Chronic bronchiolitis in children symptoms. Bronchiolitis in children: why it occurs, how it manifests itself, how to treat. Symptoms and signs that indicate bronchiolitis disease

The content of the article

This is an acute respiratory disease, mainly in children of the first year of life, accompanied by obstructive lesions of the bronchi and bronchioles.

Etiology of acute bronchiolitis

The causative agent is a virus, especially respiratory syncytial, less often parainfluenza virus, adenovirus, influenza virus and mycoplasma pneumoniae. The etiological role of bacteria is also taken into account. It is believed that bronchiolitis is the result of allergic reaction, a similar reaction in bronchial asthma (a meeting of the respiratory syncytial virus with circulating immunoglobulins). It is impossible to exclude the importance of allergies, since more than 50% of children who have had bronchiolitis subsequently experience bronchospasm and many develop bronchial asthma. There is also a higher frequency allergic manifestations from next of kin.

The pathogenesis of acute bronchiolitis

The disease is characterized by the development of respiratory failure due to obstruction in the small bronchi and bronchioles. There comes a narrowing of their lumen as a result of thickening of the wall, edema and infiltration of the mucous membrane. In addition, the lumen of the small bronchi and bronchioles contains a large amount of pathological secretion. In the development of obstruction, bronchospasm is also important, although it is not dominant.

Clinic of acute bronchiolitis

The disease begins suddenly, but there is also a gradual development. There is rhinitis, sneezing and coughing, sometimes paroxysmal.
The general condition of the child can be severe from the first days, sleep worsens, appetite decreases, the child becomes irritable, sometimes vomiting appears. Body temperature can be febrile, subfebrile, even normal, but often from the first days of the disease it reaches 39 ° C and above. The main symptoms are shortness of breath with prolonged expiration (breathing becomes more frequent up to 60 - 80 per 1 min) and tachycardia (pulse 160 - 180 per 1 min). When examining a patient, cyanosis of the nasolabial triangle, swelling of the wings of the nose, participation in the act of breathing of supple parts are determined. chest. In connection with the swelling of the lungs, a boxed shade of pulmonary sound is determined, a decrease in the area of dullness of percussion sound over the liver, heart and mediastinum. Sometimes, when examining the chest, it is possible to detect an increase in its anteroposterior diameter. The liver and spleen protrude 2–4 cm below the costal arches, which is apparently due to their displacement as a result of lung swelling.
On auscultation, against the background of weakened breathing of both lungs, both on inhalation and exhalation, multiple small bubbling rales are determined, less often - in other parts of the lungs - medium or large bubbling wet rales. At times, moist rales disappear and dry, sometimes whistling, appear instead.
With bronchiolitis, there are violations of water and electrolyte metabolism due to intoxication and vomiting, increased loss water, exsicosis often develops.
Usually in the blood pronounced changes, with the exception of sometimes detected lymphopenia, is not determined. The presence of leukocytosis with a shift of the leukocyte formula to the left is suspicious for pneumonia.
At x-ray examination swelling of the lungs is detected, which is manifested by an increase in the transparency of the lung fields. Unlike pneumonia, there are no areas of continuous infiltration in bronchiolitis.

Differential diagnosis of acute bronchiolitis

Differential Diagnosis s bronchiolitis is carried out with pneumonia, which is characterized by the detection of bronchial breathing, bronchophony, crepitant wheezing and localization of the pathological process in any part of the lung.
To distinguish bronchiolitis from attacks bronchial asthma take into account anamnestic data (detection of asthma attacks in history, their occurrence out of connection with infection, etc.). Bronchodilators are used (0.1% adrenaline solution, etc.), which relieve or alleviate an attack of bronchial asthma and have almost no effect on obstruction in bronchiolitis.

Treatment of acute bronchiolitis

Antibiotics are prescribed (methicillin, oxacillin, carbonicillin, kefzol, gentamicin, etc. - p. 232), since a secondary bacterial infection is possible from the first hours of the disease. The use of interferon is also shown. To reduce the swelling of the mucous membrane of small bronchi and bronchioles, inhalations of a 0.1% solution of adrenaline (0.3 - 0.5 ml in 4 - 5 ml of isotonic sodium chloride solution) are used 1 - 2 times a day.
Oxygen therapy is shown, best of all with the use of an oxygen tent DKP-1. In its absence, oxygen is introduced using the Bobrov apparatus (for the purpose of moisturizing) every 30-40 minutes for 5-10 minutes with moderate pressure on the oxygen cushion. In order to thin the secret in the bronchi, a 2% solution of sodium bicarbonate is simultaneously administered in the form of aerosols, isotonic solution sodium chloride, etc.
If signs of exsicosis appear, intravenous drip introduction liquids.
Sometimes the use of antispasmodics - eufillin, ephedrine and antihistamines - glycocorticoids is effective.
Tachycardia, deafness of heart sounds, liver enlargement are the basis for intravenous use strophanthin, corglicon.
Rational good nutrition and sanatorium-hygienic regimen are of great importance.

Prognosis of acute bronchiolitis

The outcome is almost always favorable. The most common complication is bacterial pneumonia.
Prevention. SARS warning.

Respiratory diseases in children are quite common, and even infants are susceptible to them. One of these is bronchiolitis. Pathology most often develops in babies in the first year of life and is accompanied by serious clinical symptoms.

What is bronchiolitis?

Bronchiolitis is a respiratory disease of the lower respiratory tract accompanied by signs of respiratory failure. The peak of cases of the development of the disease falls on the age of 2 to 6 months. This is due to reduced immunity in infants.

Bronchiolitis is most common in children under 2 years of age. In adults and older children, it is diagnosed much less frequently and occurs in the form of a cold.

Bronchiolitis is an inflammation in the bronchioles

The disease has a localized character and is accompanied by bronchospasm - narrowing of the bronchial lumen. As a result, oxygen cannot reach the alveoli in sufficient quantities, which leads to the development of respiratory failure. Against this background, the child makes significant efforts when inhaling, which is accompanied by whistling, wheezing.

Do not confuse bronchiolitis with bronchitis. The latter denotes damage to the large bronchi, while bronchiolitis affects the bronchioles - the final smallest bifurcation of the bronchi in the lung lobules.

Due to the narrowing of the lumen of the bronchi, the access of oxygen is difficult

Causes

In most cases, bronchiolitis is caused by a viral infection. Potential pathogens can be:

respiratory syncytial virus;
influenza virus, parainfluenza;
adenovirus;
rhinovirus;
mumps virus;
measles virus.

Risk factors for bronchiolitis are:

inhalation of polluted air;
frequent colds;
contact with patients;
unsatisfactory living conditions;
artificial feeding of the baby;
parents smoking;
inhalation of chemicals;
hypothermia.

As a rule, bronchiolitis develops in the cold season. In most cases, it has an epidemic character.

Kinds

Given the cause that provoked the development of bronchiolitis, the disease is divided into several types:

Post-infectious. It occurs as a result of parainfluenza, influenza, RS-virus, adenovirus entering the body.
Obliterating. It also has a viral nature, but is caused by HIV infection, the herpes virus. Sometimes it occurs as a complication of post-infectious bronchiolitis provoked by adenovirus.
Inhalation. It develops as a result of air entering the respiratory system, in which there is dust, chemical compounds.
Drug. Appears after the use of certain medications:
- cephalosporins;
- interferon;
- amiodarone;
- preparations containing gold;
- Bleomycin.
Idiopathic. This diagnosis is made in the absence of visible reasons disease development. It may be accompanied by other pathologies. internal organs:
- lymphoma;
- aspiration pneumonia;
- idiopathic pulmonary fibrosis;
- ulcerative colitis and others.

Depending on the nature of the course and changes in the bronchioles, the disease is divided into the following forms:

Acute bronchiolitis. It develops within 2–3 days after exposure to an irritating factor or infection and is accompanied by a pronounced clinical picture.
Chronic bronchiolitis. It is characterized by a long-term effect on the respiratory organs of negative factors, as a result of which the tissues of the bronchi, bronchioles, and alveoli undergo destructive changes. It usually develops in older children.

Clinical picture

Symptoms depend on the form of development of the pathology, since acute bronchiolitis occurs immediately after contact with the source of infection, and chronic is accompanied by changes that form over a long period.

Acute bronchiolitis

Bronchiolitis is most easily treated in the early stages, so the sooner you see a specialist, the more likely it is to avoid complications.

The first signs of the disease occur 2-3 days after contact with the patient and resemble viral infection. The child has the following symptoms:

sneezing
dry cough;
runny nose.

Gradually, the baby's condition worsens. The cough becomes more pronounced, hacking, the appearance of dry wheezing, whistling when inhaling is noted. The following symptoms of bronchiolitis are observed:

loss of appetite;
dehydration of the body, which is manifested by rare urination, crying without tears;
temperature rise to 38 degrees;
increasing shortness of breath;
the child becomes lethargic, capricious;
cyanosis and pallor of the skin appear due to respiratory failure;
tachycardia, tachypnea (rapid shallow breathing);
when inhaling, the wings of the nose swell, retraction of the intercostal spaces is noted;
when listening, the doctor notes wet or dry scattered rales.

If untreated, this symptomatology is constantly growing and can lead to respiratory arrest.

Chronic bronchiolitis

In the chronic form of bronchiolitis, the main symptom is increasing shortness of breath. Initially, it occurs only after physical activity on the body, then it can be observed even in a state of complete rest. Patients have a dry hacking cough, as a rule, sputum is absent.

On examination, it is possible to detect dry rales that appear on inspiration. Due to insufficient oxygen supply to the organs, patients experience cyanosis of the skin.

Symptoms of the disease in the chest

This disease at an early age occurs in a more severe form, therefore, it requires mandatory observation by a pediatrician. First of all, the baby has severe shortness of breath, since the bronchioles are completely clogged with thick sputum, and the baby cannot cough it up on its own. As a result, this can even lead to asphyxiation.

Also in children under one year old, including newborns, the following signs of bronchiolitis are noted:

dry cough;
slight rhinorrhea (watery discharge from the nose);
the child becomes lethargic or, conversely, overly excited;
not only inhalation is difficult, but also exhalation;
lack of appetite;
against the background of dehydration, a large fontanel may sink;
respiratory movements are performed mainly by the tummy;
an increase in body temperature, sometimes the indicators reach high numbers.

If any symptoms occur in a baby, you should immediately seek help from a specialist, because bronchiolitis in children under one year old develops rapidly and may be accompanied by respiratory arrest.

First aid

Sometimes the child's condition worsens so much that before the arrival of the doctor, parents need to independently take measures that will help the baby, namely:

Provide access to fresh cool air. It is necessary to ensure that the temperature in the room where the child stays does not exceed 20 degrees, because otherwise the mucus begins to dry out in the bronchioles, sweat production increases, and a lot of fluid is lost.
Prevent dehydration. The child should be given small portions, about 1 tablespoon, but often, every 10-15 minutes. You can give:
- cool boiled water;
- dried fruits compote;
- fruit drinks;
- solutions Regidron, Oralit, Hydrolit.

Regidron helps to avoid dehydration

A remedy similar to Regidron can be prepared independently. You need 1 liter of cold boiled water mix with 1 tsp. salt, 1 tsp. baking soda and 2 tbsp. l. Sahara.

In no case should you acute period carry out illnesses:

Hot inhalations.
Physiotherapy procedures on the chest.
Therapy with drugs that dilate the bronchi, as this can provoke laryngospasm.

Diagnostics

To confirm the presence of bronchiolitis, the child is assigned a number of additional diagnostic methods:

Treatment of the disease in children

Hospitalization in a hospital is carried out in such cases:

severe shortness of breath;
significant deterioration general condition child;
complete lack of appetite;
age up to 6 weeks;
the presence of signs of dehydration;
disruption of other internal organs;
premature babies born before 34 weeks.

Hospitalization is carried out in order to prevent possible complications illness. In other cases, treatment can be carried out at home.

First of all, the patient must be isolated from other people, since bronchiolitis is contagious. In the hospital, such patients are placed in a separate box. If the child's condition is critical, he is transferred to the intensive care unit.

With severe shortness of breath, respiratory failure, babies are given oxygen endonasally (through the nose) or through a mask. In a hospital setting, a pulse oximeter is installed - a sensor that determines blood gas parameters.

Typically, bronchiolitis is long-term treatment, which is at least 1–1.5 months.

Oxygen supply is used in severe respiratory failure

Treatment for bronchiolitis includes the following activities:

bed rest until body temperature returns to normal;
optimal fluid intake in the body;
drug therapy;
breathing exercises;
chest massage.

Medical treatment

With bronchiolitis in a child, the following medications are prescribed:

Antivirals. They are used in most cases, since the disease is most often caused by viruses. Ribovirin is prescribed.
Antibacterial drugs. Used in the bacterial nature of bronchiolitis. These medicines should be used with caution, as in cases viral etiology diseases, they are able to provoke the development of a secondary infection. As a rule, appoint:
Macrofoam;
Cefatoxime.
Antihistamines. Contribute to the elimination of swelling of the respiratory tract (Suprastin, Erius, Loratadin, Claritin).
Hormonal preparations. Used to eliminate signs of inflammation, administered by inhalation or intravenously.
Expectorant drugs: Lazolvan, Bromhexine. These medicines should not be used in the treatment of infants, as they can lead to bronchial obstruction with mucus.

Inhalation has a positive effect on the condition of the baby. For their implementation, saline is used, if necessary, add hormonal preparations. The procedure improves the process of sputum discharge, which is especially important for infants.

Drugs for the treatment of disease (gallery)

Massage

To improve sputum discharge, the doctor may recommend vibrating chest massage during the recovery period. In a hospital setting, manipulation is performed by a specialist.

It is necessary to put the child in such a way that the butt is slightly higher than the head. Next, you need to make light tapping movements with the edge of the palm in the direction from the lower part of the chest upwards.

Breathing exercises

This procedure is also used to improve the evacuation of mucus from the respiratory system. To do this, you need to do light pressure on the chest and tummy of the baby as you exhale. If you are doing the manipulation yourself, do it with extreme caution so as not to harm the health of the baby.

Complications

In the absence of proper treatment, bronchiolitis can be accompanied by extremely serious consequences:

pulmonary hypertension;
cardiovascular insufficiency;
emphysema;
kidney failure;
bronchial asthma;
dysfunction of the brain.

To prevent the development of the above complications, you should perform preventive measures and promptly treat the emerging pathology.

Prevention

To prevent the development of bronchiolitis in a child, it is necessary to adhere to the following recommendations:

observe the rules of personal hygiene;
avoid contact with patients;
prevent contact of the child with chemicals;
daily carry out wet cleaning, ventilate the room in which the child is located;
adhere to a balanced diet;
breastfeed your baby, as breastfeeding contributes to the formation of strong immunity.

Dr. Komarovsky about cough in children (video)

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inflammation in the small bronchi and bronchioles medical practice called bronchiolitis. Most often, the disease develops as a complication against the background of the already existing influenza and SARS. greatest danger represents not the inflammation itself, but signs of respiratory failure, manifested by shortness of breath, severe attacks of coughing and suffocation. Therefore, it is important for parents to know what bronchiolitis is in children, what are the manifestations of this disease. After all, by recognizing it in time, you can save the life of your child.

dangerous age

Children are most at risk of developing bronchiolitis. younger age, so this diagnosis is more common in medical card babies up to three years old. At the very large group risk fall babies from a month. This is due to the imperfection of the immune system, unable to resist infections. And if the virus still enters the body, it starts its attack from the most "secluded corners" of the respiratory system:

Newborns. At the age of up to a month, babies receive from their mothers passive immunity. So the probability of inflammation of the bronchioles during this period is quite low. But if the disease could not be avoided, then such babies endure bronchiolitis most difficult. Treatment of newborns is carried out only in a hospital, in the intensive care unit.
According to statistics, the most frequent cases of bronchiolitis occur in children from a month to a year.. Six-month-old babies with inflammation are also hospitalized. For children aged seven months and over home treatment subject to regular medical examinations.
Thanks to the strengthening of the immune system and the development of the respiratory system, the risks of bronchiolitis in children older than one year are reduced. And cases of diseases after three years practically do not happen.

The most dangerous bronchiolitis for premature babies, as well as for newborns with various malformations. In the absence of qualified assistance, the likelihood of death is very high.

The main causes of the disease

The occurrence of bronchiolitis as a response to an allergen is rare, and the exact relationship between these two diseases has not yet been established. But the timely treatment of SARS and influenza in children significantly increases the likelihood of avoiding severe complication in babies.

So, the main reasons due to which bronchiolitis develops in children early age:

Respiratory diseases of viral and bacterial etiology. Including rhinovirus, adenovirus, influenza, parotitis, pneumococcal infection, mycoplasmosis and others. Are transmitted infectious diseases predominantly through the respiratory route through contact with an infected person. This may happen in kindergarten, in the hospital and in any other public place. Infection from family members who have caught one of these viruses is not ruled out.
Smoking around a child. Tobacco smoke irritates the baby's mucous membranes, reducing resistance to other infections. The possibility of an allergic reaction cannot be ruled out.
General decrease in the body's defenses. Regardless of the cause, any decrease in immunity increases the risk of infection..
Underweight. Children who are weakly gaining weight have always been at risk. Weight is an indicator of the health of the baby. And its lack indicates a lack of vitamins in the body.
artificial feeding. Together with breast milk the child receives from the mother all the necessary antibodies that allow the still imperfect immune system to resist infections. Rejection breastfeeding increases the risk of developing bronchiolitis.

Any disease of the respiratory of cardio-vascular system can also cause inflammatory process.

Types of bronchiolitis

In medical practice, there are two forms of the disease: acute and chronic. Acute bronchiolitis is characterized by severe symptoms and impaired respiratory function.. Period acute form lasts approximately 4 weeks. With an incorrect diagnosis and, accordingly, unappointed treatment, the disease becomes chronic.

In chronic bronchiolitis, the child is usually sick for more than two to six months. During this period, the manifestations of the disease decrease, the signs of respiratory arrest weaken and become hardly noticeable. At this stage, most often we are talking about the so-called bronchiolitis obliterans.

Signs of acute bronchiolitis

If a newborn child has caught any viral disease, the treatment does not give tangible results, and the condition of the crumbs only worsens, this is a serious reason to go through additional examination. Acute bronchiolitis in children is manifested by the following symptoms:

loss of appetite, up to the complete refusal of food;
pale skin, cyanosis, developed due to lack of oxygen;
emotional arousal, sleep disturbance;
a slight increase in temperature (distinguishes bronchiolitis from pneumonia);
dry unproductive cough, sputum difficult to separate in small quantities;
respiratory failure, shortness of breath, superficial inhalation, wheezing;
when listening, pronounced moist rales are noted;
dry mouth and rare trips to the toilet due to dehydration;
a clinical blood test shows a slight increase in leukocytes, ESR.

Respiratory failure is the main symptom of bronchiolitis.. In a severe form of the disease, breathing becomes faster and can exceed 70-80 breaths per minute. At this stage, respiratory arrest may occur. The qualified help to the child is necessary immediately!

Clinical manifestations of bronchiolitis are similar to pneumonia with obstruction syndrome and bronchitis with an asthmatic component. Therefore, do not interfere with the work of doctors, but if possible, consult other specialists. This will help avoid confusion with the diagnosis.

Typical symptoms of bronchiolitis obliterans

Obliterating bronchiolitis is a chronic form of the disease that has developed against the background of an acute inflammatory process. At this stage, there is a partial blockage and, as a result, a narrowing of the lumen of the bronchioles.. This condition interferes with normal blood flow in the lungs and bronchi, provoking the development of respiratory and heart failure.

Obliterating bronchiolitis in children is manifested by the following symptoms:

frequent bouts of dry unproductive cough, sputum is separated heavily and in small quantities;
breathing problems after any physical activity, with progression, shortness of breath begins to bother and at rest;
the baby breathes with a whistle, wet rales are clearly audible.

Treatment of acute bronchiolitis

Acute bronchiolitis is treated for a long time, sometimes for complete relief of the inflammatory process and accompanying symptoms respiratory failure may take several months. The treatment regimen is based on normalizing the breathing of the crumbs, eliminating the cause of the disease and ensuring the discharge of a viscous secret from the bronchi. For this purpose, the following drugs are used:

Antiviral medicines. The appropriateness of the use of interferon and other similar drugs is determined by the doctor. But with a viral etiology of the disease, they cannot be dispensed with.
Antibacterial drugs. Antibiotics are prescribed when a secondary bacterial infection is attached. If a bacterial nature of bronchiolitis is suspected, culture for microflora is carried out immediately after admission to the hospital. medical institution. Most often preferred drugs a wide range actions.
Mucolytic and expectorant drugs. These are drugs for symptomatic treatment liquefying mucus and facilitating the process of its removal. Antitussives in pediatrics are not used. And their use in this situation is unjustified, as this can aggravate the inflammatory process.
Antihistamines. IN this case allergy medications help relieve swelling from tissues and make breathing easier. It is also expedient to assign them to antibiotic therapy to prevent development adverse reactions. Preference is given to the latest generation drugs with a minimum side effects.

In severe cases, Dexamethasone injections may be given. The use of glucocorticosteroids is also effective in the form of solutions for inhalation. Because of a large number side effects, their appointment is possible only in inpatient treatment.

At home, before the arrival of doctors, it is forbidden to give the child any medications, carry out warming physiotherapy and do steam inhalations, as all this can provoke laryngospasm. Parents are required to provide comfortable conditions environment(temperature 20-22 0 and air humidity 50-70%) and plentiful drink to prevent dehydration.

Treatment of bronchiolitis obliterans

Chronic bronchiolitis in infants is treated according to a similar scheme:

With frequent attacks of shortness of breath, bronchodilator drugs may be prescribed in accordance with the age dosage. Drugs in this category should be taken with caution, so only the attending physician should select the appropriate remedy.
To ensure the dilution of a viscous secret, mucolytics are prescribed. When sputum begins to move away, mucolytic syrups are replaced with expectorants.
If a bacterial infection is confirmed, antibiotics are prescribed. The course of antibiotic therapy is recommended to be combined with the intake of lactobacilli to normalize the intestinal microflora.

As adjuvant therapy in the treatment of bronchiolitis obliterans, massage courses, breathing exercises, exercise therapy are recommended and various physiotherapy treatments.

Forecasts

Both forms of the disease are treatable. There are risks of developing serious complications and even death, but with timely access to a medical institution, serious consequences can be avoided.

After a full recovery and discharge from the hospital, parents should carefully monitor the health of the baby, providing comfortable living conditions. For some time, there may still be residual effects(wheezing, shortness of breath). The state of the respiratory system is completely stabilized after a few months.

Note! Infants who were previously diagnosed with acute bronchiolitis should be registered with a pulmonologist. Since the likelihood of re-lesion of the bronchi persists over the next five years, such children are at risk of developing bronchitis and bronchial asthma.

Bronchiolitis in children occurs as a result of complications of diseases such as SARS or influenza. This disease most often affects babies under one year old. The peak of infection is from the second to the sixth month. The reason is quite simple - the immune system not yet strong enough to resist all viruses. Once in the body, the infection penetrates the bronchioles.

First warning signs

If bronchiolitis is observed in children, the symptoms can be detected as follows:

spasmodic cough, in some cases it is dry;
body temperature does not rise much;
whistling sounds appear during breathing;
there is a runny nose or the nose, on the contrary, is blocked.

The disease develops quickly, and if nothing is done during this time, then a complication may arise in the form

How to define a disease?

Suspicion of bronchiolitis can be confirmed by in a simple way. Attach an ear to the back of the baby, and if gurgling sounds are heard, then this most likely means that the diagnosis will be confirmed. It is worth noting that this does not necessarily have frequent bouts of coughing and fever.

Acute bronchiolitis: symptoms

At colds treatment does not positive result for a long time? Perhaps this is manifested by acute bronchiolitis in children. Its symptoms:

appetite decreases or disappears altogether;
the skin turns pale, and in some places cyanosis appears;
when you refuse to drink water and food, dehydration may occur, the signs of which are as follows: reduced urination, the presence of dryness in oral cavity, during crying there are no tears, the pulse quickens;
the child is more capricious, irritable, does not sleep well;
body temperature is increased, but not by much;
the presence of a dry cough, sometimes with a small amount of sputum;
there may be difficulty in breathing - groaning and groaning sounds occur, the wings of the nose swell, the chest is retracted a little more, shortness of breath is pronounced;
in more difficult cases respiratory arrest is possible;
with complications, breathing occurs more than 70 times per minute;
after examination, the doctor can diagnose clear moist rales;
after taking a blood test, it can be seen that the rate of ESR and leukocytes is lowered.

It is important not to make a mistake!

Bronchiolitis in children is characterized by respiratory failure, which, if severe, can lead to suffocation. In this case, urgent need health care, but necessarily qualified, since sometimes there are cases that this disease is confused with asthmatic bronchitis or pneumonia with obstructive syndrome.

Conditions for a small patient

While the doctor has not yet arrived, it is necessary to create all conditions so as not to aggravate the serious condition of the baby. To do this, you need to follow two basic rules:

The air in the room should not be hot and dry, as this provokes the drying of the mucous membranes and heavy sweating, which is fraught with rapid loss of moisture by the body. The temperature should not be higher than 20 degrees, and humidity - from 50 to 70 percent.
Make sure your child is drinking plenty of fluids. Newborns should be brought to the breast more often, and older ones should be given those drinks that they can drink. This must be done in order to prevent dehydration. child's body.

These activities are prohibited

carry out any physiotherapy in the chest area;
do hot inhalations;
use any pharmaceutical preparations without medical prescription.

Obliterating bronchiolitis: symptoms

What can happen when the acute form of the disease starts? Obliterating bronchiolitis can be observed in children. This means that bronchioles and small bronchi narrow, after which there is a violation of pulmonary blood flow. After some time, they may begin to develop pathological processes lungs and pulmonary heart failure.

The following symptoms will help to recognize the disease:

the occurrence of dry unproductive cough, which is accompanied by a small amount of sputum;
shortness of breath is observed not only after physical exertion, but also (with a progressive disease) in a state of calm;
you can distinguish moist rales, breath as if wheezing.

Such signs can be observed for a long time - even more than six months.

Bronchiolitis in children, especially young children, is very widespread. It goes on a par with pneumonia, which is also one of the complications after SARS. Grudnichkov with this diagnosis is immediately sent for hospitalization. But with premature babies, as well as those children who have congenital heart and bronchopulmonary defects, which is fraught with dehydration and hypoxia, it is more difficult. In some cases, it ends in death.

Treatment methods

When bronchiolitis is observed, it can be delayed for more than a month. For this, several methods are used:

Rehydration therapy, which means replenishment of the child's body with glucose and saline solutions. This can be done both intravenously and orally. It is carried out in cases where urgent assistance is needed.
Take emergency action when needed respiratory failure. In this case, both an acid mask and inhalation with drugs are used, the actions of which help to relieve an asthma attack.
use antiviral drugs because the disease occurs viral way. The basis of drugs, in most cases, is interferon.

Preparations

When, with this disease, there are also bacterial infections, which include pneumococcal or streptococcal, antibiotics are prescribed, mainly as follows:

"Amoxiclav".
"Macropen".
"Sumamed".
"Augmentin".
"Amosin" and many others.

To relieve swelling of the bronchi and facilitate breathing, antihistamines are prescribed.

Chronic bronchiolitis

The disease itself develops very quickly. Although its symptoms may be present for less than five months. The result will be either a complete recovery, or it will develop into chronic bronchiolitis in children. It is divided into several forms of inflammatory processes:

panbronchiolitis;
follicular;
respiratory.

Also, inflammation can be of the following types:

constrictive;
proliferative.

Constrictive (or narrowing) are characterized by the fact that gradually fibrous tissue grows between the muscular and epithelial layers and bronchioles. After some time, the lumen not only narrows, but can also close completely. The respiratory structures are no longer so pliable, and this is fraught with emphysema, as well as respiratory failure.

Proliferative are characterized by the fact that they damage the mucous membrane, and granulomatous and connective tissues- Masson's bodies. The respiratory department significantly reduces its diffusion capacity, and is disturbed.

Treatment of a chronic disease

Chronic bronchiolitis obliterans in children is treated by two methods:

drug therapy;
auxiliary.

In the first option, mucolytic, bronchodilator or expectorant drugs can be prescribed. If inflammation of a bacterial nature is observed, then plus to all this - also antibiotics.

Auxiliary therapies include chest massage, breathing exercises, physiotherapy, climatotherapy, speleotherapy and physiotherapy.

Consequences

If bronchiolitis was observed in young children, the consequences can be very diverse (this is the case when there was no timely treatment). Now we will consider them

Pneumonia. It affects tissues in the respiratory system, resulting in coughing. Such a disease, if it occurs in running form, may be accompanied by a little high temperature. Complications with the breathing process are often observed. If in this case you do not undergo antibiotic treatment, then this is fraught with even more detrimental complications.
the process is characterized by the fact that it expands and further damages the walls of the bronchi.
Heart and respiratory failure. Due to the disease, gas exchange is disturbed, and many of the internal organs do not receive enough oxygen. This primarily affects the heart muscles. As a result, this organ is overworked, and the blood no longer circulates in the volume necessary for the body. And this, in turn, disrupts the performance of other organs and systems of the child's body.
Bronchitis in a chronic form. If left untreated, the consequences can be severe. In this case, an important role is played by harmful factors like dust, gases and a variety of allergens.
Bronchial asthma, which passes from the advanced stage of allergic bronchitis. The disease is characterized by swelling of the mucous membrane and periodic spams. This consequence of bronchiolitis is dangerous because asthma attacks occur.
Pulmonary emphysema. This outcome is extremely rare in children. It is characterized by the fact that gas exchange and their elasticity are disturbed in the lungs. In the early stages, this is manifested by shortness of breath in cold weather. But if deterioration occurs, then in any other season.
Bronchial obstruction. It is characterized by heavy breathing, which is accompanied by a disturbed exhalation. The child does not have time to completely exhale the air, as he inhales again. As a result, the accumulation of these residues provokes increased pressure.
But the rarest consequence is It provokes a constant increased arterial pressure. As a result, gas exchange is disturbed, the child is not able to do anything from physical activity.

To prevent bronchiolitis in children, you need to try to protect them from communicating with already sick babies. Also, do not ignore antiviral measures, hardening procedures and correct usage food.

It is desirable to create a hypoallergenic life, since allergies and bronchiolitis have a lot in common. Do not forget to monitor the children's nasopharynx. It is necessary that it is always clean, and there are no accumulations.

Young children are very vulnerable to various diseases, because their immunity is not yet fully developed. For the same reason, bronchiolitis is very common in young children. This disease is very dangerous and is acute inflammation lower respiratory tract.

In bronchiolitis, the bronchioles are affected, causing them to become blocked and swollen. As a result of this process, respiratory failure occurs, which is especially dangerous for young children, because temporary respiratory arrest and death can occur.

As a rule, children of early age up to three years are sick with bronchiolitis, but they are especially at risk, because they still have weak immunity and are not fully developed. respiratory system.

Young children up to 4 weeks old have. During this period, the baby is protected and rarely gets sick.

If the baby fell ill during this period with bronchiolitis, then he must be immediately hospitalized, because such patients are the most difficult to tolerate this disease. Especially dangerous is the case with premature infants and those with various congenital abnormalities.

Bronchiolitis in infants up to a year

When the baby has crossed the line of 4 weeks, his immunity is very weak and therefore he is especially at risk of getting sick with bronchiolitis. According to statistics, 12 out of 100 babies suffer from this disease, mostly children from 3 to 9 months.

The course of the disease in children from a year

Due to the fact that by the age of three the child's immunity is strengthened, and the respiratory system becomes more developed, children almost do not get sick with bronchiolitis. 6% of babies from one to two years old and only 3% from two to three years old are susceptible to this disease.

Possible causes of bronchiolitis

The reason that served as the development of bronchiolitis in a child may be the lack of milk in the mother, and the child's tendency to allergies. The most common is various infectious diseases of the respiratory tract. Cardiovascular diseases, underweight a child, weak immunity, and tobacco smoke can provoke this disease in the early stages of life.

Based on the above reasons, bronchiolitis can be classified into the following types:

Given the nature of the course of bronchiolitis, it can be divided into and. In acute bronchiolitis, the child's condition is rapidly deteriorating, the symptoms of the disease are pronounced, breathing is very heavy. Chronic form proceeds with mild symptoms for one to three months. It most often occurs in young and older children.

Symptoms and signs that indicate bronchiolitis disease

IMPORTANT! Due to the fact that young children cannot tell what worries them and to what extent, it is very difficult for parents to determine the disease. It is necessary to carefully monitor the child and, in case of detection of deviations from the normal state, show the baby to a specialist.

The main symptoms of this disease:

runny nose and cough;
chills are observed, body temperature rises;
heartbeat quickens;
the skin takes on a blue tint;
appetite decreases;
there is shortness of breath and;
the baby becomes irritable, sleep is disturbed;
general weakness of the body.

Due to refusal to eat and drink, young children may show symptoms of dehydration. The baby's pulse quickens, dry mouth appears, crying becomes without tears, and urination occurs very rarely.

IMPORTANT! Bronchiolitis is very dangerous for a child, because there is a risk of transition to chronic bronchopulmonary pathology, and it is also possible death. It is necessary to consult a doctor in time, because on early stage bronchiolitis is easier to treat, and unpleasant consequences are minimized.

Methods of treating the disease in young children

For exact definition diagnosis of bronchiolitis in young children, the doctor carefully examines the patient, listens to breathing. After analyzing the situation, he directs the patient to the necessary studies. These include radiography, pulse oximetry, general and biochemical, analysis of swabs from the nasopharynx.

After the necessary studies and an accurate diagnosis, the doctor prescribes a course of treatment, taking into account the age and severity of the disease. In the case of an acute form, there is a need for hospitalization of the baby. The child is isolated to avoid and monitor the condition. Treatment is by eliminating the cause of the disease. Either antiviral drugs or antibiotics are prescribed, depending on the pathogen.

Recovery normal level fluids in the body, the baby is given to drink twice more water, than usual. They also restore the desired level of oxygen in the blood by breathing through a special mask.

Disease prevention

If bronchiolitis is diagnosed in time and all the doctor's recommendations are followed, the disease is quickly eliminated without undesirable consequences. In case of late referral to a specialist and non-compliance necessary measures all sorts of complications can arise. Particularly prone to undesirable consequences are premature babies and those who have chronic diseases lungs and heart.

In order for a young child not to get sick with bronchiolitis, it is necessary to adhere to certain preventive measures:

The health of young children should be fully monitored by parents. If any undesirable symptoms are found, self-medication is excluded, you should immediately seek help from the hospital. In the first years of life, the baby adapts to our world and he needs every possible help in this!