Diseases in which breathing is impaired are most common in children's practice. The leading symptom of these diseases is cough. A pronounced narrowing in the bronchi can lead to it.
What it is?
With obstructive bronchitis, there is a strong narrowing of the bronchi - obstruction. This condition is caused by numerous causes and provoking factors. Breathing is impaired as a result of obstruction. A few days after the onset of the disease, all symptoms begin to progress, which leads to a deterioration in the baby's condition.
The bronchial tree is covered with microscopic cilia. They are found on the surface of the cells that form the bronchi. After exposure to provoking factors, the movements of the cilia are disrupted, which also contributes to the violation of sputum discharge and increases the obstruction.
Causes of occurrence
Any bronchitis develops only after exposure to the child's body of various provoking factors. There are quite a few of them. They are especially dangerous for newborns and babies.
The immunity of babies of the first year has not yet been finally formed. Any agent foreign to the child's body can cause severe inflammation in the bronchi. This immediately leads to bronchial obstruction.
The reasons that can cause illness include:
Viral infections. The most frequent culprits of the disease: influenza and parainfluenza viruses, MS - virus, adenoviruses. They easily penetrate the baby's upper respiratory tract and quickly spread through the bloodstream, reaching the bronchi and lungs. Viral infections are the leading cause of bronchial obstruction in babies in the first months of life.
Bacteria. Streptococci, staphylococci and moraxella are the most common causes that can cause bacterial forms of the disease. These microorganisms contribute to the development of severe inflammation, which leads to a pronounced narrowing of the bronchial lumen. The disease caused by the bacterial flora has a more severe course and requires intensive therapy.
Allergies. When an allergen enters the body, the immune system is activated. This promotes a large release of various biologically active substances into the bloodstream, which strongly spasm the bronchi. Against the background of allergies, breathing is significantly impaired, and shortness of breath increases.
Inhalation of contaminated air. Living near large industrial plants or factories, the baby has a higher risk of bronchial obstruction. This happens as a result of the constant ingress of the smallest toxic substances into the small bronchi. Industrial emissions quickly lead to the development of respiratory failure.
Prematurity. In the third trimester of pregnancy, the final formation of the respiratory organs in the unborn baby takes place. This process takes place almost until the days of childbirth. If for some reason the child is born earlier, then the risk of underdevelopment of the respiratory system increases several times. This anatomical defect often leads to impaired respiratory function.
Fast refusal of breastfeeding. Babies who have been breastfeeding for a very short time have a higher risk of developing bronchitis. A good level of immunity is needed to fight various infections. During breastfeeding, babies receive a large amount of immunoglobulins G. These protective antibodies help them not to get sick during the period of seasonal colds and prevent the development of diseases of the bronchopulmonary system.
How does it arise?
The influencing provoking factor leads to the development of severe inflammation. Most viruses and bacteria enter the body through the upper respiratory tract. By settling on the cells of the epithelium lining the respiratory organs, they begin to have a strong toxic effect.
The incubation period is different and depends on the characteristics of the specific microorganism that causes the disease. On average, it is 7-10 days. At this time, the child does not make any complaints. There are no specific signs of the disease during the incubation period. Only weakened children can feel a little fatigue and drowsiness.
After the end of the incubation period, the first specific symptoms characteristic of this disease appear. An active inflammatory process that occurs in the bronchial tree contributes to the violation of the discharge of mucus and sputum.
Babies who have anatomical defects in the structure of the bronchi have a very narrow lumen of the bronchi. Bronchial obstruction in such children develops much more often and is much more difficult.
Kinds
The course of diseases accompanied by bronchial obstruction can be different. It depends on the initial state of the baby's immunity, the peculiarities of the anatomical structure of the respiratory system, as well as the reason that caused the disease.
By the frequency of occurrence, all obstructive bronchitis can be divided:
Sharp. These variants of the disease appear for the first time. They last 1-2 weeks on average. After the therapy, the baby is completely cured.
Chronic. May be recurrent. Proceed with periods of exacerbation and remission. With insufficient quality treatment or the presence of concomitant diseases in the baby, acute forms turn into chronic ones.
By severity:
Lungs... They proceed with minimal symptoms. They are well treated. After the therapy, the babies fully recover. There are no long-term consequences of the disease.
Medium. The cough is more severe, harsh. The body temperature with obstructive bronchitis of moderate severe course rises to 38 degrees. Shortness of breath may increase. The general condition of the child suffers greatly. In some cases, hospitalization and more intensive therapy are required.
Heavy. They proceed with a pronounced violation of the general condition and well-being of the baby. Body temperature rises to 38.5-39.5 degrees, severe shortness of breath, accompanied by signs of respiratory failure. Treatment is carried out only in a children's hospital, and with the development of cardiopulmonary insufficiency - in the intensive care unit.
Symptoms
Narrowing of the bronchial lumen and impaired sputum discharge lead to the fact that the child has specific signs of the disease:
Cough... Appears 2-3 days after the end of the incubation period. A hacking cough worries the baby more in the daytime. May be paroxysmal.
Dyspnea... It occurs with moderate and severe disease. With shortness of breath, the number of respiratory movements increases in one minute. Babies breathe more often. This symptom can be seen from the outside, paying attention to the movement of the chest during breathing.
Soreness in chest on expectoration. With bronchial obstruction, the sputum becomes very dense and thick. All attempts to cough up lead to increased pain in the chest area.
Increased body temperature. It rises to 37-39.5 degrees. Bacterial forms of the disease are accompanied by a higher temperature.
Blue nasolabial triangle. The skin in this area on the face is very thin and sensitive. A pronounced decrease in the level of oxygen in the blood leads to the development of acrocyanosis (blue discoloration) in this area. Against the background of a pale face, the nasolabial triangle contrasts strongly.
Violation of nasal breathing and redness of the throat. These secondary signs occur in viral and bacterial infections and often appear in a child with obstructive bronchitis.
Severe drowsiness and impaired well-being. Sick kids refuse to eat, start to be capricious. Little kids ask for pens more. Prolonged bouts of coughing cause the baby to cry.
Thirst. It manifests itself during severe intoxication of the body. The more severe the disease progresses, the brighter this symptom manifests itself in the baby.
Active movements of the ribs during breathing. Respiratory movements have a large amplitude and become visible from the side.
Loud breathing. During breathing movements, bubbling sounds are heard. They arise as a result of the passage of air through tightly closed bronchi.
Diagnostics
At the first appearance of signs of bronchial obstruction, the child should be shown to the pediatrician. The doctor will conduct a clinical examination and recommend additional examinations. Such tests are needed to establish the severity and cause of the disease.
To diagnose obstructive bronchitis, use:
General blood analysis. An increase in the number of leukocytes and an accelerated ESR indicate the presence of an inflammatory process. Changes and shifts in the leukocyte formula make it possible to clarify the viral or bacterial nature of the disease.
Blood biochemistry. Allows you to identify the presence of complications that develop with respiratory pathology. Also used for differential diagnostics.
Chest x-ray. This method is used in babies over one year old. This study allows you to establish the degree of narrowing of the bronchi, as well as identify concomitant lung diseases.
Spirometry. Helps assess functional impairment. Indications for forced inhalation and exhalation allow doctors to conclude about the presence and severity of bronchial obstruction.
Specific laboratory tests to identify allergens. Necessary to establish the cause of bronchial obstruction in babies with an allergic form of the disease.
Differential diagnosis
Narrowing of the lumen of the bronchi occurs not only with obstructive bronchitis. Bronchial obstruction syndrome can be associated with various diseases. In order to establish the correct diagnosis, a differential diagnosis is required.
Most often, obstructive bronchitis can be confused with:
Stenosing laryngotracheitis. It is most often caused by viruses. It usually occurs 3-4 days after the onset of a viral infection. It is characterized by the appearance of a barking cough and severe shortness of breath.
Obliterating alveolitis. In this disease, the internal epithelial layer of the bronchi grows, which leads to the appearance and accumulation of foamy sputum. Usually the cough is paroxysmal. Often the disease leads to the appearance of various complications.
Acute bronchitis. Symptoms are similar. Only spirometry allows you to accurately establish the correct diagnosis.
Infection with parasites. Some helminths during development in the body with blood flow can enter the bronchopulmonary tree. While developing, they release numerous products of their vital activity, which have a toxic effect.
Cystic fibrosis. This disease is congenital. Usually babies develop poorly, lag behind in physical development from their peers. During an exacerbation, a strong cough appears with difficult and very viscous sputum. The course of the disease is quite severe. The disease requires systemic treatment.
Consequences and complications
Frequent obstructive bronchitis can lead to the development of persistent breathing problems in children. With reduced immunity, the baby has more and more exacerbations within a relatively short period of time.
Poorly carried out treatment or untimely diagnosis of the disease contribute to the development of complications in the future. Persistent bronchial obstruction can lead to the development of bronchial asthma, especially if allergy is the cause of the narrowing of the bronchial lumen.
A long and hacking cough promotes the formation of bronchiectasis. With this pathology, the distal sections of the bronchi expand with the formation of additional cavities. Bronchiectasis contributes to the appearance of shortness of breath with an increase in respiratory failure. To eliminate this condition, surgical operations are performed.
During an exacerbation of obstructive bronchitis caused by a bacterial infection, the inflammatory process may spread to the lungs.
In this case, pneumonia or abscesses appear. They, in turn, lead to a deterioration in the well-being of the baby. To eliminate purulent formations, intensive antibiotic therapy is required.
Treatment
Various methods of therapy are used to eliminate the adverse symptoms of the disease. After examining the child and establishing the diagnosis, the pediatrician will recommend a specific treatment regimen, which is provided in the clinical guidelines. These medical developments contain the necessary algorithm for the actions of doctors in identifying a specific pathology.
Obstructive bronchitis should be treated from the first days after the onset of symptoms. Early prescription of medications helps to cope with all the unfavorable manifestations of the disease and prevent chronicity. Medicines that eliminate bronchial obstruction and promote better sputum discharge are prescribed by the attending physician.
For the treatment of obstructive bronchitis, use:
- Means with mucolytic action. They help to liquefy thick phlegm and make it easier for it to pass through the bronchopulmonary tree. Ambroxol-based preparations are widely used in pediatric practice. "Ambrobene", "Lazolvan", "Flavamed" help to eliminate even a strong cough. Appointed by age, 2-3 times a day for 7-10 days.
- Antipyretic. Appointed when the temperature rises above 38 degrees. Babies use various paracetamol-based products. Not assigned for long-term admission. May cause allergic reactions and side effects.
- Bronchodilating. PDesigned to eliminate blockages in the bronchi and improve breathing. They are usually prescribed in the form of aerosols or inhalation. The effect is achieved in 10-15 minutes. Salbutamol-based short-acting bronchodilators act after 5 minutes.
- Combined drugs containing bronchodilators and anticholinergic drugs. To improve bronchial conductivity in children, "Berodual" is used. It is prescribed by inhalation. The dosage and frequency of inhalations is carried out taking into account the age of the child. Usually the drug is prescribed 3-4 times a day.
- Antihistamines. They help to cope with adverse symptoms in allergic forms of the disease. In children, drugs are used based on loratadine, "Claritin", "Suprastin". Appointed 1-2 times a day, usually in the morning. They are discharged for 7-10 days. With a more severe course - for 2-3 weeks.
- Vitamin complexes enriched with selenium. These substances are needed to combat intoxication. The biologically active components that are present in the vitamin complex help the baby fight infection and improve the functioning of the immune system. Selenium is needed for active immune function.
- Glucocorticosteroids. They are used for severe and prolonged disease. Usually, inhalation is prescribed by "Pulmicort". The drug is prescribed for long-term use. It is applied 1-2 times a day until a stable good result is achieved.May cause side effects with prolonged use.
- Leukotriene receptor blockers. They help to quickly eliminate bronchospasm. They have a long-lasting effect. The drug "Singular" begins to exert its effect within 2 hours after administration. It is applied once a day.
Home treatment
Helping a baby to cope with an illness is possible not only with the help of drugs and pills. The use of home-made medicines is also good for eliminating a hacking cough and improving the child's well-being.
Methods that are safe and effective for self-administration include:
Warm, abundant drink. Alkaline mineral water warmed up to 40-45 degrees is perfect. They are prescribed 20 minutes before or one hour after meals, 3-4 times a day. The course of treatment is 7-10 days. You can use "Essentuki" or "Borjomi".
Liquorice root. This wonderful remedy improves the flow of phlegm and promotes better expectoration. It should be applied carefully, keeping in mind possible allergic reactions. It copes well even with a strong cough.
Breast fees. The composition of such pharmaceutical preparations includes several medicinal plants at once, which have an expectorant and anti-inflammatory effect. Licorice, coltsfoot, sage help to cope with coughs and improve bronchial conduction.
Radish juice. An ordinary black radish is suitable for preparing such a home remedy. It only takes 1 teaspoon of juice to make a 250 ml drink. Add honey to taste before use.
Breathing exercises
It is used after the acute process subsides. Usually, such gymnastics is carried out 5-6 days from the onset of the disease. The correct sequence of breathing movements helps to normalize the functioning of the respiratory system and cope with adverse symptoms.
In order to improve the outflow of sputum, when performing breathing exercises, a sharp and short breath is taken. The exhalation is quite slow and smooth. During exhalation, count to 5. Each set of exercises consists of 3-4 repetitions. It is recommended to practice every day. Even during the period of remission, breathing exercises will be very useful.
How to carry out breathing exercises, see in more detail in the view below.
Nutrition
The diet of a baby suffering from bronchial obstruction should be complete and contain all the necessary nutrients and vitamins.
Breastfeeding in the acute period of the disease should not be canceled. Together with breast milk, the baby receives all the necessary protective antibodies that help him fight the infection that causes bronchitis.
Older kids should eat fractionally, at least 5-6 times a day. A variety of protein foods should be included in the child's diet. Better that with every meal the baby gets some source of protein. Veal, rabbit, chicken or fish are perfect.
Try to choose leaner varieties. Fatty foods take longer to be absorbed by a weakened child's body. You can supplement proteins with cereals and vegetables. Fresh dairy products are also well suited as protein dishes. They will be the perfect afternoon snack or second dinner.
All dishes are best steamed, baked or stewed. They should be more liquid consistency. Fruit and vegetable purees are great for young toddlers. It is not necessary to give your child food from jars. Homemade cauliflower or potato puree is a good choice.
The kid must definitely drink enough liquid. As drinks, you can use compotes, various fruit drinks and juices made from fruits and berries. Frozen fruits are also great for making healthy teas. Try to give your child plenty of boiled water. This will help eliminate the adverse symptoms of intoxication.
Prevention
In order to prevent the baby from getting sick with obstructive bronchitis, use the following recommendations:
Visit the dentist regularly with your child. Often, the presence of carious and untreated teeth leads to the development of various infectious pathologies. Make sure your baby brushes his teeth regularly.
Avoid colds. Any frequent respiratory diseases, which mainly occur during the cold season, lead to disruption of the respiratory system and reduce immunity. The risk of bronchial obstruction in frequently ill babies increases several times.
Strengthen your immune system. Active walks in the fresh air, good nutrition and the correct daily routine contribute to the normal functioning of the immune system.
Treat inflammatory diseases of the upper respiratory tract in time. Babies with chronic otitis media or sinusitis are more likely to develop obstructive bronchitis in the future. To prevent this, visit an otolaryngologist with your child regularly.
Use special room humidifiers... Too dry air contributes to breathing problems. Room humidifiers help create a comfortable and physiologically favorable microclimate in any room.
After the complex of treatment, the kids feel much better. Their breathing is normalized, shortness of breath goes away. With properly selected therapy, the transition of an acute process to a chronic one does not occur. Compliance with preventive recommendations allows you to prevent the emergence of new exacerbations in the future.
Dr. Komarovsky will tell you more about obstructive bronchitis in the video below.
