

Respiratory gymnastics and massage

Breathing exercises are very useful in the recovery stage, when only 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 home stretch.

Drainage massage helps well in the process of sputum removal in the second stage of the disease. Even babies can do it. To do this, use your fingertips to make light tapping movements in the ribs, chest and back. An older child should be laid on his knees face down so that the head is slightly lower than the priests, with similar tapping movements they massage the chest, back and child, and then ask the child to stand up and cough.

Prevention

There is no vaccine against bronchitis, but a healthy lifestyle can help reduce the likelihood of getting it. The main preventive measure is to strengthen the immune system.

To do this, the child must walk a lot, breathe fresh air, play sports. Food should include a sufficient amount of vitamins and minerals.

It is important not to give up preventive vaccinations due to age, they significantly reduce the likelihood of contracting dangerous infectious diseases, a frequent complication of which is bronchitis. With the onset of 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 correctly. For example, the use of antibiotics for a viral infection significantly increases the likelihood of complications, including obstruction of the bronchi.

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

For information on how to treat bronchitis in children, see the video below.