Bronchiolitis in infants treatment. Bronchiolitis in children: symptoms and treatment. How to determine bronchiolitis in a child: diagnostic methods

Diseases of the respiratory system are very common in children, especially infants and newborns are susceptible to them, which is explained by the not yet fully formed immune system. One of the diseases affecting the lungs is bronchiolitis. How to quickly recognize a pathology and provide a child with qualified assistance?

Bronchiolitis is an acute inflammatory disease of the lower respiratory tract, in which the bronchioles are affected - the final smallest bifurcations of the bronchi in the pulmonary lobules. The pathology is accompanied by symptoms of respiratory failure, or bronchial obstruction, and clinical signs similar to the manifestations of ARVI.

Bronchial obstruction is a clinical syndrome characterized by impaired pulmonary ventilation and difficulty in passing mucus.

Bronchiolitis is an inflammatory process that occurs in the bronchioles

Most often, the disease is provoked by viruses, and the peak of cases of its development occurs in the autumn-winter period. Diagnosis of bronchiolitis today is not difficult, but ignoring the disease can lead to serious complications.

Classification and causes of the disease

Depending on the cause that provoked the development of the disease, the following types of bronchiolitis are distinguished:

post-infectious. At an early age, it is diagnosed most often. Infection occurs by airborne droplets;
inhalation. It is found in children who are forced to constantly inhale tobacco smoke;
drug. May develop after a course of antibiotic therapy;
obliterating. Differs in the most severe course. It is extremely rare in children;
idiopathic. It is combined with other pathological conditions such as lymphoma, idiopathic pulmonary fibrosis, and others.

Children prone to allergic reactions are more susceptible to bronchiolitis than others.

By the nature of the course of the disease, it is customary to distinguish:

Acute bronchiolitis - develops within 2-3 days after infection, while a pronounced clinical picture is observed. The acute period of the disease lasts 5-7 days.
Chronic - as a result of prolonged exposure to negative factors, the tissues of the bronchioles undergo destructive changes. In most cases, it develops in older children.

Causes and causative agents of the disease at an early age - table

Risk factors

There are a number of factors that significantly increase the risk of developing bronchiolitis in children:

child's age up to 3 months;
prematurity;
low birth weight;
improper treatment of respiratory diseases in a baby;
the presence of other lung diseases or pathologies of the cardiovascular system;
immunodeficiency states;
hypothermia.

The fact that this disease mainly affects young children is explained by the following:

The bronchial tree in infants is not yet fully formed, therefore, inflammation of even a small number of bronchioles can lead to serious consequences for the child.
Unprotected immune system. Interferon and immunoglobulin A are produced in the respiratory organs in insufficient quantities.

Symptoms and Signs

The first manifestations of acute bronchiolitis are:

runny nose:
nasal congestion;
cough.

Then the disease spreads to the small bronchi, the following symptoms join:

irritability;
lethargy;
rapid breathing;
dry wheezing;
weight loss associated with a child's refusal to eat;
shortness of breath, which is very disturbing while eating.

At the same time, the patient's condition deteriorates very quickly.

Early bronchiolitis is the easiest to treat, and with a late form of the disease, symptoms may persist for more than 3 months.

As for chronic bronchiolitis, shortness of breath is its constant companion. The body temperature is constantly rising and falling. Weakness is observed, when coughing, phlegm is released, the skin has a bluish tint. The fingers become like drumsticks.

Features of the disease in infants and newborns

Most often, it is children under the age of one year who suffer from bronchiolitis. Infants tolerate this disease much more severely, therefore, when the first signs appear, it is necessary to seek medical help.

Babies, including newborns, have the following symptoms:

asphyxiation attacks (temporary cessation of breathing);
watery nasal discharge;
cough;
shortness of breath (a sick child makes great efforts to exhale);
lack of appetite;
retraction of the large fontanelle (against the background of dehydration);
an increase in body temperature up to 39 degrees;
excessive agitation or, conversely, drowsiness.

Diagnostics

Diagnosis is made by a pulmonologist based on physical examination and auscultation (listening).

During the examination of patients with bronchiolitis, the doctor pays attention to the frequency and nature of breathing, the presence of cyanosis of the skin, the retraction of the compliant places in the chest (the spaces between the ribs and near the collarbones), the duration of exhalation.

With an increased risk of complications, additional examinations are prescribed, in particular:

biochemical and general blood tests (with bronchiolitis, an increase in the number of leukocytes is noted);
general urine analysis;
bacteriological examination of mucus from the nose and throat (to exclude the bacterial nature of the disease);
CT scan;
spirometry, or spirography (allows you to measure the volume of the respiratory system);
gas analysis of blood (carried out in order to detect insufficient oxygen supply to the body);
chest x-ray (to exclude pneumonia, acute pulmonary emphysema).

Treatment of bronchiolitis in children

The essence of therapy is to eliminate respiratory failure and fight infection. In the acute course of the disease, it is necessary to admit the child to the hospital.

Treatment of bronchiolitis requires an integrated approach and includes:

Bed rest (until the body temperature returns to normal).
Limiting the amount of fluid consumed by the child.
Drug therapy, in particular:
- antiviral agents (Ribavirin);
- expectorant drugs (Lazolvan, Bromhexin);
  
  Such drugs cannot be used in the treatment of infants, as this can lead to blockage of the bronchi with mucus.
- saline solutions (Otrivin Baby);
- bronchodilators;
- inhalation with corticosteroids;
- antibacterial drugs (Sumamed, Macropen, Clarithromycin).
  
  Antibiotic therapy is indicated only if the bacterial nature of bronchiolitis is identified. Appointed at the discretion of the attending physician.
Respiratory gymnastics. It is necessary to make light pressure on the chest and tummy of the baby as you exhale.
Vibration massage, which consists in light tapping movements with the edge of the palm in the direction from the lower part of the chest upwards. At the same time, the baby is laid in such a way that the priest is slightly higher than the head.
Oxygen therapy (to eliminate respiratory distress syndrome).

Since bronchiolitis is transmitted by airborne droplets, the patient should be isolated. As a rule, when the baby's appetite is restored, the body temperature returns to normal and the need for oxygen therapy disappears, the child is released from the hospital home.

Drugs for the treatment of the disease - gallery

Prognosis and possible complications

With the timely diagnosis of the disease and compliance with all the doctor's recommendations, the treatment has a favorable prognosis. Otherwise, the following complications may occur:

pulmonary hypertension;
cardiovascular insufficiency;
prolonged respiratory arrest;
emphysema of the lungs;
renal failure;
bronchial asthma;
pneumonia.

Complications of bronchiolitis are most often observed in premature babies, as well as in those who suffer from chronic heart or lung diseases.

Prophylaxis

To avoid bronchiolitis, you must:

exclude contacts of healthy children with sick children;
temper the child, provide him with good nutrition and organize a healthy daily routine;
monitor the condition of the baby's nasopharynx, cleanse it of crusts and remove mucus;
avoid hypothermia;
timely treat infectious and viral diseases;
avoid crowded places during SARS outbreaks.

Doctor Komarovsky about cough in children - video

Bronchiolitis is a serious illness that often occurs in young children. Timely diagnosis and competent treatment will help to avoid serious complications. Therefore, if you experience the first symptoms, see your doctor immediately. Health to you and your baby!

Hello! My name is Elizabeth, I am 21 years old. An economist by education. I am writing about children because it is important for me personally. Rate the article:

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

Dangerous age

Young children are most at risk of developing bronchiolitis, therefore this diagnosis is more common in the medical record of babies under three years old.... Babies from one month old fall into the greatest risk group. This is due to imperfect immunity, unable to resist infections. And if the virus nevertheless entered the body, it begins its attack from the most "secluded corners" of the respiratory system:

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

The most dangerous is 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 in response to an allergen is rare, and the exact relationship between the two has not yet been established. But the timely treatment of acute respiratory viral infections and influenza in children significantly increases the likelihood of avoiding a serious complication in infants.

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

Respiratory diseases of viral and bacterial etiology. Including rhinovirus, adenovirus, influenza, mumps, pneumococcal infection, mycoplasmosis and others. Infectious diseases are transmitted mainly by the respiratory route through contact with an infected person. This can happen in kindergarten, hospital, or any other public place. Infection from family members who have contracted one of these viruses is not excluded.
Smoking surrounded by a child. Tobacco smoke irritates the baby's mucous membrane, reducing resistance to other infections. The likelihood of an allergic reaction cannot be ruled out.
A general decrease in the body's defenses. Regardless of the cause, any decrease in immunity increases the risk of contracting an infection..
Underweight. Children with little weight gain have always been at risk. Weight is an indicator of your baby's health. And its lack indicates a lack of vitamins in the body.
Artificial feeding. Together with breast milk, the baby receives from the mother all the necessary antibodies that allow the still imperfect immune system to resist infections. Avoiding breastfeeding increases the risk of developing bronchiolitis.

Any diseases of the respiratory and cardiovascular system can also cause an inflammatory process.

Types of bronchiolitis

In medical practice, two forms of the disease are distinguished: acute and chronic. Acute bronchiolitis is characterized by pronounced symptoms and impaired respiratory function... The acute period lasts approximately 4 weeks. With an incorrect diagnosis and, accordingly, unassigned treatment, the disease becomes chronic.

With 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 stopping breathing weaken and become barely noticeable. At this stage, most often we are talking about the so-called obliterating bronchiolitis.

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 undergo additional examination. Acute bronchiolitis in children is manifested by the following symptoms:

decreased appetite, up to a complete refusal to eat;
pallor of the skin, cyanosis, developed due to a lack of oxygen;
emotional agitation, 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, shallow breath, wheezing;
when listening, there are pronounced wet wheezing;
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 more frequent and can exceed 70-80 breaths per minute. At this stage, respiratory arrest may occur. The child needs qualified help immediately!

The 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 with other specialists. This will help avoid confusion about 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, partial blockage occurs and, as a result, 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 will be 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, moist rales are clearly audible.

Treatment of acute bronchiolitis

Acute bronchiolitis is treated for a long time, sometimes it may take several months to completely stop the inflammatory process and the accompanying symptoms of respiratory failure... The treatment regimen is based on normalizing the respiration of the crumbs, eliminating the cause of the disease and ensuring the discharge of viscous secretions 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, you cannot do without them.
Antibacterial drugs. Antibiotics are prescribed when a secondary bacterial infection occurs. In case of suspicion of the bacterial nature of bronchiolitis, inoculation of the microflora is carried out immediately after admission to the hospital. Most often, preference is given to drugs with a wide spectrum of action.
Mucolytic and expectorant drugs. These are drugs for symptomatic treatment, thinning phlegm and facilitating the process of its excretion. Antitussives are not used in pediatrics. And their use in this situation is unjustified, as this can aggravate the inflammatory process.
Antihistamines. In this case, drugs for allergies help to remove swelling from tissues and facilitate breathing. It is also advisable to prescribe them as part of antibacterial therapy to prevent the development of adverse reactions. Preference is given to drugs of the latest generation, which have a minimum of side effects.

In severe cases, dexamethasone injections may be prescribed. The use of glucocorticosteroids is also effective in the form of solutions for inhalation. Due to the large number of 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, since all this can provoke laryngospasm. Parents are required to provide comfortable environmental conditions (temperature 20-220 and humidity 50-70%) and drink plenty of fluids to prevent dehydration.

Treatment of bronchiolitis obliterans

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

With frequent bouts 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.
Mucolytics are prescribed to ensure liquefaction of the viscous secretion. When phlegm begins to drain, mucolytic syrups are replaced with expectorants.
When 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 an adjunct therapy in the treatment of obliterating bronchiolitis, massage courses, breathing exercises, exercise therapy are recommended and various physiotherapy treatments.

Forecasts

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

After complete recovery and discharge from the hospital, parents should closely monitor the baby's health, ensuring comfortable living conditions. For some time, residual effects (wheezing, shortness of breath) may still be observed. The respiratory system completely stabilizes after a few months.

Note! Babies who have previously been diagnosed with acute bronchiolitis should be registered with a pulmonologist... Since the likelihood of repeated bronchial damage 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 ARVI or influenza. This disease is most often affected by babies under one year old. The very peak of infection is from the second to the sixth months. The reason is quite simple - the immune system is not yet strong enough to withstand all viruses. Once in the body, the infection enters the bronchioles.

First warning signs

If bronchiolitis is observed in children, the symptoms can be found 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 stuffy.

The disease develops quickly, and if nothing is done during this time, then a complication in the form of respiratory failure may occur.

How to define a disease?

Suspicions of bronchiolitis in young children can be confirmed in such 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 should be noted that this does not necessarily have to have frequent coughing fits and fever.

Acute bronchiolitis: symptoms

With a cold, the treatment does not give a 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;
if you refuse to drink water and food, dehydration may occur, the signs of which are as follows: decreased urination, dryness in the mouth, there are no tears during crying, the pulse quickens;
the child is more moody, irritable, does not sleep well;
body temperature is elevated, but not much;
the presence of a dry cough, sometimes with a small amount of sputum discharge;
difficulty breathing is possible - grunting and moaning sounds occur, the wings of the nose swell, the chest is pulled in a little more, shortness of breath is pronounced;
in more difficult cases, respiratory arrest is possible;
in case of complications, breathing occurs more than 70 times per minute;
after examination, the doctor can diagnose clear moist rales;
after taking a blood test, it is clear that the rate of ESR and leukocytes is lowered.

It is important not to be mistaken!

Bronchiolitis in children is characterized by respiratory failure, which, if severe, can lead to suffocation. In this case, medical assistance is urgently needed, but definitely qualified, since sometimes there are cases that this disease is confused with asthmatic bronchitis or pneumonia with obstructive syndrome.

Conditions for the little 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 adhere to two basic rules:

The air in the room should not be hot and dry, as this provokes drying out of the mucous membranes and heavy sweating, which is fraught with a rapid loss of moisture in the body. The temperature should not be higher than 20 degrees, and the humidity should be between 50 and 70 percent.
The child should be provided with abundant fluid intake. Newborns should be brought to the chest more often, and older ones should be given those drinks that they can drink. This must be done in order to prevent dehydration of the child's body.

It is forbidden to perform these actions

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 is triggered? You can observe bronchiolitis obliterans in children. This means that the bronchioles and small bronchi narrow, after which there is a violation of pulmonary blood flow. After some time, pathological processes of the lungs and pulmonary heart disease may begin to develop.

The following symptoms will help to recognize the ailment:

the occurrence of a 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 illness) in a state of calm;
humid wheezing can be discerned, breathing seems to be wheezing.

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

Bronchiolitis in children, especially small children, is very widespread. It goes on a par with pneumonia, which is also one of the complications after ARVI. Grudnichkov with this diagnosis is immediately sent to hospital. 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 is fatal.

Treatment methods

When bronchiolitis is observed, treatment in children can take 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 help is needed.
Emergency measures are taken when respiratory failure occurs. In this case, both an acid mask and inhalation with medications are used, the actions of which help to relieve an attack of suffocation.
Antiviral drugs are used, since the disease occurs virally. The basis of drugs, in most cases, is interferon.

Drugs

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

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

Antihistamines are prescribed to relieve bronchial swelling and facilitate breathing.

Chronic bronchiolitis

The disease itself develops very quickly. Although its symptoms may be present for less than five months. As a result, there 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) is characterized by the fact that gradually fibrous tissue grows between the muscle and epithelium layers and bronchioles. After some time, the lumen not only narrows, but can also completely close. Respiratory structures are no longer so malleable, and this is fraught with emphysema, as well as impaired breathing.

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

Chronic disease treatment

Chronic bronchiolitis obliterans in children is treated with two methods:

drug therapy;
auxiliary.

In the first variant, mucolytic, bronchodilator or expectorant drugs may be prescribed. If there is inflammation of a bacterial nature, then plus to all this - there are also antibiotics.

Supportive therapies include chest massage, breathing exercises, exercise therapy, climatotherapy, speleotherapy and physiotherapy.

Consequences

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

Pneumonia. It damages tissues in the respiratory system, resulting in a severe cough. Such a disease, if it proceeds in an advanced form, may be accompanied by a slightly high temperature. Breathing complications are common. If, in this case, you do not undergo a course of antibiotic treatment, then this is fraught with even more pernicious complications.
Bronchiectasis. This 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 disrupted, 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.
Chronic bronchitis. If left untreated, the consequences can be dire. In this case, such harmful factors as dust, gases and various allergens play an important role.
Bronchial asthma, which passes from the advanced stage of allergic bronchitis. The disease is characterized by swelling of the mucous membrane and periodic spam. This consequence of bronchiolitis is dangerous because there are attacks of suffocation.
Pulmonary emphysema. This consequence 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 there is a deterioration, then in any other season.
Bronchial obstruction. It is characterized by heavy breathing, which is accompanied by impaired 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 high blood pressure.
But the rarest consequence is cor pulmonale. It provokes constant high blood pressure. As a result, gas exchange is disrupted, 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 proper food intake.

It is advisable to create a hypoallergenic life, since allergies and bronchiolitis have much in common. Remember to keep an eye on the baby's nasopharynx. It is necessary that it is always clean, and there are no accumulations.

When a child is sick, parents are always worried. It is of particular concern if the doctor makes a less popular diagnosis, such as bronchiolitis. What is this ailment and how does it manifest itself?

Causes of the disease

Experts consider the respiratory syncytial virus to be the leading causative agent of acute bronchiolitis.

Bronchiolitis is the inflammation of the smallest branches of the bronchi - bronchioles. This disease most commonly affects children under 3 years of age. More than 60% of young patients are boys.

By the nature of the course, the ailment happens:

acute - lasts no more than 5 weeks,
chronic - drags on for 3 months or longer.

Respiratory syncytial virus (RSV) is the culprit in most cases of acute bronchiolitis. Like SARS, this infection loves to "walk" in the cold season - from October to April. However, unlike the common cold, RSV inflicts the main blow not on the upper, but on the lower respiratory tract.

Infection, as a rule, occurs by airborne droplets. This means that the virus is transmitted from sick people to healthy people when sneezing, coughing, and communicating. Less commonly, the infection is transmitted through dirty hands, shared towels, toys.

In a small number of children, other microorganisms become causative agents of the disease:

influenza viruses,
adenoviruses,
parainfluenza,
pneumococci,
mycoplasma.

Chronic bronchiolitis can develop as a consequence of acute, but usually it is an independent disease caused by prolonged inhalation of irritating gases. Very often, this ailment is found in babies living in smoking families.

The rapid development of inflammation is facilitated by:

low weight of the child,
weakened immunity
age under 3 months,
diseases of the cardiovascular system,
congenital malformations of the respiratory tract,
visit to a nursery / kindergarten,
smoking parents in the presence of the baby.

Among newborns, children who are bottle-fed are more likely to get sick. Their bodies are more susceptible to infections due to the fact that they do not receive antibodies from their mother's milk.

Clinical picture

The initial symptoms of the disease are similar to bronchitis or a cold. Babies have a dry cough and runny nose, and the temperature rises. After a few days, the condition worsens. The temperature continues to rise (up to 39 degrees), the appetite decreases. But the main thing is that respiratory failure develops.

Inhaling air, the child wheezes, his nose wings swell and the nasolabial triangle turns blue. Shortness of breath, palpitations are added. Vomiting may occur after severe coughing fits. Babies have the hardest time, because due to the anatomical features of the chest, they are not able to clear their throat properly.

In severe cases, the following are noted:

"Swelling of the chest,
sudden holding of breath (apnea),
swelling.

A dangerous complication of the disease can be the development of bronchial asthma.

Diagnostics

To make a diagnosis, the doctor only needs to examine the child and listen to the complaints of the parents. To distinguish bronchiolitis from other conditions (such as pneumonia), your doctor may order a chest x-ray.

The causative agent of the disease is identified by a general blood test. In viral infections, the results show an increased number of lymphocytes and monocytes. The content of neutrophils is below the norm. With bacterial infections, the number of leukocytes and neutrophils increases.

To detect respiratory syncytial virus, express diagnostic methods are used. As a material for analysis, washings from the nasal cavity are taken. They are applied to special test systems that react to the presence of PCB by changing their color.

In case of severe shortness of breath, pulse oximetry is performed - a study that helps determine the degree of oxygen saturation in the blood. Values below 95% indicate respiratory failure.

Therapies

The child is prescribed ultrasonic inhalations with saline, and in severe cases, with corticosteroids.

With bronchiolitis, the child must be hospitalized. Treatment tactics are aimed at maintaining normal breathing and preventing complications.

When RSV is detected, a specific antiviral agent, Ribavirin, is prescribed. It blocks the reproduction of the pathogen and prevents the further development of the disease.

If a bacterial infection has been identified, the child is prescribed antibiotics. Preference is given to drugs from the group of penicillins and cephalosporins (Ampicillin, Cefotaxime). Medicines are injected intramuscularly for 7-10 days.

If necessary, the doctor recommends phlegm thinning agents (mucolytics - Ambroxol, Bromhexin). To facilitate the passage of mucus, ultrasonic inhalations with sodium chloride solution are also prescribed. In severe cases, add inhalation with corticosteroids (Dexamethasone), which have an anti-inflammatory effect.

In addition to drugs, a mixture of oxygen and helium is given through the mask. This allows you to reduce the manifestations of respiratory failure and improve the patient's well-being.

Since babies lose a lot of fluids due to rapid breathing, they are shown to drink plenty of fluids. Liquids give 2 times more than the daily requirement. If the child refuses to drink, he is injected with saline through a dropper.

Within 5 years after suffering bronchiolitis, children retain a high susceptibility of the bronchi to the action of negative factors. Such babies are more prone to bronchitis and bronchial asthma, therefore they require long-term observation by a specialist.

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 an acute inflammation of the lower respiratory tract.

With bronchiolitis, the bronchioles are affected, which leads to blockage and swelling. As a result of this process, respiratory failure occurs, which is especially dangerous for young children, because temporary respiratory arrest and death may occur.

As a rule, children under three years of age suffer from bronchiolitis, but they are especially at risk, because they still have fragile immunity and the respiratory system is not fully developed.

Young children under 4 weeks of age have. During this period, the baby is protected and rarely gets sick.

If the baby falls ill with bronchiolitis during this period, then he must be immediately hospitalized, because such patients are the hardest to tolerate this disease. Particularly dangerous is the case with premature infants of an early age and those with various congenital abnormalities.

Bronchiolitis in infants up to a year

When the baby has passed the turn of 4 weeks, his immunity is very weak and therefore is especially at risk of contracting bronchiolitis. According to statistics, 12 out of 100 babies suffer from this ailment, mainly 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 hardly 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 for the development of bronchiolitis in the child may be the lack of milk in the mother, and the child's tendency to allergies. The most common are various infectious diseases of the respiratory tract. Cardiovascular diseases, an underweight 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 according to 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. The chronic form proceeds with mild symptoms for one to three months. Most often it manifests itself in young children and older.

Symptoms and signs that indicate bronchiolitis

IMPORTANT! Due to the fact that young children cannot talk about 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 deviations from the normal state, show the baby to a specialist.

The main symptoms of this disease:

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

Because of the refusal to eat and drink in young children, symptoms of dehydration may appear. 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 a fatal outcome is also possible. It is necessary to consult a doctor in time, because at an early stage bronchiolitis is easier to treat, and unpleasant consequences are minimized.

Methods of treating the disease in young children

To accurately determine the 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 research. These include radiography, pulse oximetry, general and biochemical, analysis of nasopharyngeal smears.

After the necessary research and accurate determination of the 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 monitored for the condition. Treatment is performed by excluding the cause of the disease. Either antiviral drugs or antibiotics are prescribed, depending on the pathogen.

To restore the normal level of fluid in the body, the baby is allowed to drink twice as much water as usual. They also restore the required level of oxygen in the blood by breathing through a special mask.

Disease prevention

If bronchiolitis is diagnosed on time and all the doctor's recommendations are followed, the ailment is quickly eliminated without undesirable consequences. In the event of a late appeal to a specialist and non-observance of the necessary measures, all kinds of complications may arise. Premature babies and those with chronic diseases of the lungs and heart are especially prone to undesirable consequences.

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

Parents should fully monitor the health of young children. If any unwanted symptoms are found, it is excluded to self-medicate, you should immediately seek help from the hospital. In the first years of life, the baby adapts to our world and he needs help in every possible way in this!

What is bronchiolitis

Bronchial obstruction is a clinical syndrome characterized by impaired pulmonary ventilation and difficulty in passing mucus.

Bronchiolitis is an inflammatory process that occurs in the bronchioles

Classification and causes of the disease

Depending on the cause that provoked the development of the disease, the following types of bronchiolitis are distinguished:

post-infectious. At an early age, it is diagnosed most often. Infection occurs by airborne droplets;
inhalation. It is found in children who are forced to constantly inhale tobacco smoke;
drug. May develop after a course of antibiotic therapy;
obliterating. Differs in the most severe course. It is extremely rare in children;
idiopathic. It is combined with other pathological conditions such as lymphoma, idiopathic pulmonary fibrosis, and others.

Children prone to allergic reactions are more susceptible to bronchiolitis than others.

By the nature of the course of the disease, it is customary to distinguish:

Acute bronchiolitis - develops within 2-3 days after infection, while a pronounced clinical picture is observed. The acute period of the disease lasts 5-7 days.
Chronic - as a result of prolonged exposure to negative factors, the tissues of the bronchioles undergo destructive changes. In most cases, it develops in older children.

Causes and causative agents of the disease at an early age - table

Type of bronchiolitis	Causative agent / cause
Post-infectious	respiratory syncytial virus (RSV); adenovirus; influenza virus, parainfluenza; mumps virus; rhinovirus; virus.
Inhalation	gas (carbon monoxide, sulfur dioxide, etc.); evaporation of acids; tobacco smoke; dust, etc.
Drug	Preparations containing the following active ingredients: penicillin; interferon; cephalosporins; bleomycin; amiodarone.
Obliterating	cytomegalovirus; legionella; HIV infection; herpes virus; Klebsiella, etc.
Idiopathic	the reason is unknown

Risk factors

There are a number of factors that significantly increase the risk of developing bronchiolitis in children:

child's age up to 3 months;
prematurity;
low birth weight;
improper treatment of respiratory diseases in a baby;
the presence of other lung diseases or pathologies of the cardiovascular system;
immunodeficiency states;
hypothermia.

The fact that this disease mainly affects young children is explained by the following:

The bronchial tree in infants is not yet fully formed, therefore, inflammation of even a small number of bronchioles can lead to serious consequences for the child.
Unprotected immune system. Interferon and immunoglobulin A are produced in the respiratory organs in insufficient quantities.

Symptoms and Signs

The first manifestations of acute bronchiolitis are:

nasal congestion;
cough.

Then the disease spreads to the small bronchi, the following symptoms join:

irritability;
lethargy;
rapid breathing;
dry wheezing;
weight loss associated with a child's refusal to eat;
shortness of breath, which is very disturbing while eating.

At the same time, the patient's condition deteriorates very quickly.

Early bronchiolitis is the easiest to treat, and with a late form of the disease, symptoms may persist for more than 3 months.

Features of the disease in infants and newborns

Babies, including newborns, have the following symptoms:

asphyxiation attacks (temporary cessation of breathing);
watery nasal discharge;
cough;
shortness of breath (a sick child makes great efforts to exhale);
lack of appetite;
retraction of the large fontanelle (against the background of dehydration);
an increase in body temperature up to 39 degrees;
excessive agitation or, conversely, drowsiness.

Diagnostics

Diagnosis is made by a pulmonologist based on physical examination and auscultation (listening).

During the examination of patients with bronchiolitis, the doctor pays attention to the frequency and nature of breathing, the presence of cyanosis of the skin, the retraction of the compliant places in the chest (the spaces between the ribs and near the collarbones), the duration of exhalation.

With an increased risk of complications, additional examinations are prescribed, in particular:

biochemical and general blood tests (with bronchiolitis, an increase in the number of leukocytes is noted);
general urine analysis;
bacteriological examination of mucus from the nose and throat (to exclude the bacterial nature of the disease);
CT scan;
spirometry, or spirography (allows you to measure the volume of the respiratory system);
gas analysis of blood (carried out in order to detect insufficient oxygen supply to the body);
chest x-ray (to exclude acute pulmonary emphysema).

Treatment of bronchiolitis in children

The essence of therapy is to eliminate respiratory failure and fight infection. In the acute course of the disease, it is necessary to admit the child to the hospital.

Treatment of bronchiolitis requires an integrated approach and includes:

Bed rest (until the body temperature returns to normal).
Limiting the amount of fluid consumed by the child.
Drug therapy, in particular:
- antiviral agents (Ribavirin);
- expectorant drugs (Lazolvan, Bromhexin);
  Such drugs cannot be used in the treatment of infants, as this can lead to blockage of the bronchi with mucus.
- saline solutions (Otrivin Baby);
- bronchodilators;
- inhalation with corticosteroids;
- antibacterial drugs (Sumamed, Macropen, Clarithromycin).
  Antibiotic therapy is indicated only if the bacterial nature of bronchiolitis is identified. Appointed at the discretion of the attending physician.
Respiratory gymnastics. It is necessary to make light pressure on the chest and tummy of the baby as you exhale.
Vibration massage, which consists in light tapping movements with the edge of the palm in the direction from the lower part of the chest upwards. At the same time, the baby is laid in such a way that the priest is slightly higher than the head.
Oxygen therapy (to eliminate respiratory distress syndrome).

Drugs for the treatment of the disease - gallery

Prognosis and possible complications

With the timely diagnosis of the disease and compliance with all the doctor's recommendations, the treatment has a favorable prognosis. Otherwise, the following complications may occur:

pulmonary hypertension;
cardiovascular insufficiency;
prolonged respiratory arrest;
emphysema of the lungs;
renal failure;
bronchial asthma;
pneumonia.

Complications of bronchiolitis are most often observed in premature babies, as well as in those who suffer from chronic heart or lung diseases.

Prophylaxis

To avoid bronchiolitis, you must:

exclude contacts of healthy children with sick children;
temper the child, provide him with good nutrition and organize a healthy daily routine;
monitor the condition of the baby's nasopharynx, cleanse it of crusts and remove mucus;
avoid hypothermia;
timely treat infectious and viral diseases;
avoid crowded places during SARS outbreaks.

Doctor Komarovsky about cough in children - video

Some of the researchers point to the connection between bronchiolitis and the further debut of bronchial asthma, others reject such a connection.

It is only known for certain that bronchiolitis often develops in children who exhibit atopic properties both on the skin and on the part of internal organs. At the same time, bronchiolitis mainly occurs among children of early and young age, therefore, doctors of the intensive care and intensive care units are engaged in its treatment, since it is quite difficult.

Reasons for development

Many of the diseases that occur sideways to bronchitis and affect certain parts of the respiratory tract in the lower respiratory tract, including bronchiolitis, are usually caused by viral causes. Respiratory syncytial virus (RS infection) often causes acute bronchiolitis. From 40 to 75% of bronchiolitis in children who are treated inpatiently with a diagnosis of bronchiolitis, have this particular virus as the root cause of inflammation of the small bronchi.

Other pathogens of bronchiolitis include viruses such as parainfluenza virus of the third type, rhinovirus, adenoviruses of the third, seventh and twenty-first types, influenza virus type a, in rare cases the causative agent can be the mumps virus (mumps). Mycoplasma can become one of the atypical pathogens of bronchiolitis in young children, although it usually causes other diseases in adults and older children.

Often, manifestations of bronchiolitis are called the term "whistling children with respiratory infections", since most often children of the first year of life get sick with bronchiolitis, among them it is 12%, while in the second year already 5-6%.

At the same time, a regularity is noted that the younger the baby's age, the more severe the disease progresses, mainly such children require hospitalization and intensive care. Typically, these children with bronchiolitis have low levels of antiviral antibodies that the mother passes on to the baby during pregnancy. In some children, bronchiolitis of a respiratory syncytial nature can give attacks of apnea (respiratory arrest), mostly premature children, young children or those with heart defects. In such groups of children, mortality from bronchiolitis is very high.

Usually, the incidence increases in winter, when the activity of RS viruses is high, while the infectiousness of such an infection is very high, up to 98% of children become infected from a sick child in a children's team. This virus is also dangerous for intrafamilial contacts, usually the whole family gets sick at once, but younger children get sick the most. This virus also becomes quite relevant with nosocomial infection.

What happens with bronchiolitis

Usually viruses infect the mucous membranes of the lower respiratory tract, mainly small bronchioles, which leads to the formation of their obstruction (blockage) and the formation of emphysema (swelling).

The intrathoracic air volumes and the final expiratory volume during bronchiolitis are almost doubled compared to normal, while an increase in air resistance in the area of the small bronchi is revealed both during inhalation and exhalation. Due to this, pulmonary ventilation is impaired. Shortness of breath occurs both expiratory (on inspiration) and inspiratory (on exhalation) - and this shortness of breath is usually stronger.

Due to shortness of breath and increased breathing, the connection of auxiliary respiratory muscles, satisfactory pulmonary ventilation is maintained and the supply of oxygen to the blood with the removal of carbon dioxide. But gradually respiratory disturbances increase and tissue hypoxia and hypercapnia (excess carbon dioxide in tissues) can develop. With fatigue of the respiratory muscles, the formation of respiratory failure occurs. As a result of respiratory fatigue in young children, periods of apnea can form - respiratory arrest, this is understandable - due to increased muscle work six or more times, their reserves are quickly depleted.

Clinical manifestations of bronchiolitis

Infection of a viral infection of babies occurs mainly from older children or adults at home or in a children's collective (nursery). With bronchiolitis, manifestations of a respiratory infection with cough, runny nose and sneezing initially occur, then the first manifestations of respiratory tract damage. In the future, the infection spreads lower, into the area of small bronchi. There is a formation of irritability, lethargy, increased breathing occurs, with the participation of auxiliary muscles, dry wheezing occurs in the lungs. In this case, there may be phenomena of low fever. Shortness of breath for breathing disorders can make it difficult to suckle or feed with complementary foods. The general condition of the child is progressively worsening, which forces the parents to see a doctor or call an ambulance.

When examining such babies, signs of an acute inflammatory infection in the lower respiratory tract are revealed - the respiratory rate is increased, the child turns blue, the wings of the nose swell, in the chest area there is a retraction of compliant places (intercostal spaces, areas near the collarbones), while the lungs are swollen, can clearly enter the edge of the liver from under the costal arch on the right. When listening to the lungs, dry scattered rales, moist rales are observed, exhalation is sharply lengthened.

Diagnostic methods

To confirm the diagnosis and clarify the degree and severity of the lesion, it is necessary to conduct a number of laboratory and instrumental studies. First of all, it is necessary to perform an overview X-ray of the chest organs, conduct a general blood test, examine the gas composition of the blood and make a virological study of swabs and swabs from the throat and nose of the child to determine the virus. To exclude microbial pneumonia, blood and sputum are cultured on the microflora with the determination of antibiotic sensitivity.

X-ray in children with acute bronchiolitis reveals the presence of acute pulmonary emphysema, there may be peribronchial thickenings in the area of large bronchi, a blood test may show a slight lymphocytosis or a normal reaction. The virus is detected by a complement binding reaction or indirect immunofluorescence in a swab from the nasal mucosa.

Of particular importance is the study of blood gases, in which a decrease in blood oxygen saturation e is revealed, which lasts about a month, even with an improvement in the condition. In most of them, breathing in ordinary air, hypoxia and the development of respiratory failure were detected, metabolic acidosis was formed.

Patient treatment methods

All children with manifestations of acute bronchiolitis and severe breathing disorders, especially those who are not yet six months old, are urgently hospitalized in the intensive care unit of a children's hospital. First of all, it is necessary to calculate the heart rate, find out from the parents if there are any problems with the lungs and heart, which can complicate the course of the disease. Children with severe manifestations of respiratory failure should be transferred to the intensive care unit, sometimes they need breathing with oxygen or an oxygen mixture.

It is important to isolate children with similar manifestations in a boxed ward, as they are very contagious to others. When caring for a child, personnel should strictly observe the regime.

A pulse oximeter is connected to the child's finger or earlobe and the gas composition of the blood is determined, and in severe hypoxemia, oxygen therapy is administered through a nasal catheter or mask. Sometimes an oxygen tent or humidified oxygen is used.

On the recommendation of the AAP, treatment is carried out with ribaverin at a high risk of complications associated with concomitant pathology - if the child has heart defects, pulmonary hypertension, with prematurity, with defects of the lungs, pancreas, and immunodeficiencies. Also, ribaverin is indicated for children with a severe course of bronchiolitis and for whom the gas composition of the blood is changed, the level of carbon dioxide in the tissues is increased. It is obligatory to use it in children who require mechanical ventilation.

It is important to control the use of fluids in children with bronchiolitis due to the fact that with this disease the production of antidiuretic hormone suffers and fluid retention is observed with an increase in blood pressure. In the future, renin production by the kidneys also suffers, which leads to a decrease in urination, low urinary sodium excretion and fluid retention with an increase in body weight. This leads to increased edema in the bronchi and aggravation of the condition.

The use of diuretics in minimal doses, controlled by weight and condition, with some fluid restriction, helps in alleviating the condition.

The child is constantly monitored the effectiveness of the behavior of oxygen therapy according to the state of blood gases on the pulse oximeter, if spontaneous breathing is possible, oxygen is shown with a mask, a nasal catheter or a mixture of air with oxygen.

In the treatment, bronchodilators are used, which act on muscle spasms. In addition, it is possible to use corticosteroids in the form of inhalation, but they may not always be effective, since the inflammatory edema of small bronchioles and not spasm mainly plays a role. The basis of treatment is the effect on viruses and the fight against edema and inflammation in the area of small bronchi, respiratory therapy.

In therapy, the following stages can be distinguished:

the use of oxygen therapy,
fluid use and urine output control,
the use of antibiotics to prevent secondary infection,
glucocorticoid therapy to relieve inflammation,
the use of funds to support the work of the heart.

All therapy is selected based on the severity, and is strictly monitored by doctors.

Forecasts and prevention

Even if bronchiolitis has been treated in full, children may still suffer from respiratory disorders for a long time and their bronchi will be highly sensitive to the effects of various external factors and infections. In half of children with bronchiolitis, subsequently, with the development of colds and flu, bronchial obstruction syndrome is formed and there may be transitions to asthma.

A particularly dangerous variant of bronchiolitis is obliterating bronchiolitis, with it, in half of the cases, chronic broncho-pulmonary pathology is formed.

The basis for the prevention of bronchiolitis is the separation of young children from sick children, the prevention of viral infections, hardening procedures and a balanced diet. It has been noticed that bronchiolitis develops less often among infants due to their protection by maternal antibodies. With the development of a cold, young children need early use of antiviral drugs.

It will be useful to create a hypoallergenic life and prevent allergies, since bronchiolitis has a component common with allergies. It is important to monitor the condition of the child's nasopharynx, constantly cleanse it of crusts and mucus. After recovery, children with bronchiolitis are registered for a long time with a pediatrician and a pulmonologist, and require periodic health improvement and prevention measures.

Bronchiolitis, transferred by an infant under one year old or under the age of 2 years, affects the quality of his health in adulthood.

Disease of the bronchioles - the smallest bronchi of the tracheobronchial tree, causes a deficiency of oxygen in the tissues, disrupts the development of all organ systems.

Unformed immunity, incomplete development of the respiratory organs of infants are the cause of frequent damage by viruses of bronchioles, bronchi of small diameter with the occurrence of bronchiolitis.

The severe course of acute bronchiolitis is observed in children under 2 years of age, the maximum diseases occur in infants 1 - 9 months (80% of cases). With age, the number of diseases decreases, and the older children become, the easier their immunity resists infection.

Causes

Bronchiolitis is caused mainly by the RSV virus - respiratory syncytial (50% of cases), parainfluenza virus (about 30%), adenovirus (up to 10%), influenza viruses (8%), rhinovirus (10%).

Bronchiolitis is severe in newborns suffering from pathologies of the heart, lungs, premature babies are often infected with this disease. The RSV virus is highly contagious, affecting mainly babies 2 to 24 months old.

The high concentration of this virus in the blood plasma causes the formation of antibodies to it, the formation of bronchial sensitivity, which increases the likelihood of bronchial asthma.

Matured people who have undergone bronchiolitis in a complicated form are at risk of developing COPD, a chronic lung disease.

Infection does not always provoke bronchiolitis, more often it causes infection in children. The emergence of bronchiolitis is provoked by external factors and features of the baby's immunity.

Who is at risk for bronchiolitis

Male infants suffering from pathologies of the development of the respiratory system, children born prematurely are at greatest risk.

The likelihood of contracting viruses increases if you smoke in the environment. Even passive smoking causes a spasm of the smallest bronchioles in an infant, provokes a circulatory disorder, which contributes to the spread of the virus along the bronchial tree.

There is a high probability of bronchiolitis in infants if older children attend educational institutions, especially in winter, during seasonal SARS epidemics.

Mechanism of inflammation

Blockage of bronchioles with viscous secretion is caused by mucosal edema. In children, bronchospasm does not make an insignificant contribution to the development of bronchiolitis.

And the younger the children, the smaller the diameter of their bronchioles, the greater the contribution to the progression of bronchiolitis belongs to the edema of the mucosa. This phenomenon is the reason that antispasmodics do not have the expected effect in the treatment of children with bronchiolitis.

Another feature of bronchiolitis in infants is rapid dehydration, changes in the properties of secretions, desquamation of the ciliated epithelium, followed by its replacement with germ cells that are not provided with cilia.

The absence of ciliated cells, the directed movement of which, like a brush, clears the airways, leads to the accumulation of secretions.

It becomes viscous, forms plugs that clog the lumen, which creates an opportunity for the accumulation of viscous thick phlegm in the bronchioles and colonizing them with bacteria.

We suggest that you familiarize yourself with the disease of bronchiolitis in adults in our next article.

How to recognize bronchiolitis

The manifestations of the disease begin with minor symptoms of a cold, the appearance of a runny nose. Usually the temperature is normal at this time.

From infection to symptoms of bronchiolitis, children lose their appetite, become lethargic, reluctant, and drink very little.

4 days after the first signs of a viral infection appear:

shortness of breath with a frequency of 90 breaths in 1 minute, difficult on exhalation;
cyanosis of the skin in the area of the nasolabial triangle;
dry cough quickly changing to wet;
a sharp rise in temperature to 39 0 C, lasting 2 days, after which it does not rise above 38 0 C;
the occurrence of respiratory failure caused by hyperventilation of the lungs due to changes in the concentrations of carbon dioxide, oxygen;
an increase in the chest with the appearance of a box-shaped sound when tapping (percussion);
listening (auscultation) allows you to hear a wheezing exhalation and small bubbling rales during exhalation and inhalation.

How to prevent bronchiolitis in babies at home

Bronchiolitis in newborns, premature babies

Even a perfectly healthy child can get bronchiolitis, but it is the hardest and most dangerous infection for newborns, for premature babies. The peculiarity of this group is that it has not yet developed immunity.

In case of bronchiolitis, premature babies almost always need oxygen therapy. More often than full-term children, they need intensive care, artificial ventilation.

In premature infants, bronchiolitis begins not with signs of a cold, but with respiratory arrest (apnea). And the younger the baby, the earlier he was born, the more dangerous the apnea.

The risk of bronchiolitis increases in premature babies with heart disease, lung pathologies. Due to rapid breathing, high body temperature, babies quickly become dehydrated.

To stabilize a satisfactory condition with bronchiolitis, babies are given more drink, fed in fractional portions, and the purity of the nasal passages is monitored. To moisturize the nasal mucosa, inhalation is done through a nebulizer. You can read more about inhalation and the benefits of these procedures in the article.

Adenovirus infection with bronchiolitis

With adenovirus infection, a persistent long-term temperature is observed. This type of infection is more severe than other forms of bronchiolitis.

With late diagnosis, adenovirus infection can lead to the formation of obliterating acute bronchiolitis, in which the walls of the bronchioles are destroyed, filling with connective tissue.

The result of these changes is the hardening of the affected area of the lung or the appearance of an unventilated area - a "transparent lung".

Bronchiolitis obliterans may be suspected if symptoms recur after temporary improvement. The X-ray shows "cotton lung" - scattered infiltrates (compaction).

The temperature can be kept for 3 weeks, after the improvement of the condition, crepitus (sounds resembling a crackling) persists for a long time, usually one-sided, over the lesion.

Treatment of this type of bronchiolitis requires the use of antibiotics, hormonal agents, and artificial ventilation of the respiratory organs.

Bronchiolitis treatment

Children under 1 year of age must be treated in a hospital, hospitalized to avoid complications. Depending on the state of health, the severity of the condition, the babies are prescribed oxygen therapy, in rare cases, according to indications, antibiotics are used.

Salbutamol treatment is indicated by inhalation through a nebulizer or through a spacer - a face mask with a nebulizer of a drug solution.

It is preferable to use the inhalation method of drug delivery because of the speed and selectivity of the drug's action on the site of inflammation.

Antitussives, antihistamines are not prescribed for children. Mucolytics - only if necessary, in the acute phase of bronchiolitis.

Severe neonatal bronchiolitis is treated with the antiviral drug riboverin. In the treatment of bronchiolitis caused by the RSV virus, the drug palivizumab (USA) is used.

Complications

Obliterating acute bronchiolitis;
apnea;
acute form of pulmonary heart - pulse with a frequency of 200 beats per minute;
visually noticeable enlargement of the liver.

Very rare complications of bronchiolitis include respiratory arrest, sudden death.

Forecast

With an uncomplicated course of bronchiolitis, the symptoms disappear 2-3 weeks after the first signs of the disease appear. However, the hypersensitivity of the bronchi persists for a long time after recovery, and a lingering cough persists.

Difficult prognosis in bilateral obliterating bronchiolitis caused by adenovirus infection.