Bronchitis symptoms in children 5 years old. Bronchitis in a child: how to recognize what to take and when to see a doctor. Symptoms of the chronic form in children

Bronchitis in children most often occurs as a complication against the background of SARS, flu or severe colds, hypothermia. Provoking factors for the development of bronchitis are seasonal temperature fluctuations, especially periods of rain with high humidity, so this disease usually occurs in autumn or spring.

According to the form, all bronchitis in children are divided into: Acute, Protracted and Recurrent.

For reasons of occurrence, it depends on the causative agent of inflammation and is divided into:

• Viral - influenza, adenoviruses, parainfluenza
• Bacterial - can be acute and obstructive (the causative agent is streptococcus, staphylococcus, moraxella, Haemophilus influenzae, as well as mycoplasma and chlamydia)
• Allergic, obstructive, asthmatic - arises from irritating chemical or physical factors, such as household chemicals, house dust (read about), animal hair, plant pollen, etc.

Bronchitis in a child under one year old - symptoms and treatment

Breastfed babies who do not have contact with sick children and adults should not have any respiratory disease. However, if a child was born prematurely, has congenital malformations of the respiratory organs and other diseases, and there are preschool children in the family who attend kindergartens and are often ill, the development of bronchitis in a child under one year old is possible for the following reasons:

• narrower than in an adult, bronchi, more dry and vulnerable mucous membranes of the respiratory tract
• existing congenital malformations
• after a viral or bacterial infection
• the presence of individual sensitivity to chemical and physical irritants - an allergy to something.

The most basic symptom of developing bronchitis is a strong dry cough, paroxysmal, accompanied by shortness of breath, shortness of breath. Gradually, the cough becomes wet, but mucus, sputum with bronchitis in a child up to a year makes it difficult to breathe, the normal functioning of the lungs is disturbed, since the airways in infancy are narrow. Bronchitis in children up to a year and even up to 3-4 years is most often of the following types:

• Acute bronchitis simple
• Obstructive bronchitis
• bronchiolitis

On acute and obstructive bronchitis, we will dwell in more detail below. And now consider the most common in children under one year old. bronchiolitis.

Bronchitis in children under one year old - bronchiolitis

This bronchitis affects both small bronchi and bronchioles, develops more often against the background of SARS, influenza viruses, followed by the reproduction of pneumococci (and other streptococci). In case of inhalation of icy air or sharp concentrations of various gases, bronchiolitis can develop as an independent disease. The danger of such bronchitis is a pronounced broncho-obstructive syndrome with the development of sometimes even acute respiratory failure:

• Characterized by dry cough attacks, pronounced shortness of breath of a mixed or expiratory form with syndromes of swelling of the wings of the nose, with the participation of auxiliary muscles, retraction of the intercostal spaces of the chest, pallor of the skin, cyanosis.
• The child is observed, there are no tears when crying.
• The child eats and drinks less than usual, respectively, and his urination is more rare.
• An increase in body temperature, but unlike pneumonia, it is less pronounced (see).
• Shortness of breath up to 60-80 breaths per minute, while breathing is grunting, superficial.
• Diffuse, moist, voiced, finely bubbling and crepitant rales are heard on both sides.
• Symptoms of intoxication in bronchiolitis in children are not expressed.
• On the X-ray, a sharp transparency of the lung tissue, a variegated pattern, a horizontal standing of the ribs, and the absence of infiltrative changes in the lungs are determined.
• If at first there was a simple bronchitis, then the accession of bronchiolitis after a while is manifested by a sharp deterioration in the general condition of the child, the cough becomes more painful and intense, with scanty sputum.
• Children are usually very restless, capricious, excited.
• The blood test may be slightly changed, a slight leukocytosis and an increase in ESR are possible.
• Usually bronchiolitis in children up to a year has a long course of up to 1-1.5 months.
• The causes of acute bronchiolitis in children are similar to the causes of obstructive bronchitis in children older than a year -2-4 years. The local immune system of the respiratory tract in children under 2 years of age is weak, protection against viruses is insufficient, so they easily penetrate deep into the bronchioles and small bronchi.

Treatment of bronchiolitis in children

There is no cure for bronchiolitis at home. If bronchiolitis occurs in an infant, hospitalization is usually indicated so that the child is under the supervision of doctors. In the hospital, pediatricians, pulmonologists will establish an accurate diagnosis and prescribe appropriate treatment. What should mom do before the ambulance arrives?

You can only alleviate the symptoms of a cold - create optimally comfortable air in the room, turn on a humidifier, air purifier.

If the child does not have a high temperature, it is possible to ease breathing with the help of warming creams and ointments, smear their legs and calves with them. Only you need to be careful with this, if the child has not had any allergic manifestations before, then it helps a lot if the child is allergic, warming ointments should be excluded.

To make the cough softer, you can do steam inhalations - over a boiling pot with a weak saline solution, hold the baby in your arms. Or seat him at the table and cover with a towel over a cup of hot healing solution.

Try to get the baby to drink more to avoid dehydration, if the baby refuses breast or formula, just give the baby clean water.

In the hospital, in order to relieve signs of respiratory failure, the baby is given inhalations with bronchodilators and allowed to breathe oxygen. Also, at the discretion of the doctor, an antibiotic is selected - Sumamed, Macropen, Augumentin, Amoxiclav. It is possible to use various drugs with interferon. Be sure to prescribe antihistamines to relieve swelling at the site of inflammation and a possible allergic reaction to treatment. If observed, then carry out the necessary rehydration therapy.

Acute bronchitis in children - symptoms

Bronchitis is the most common type of respiratory disease in children. Acute bronchitis is considered an acute inflammation of the bronchial mucosa without symptoms of inflammation of the lung tissue. Simple bronchitis in children in 20% is an independent bacterial disease, 80% is either in the program of viruses (Coxsackie virus, adenovirus, influenza, parainfluenza) or as a bacterial complication after these viral infections.

Clinical symptoms of bronchitis in children are as follows:

First, the child develops general weakness, malaise, headache, lack of appetite, then a dry cough or cough with sputum appears, the intensity of which is rapidly increasing, when listening, dry diffuse or various wet rales are determined. Sometimes it can be a little different.

In the first 2 days, the temperature rises to 38 C, however, with a mild form, the temperature can be 37-37.2.

After 6-7 days, a dry cough turns into a wet one, sputum discharge relieves the child's condition and is a good sign that the body is coping with the infection and the virus.

On average, the duration of acute bronchitis in children is 7-21 days, but the nature of the disease, the severity of the inflammatory process depend on the age of the child, the strength of his immune system, the presence of concomitant chronic and systemic diseases. With inadequate or untimely treatment, acute bronchitis can lead to complications - bronchiolitis, pneumonia.

Sometimes after the flu, for some time, the child's condition improves, and then a sharp deterioration, a rise in temperature, an increase in cough - this is due to a weakening of the immune system in the fight against the virus and the addition of a bacterial infection, in which case an antibiotic is indicated.

With mycoplasmal or adenovirus acute bronchitis in children, symptoms of intoxication, such as high fever, headaches, chills, lack of appetite, can be about a week. Usually, acute bronchitis is bilateral, however, with mycoplasmal bronchitis, it is most often unilateral, sometimes combined with conjunctivitis.

Acute bronchitis in children - treatment

Most often, the duration of acute bronchitis in children, the treatment of which is correct and carried out on time, should not be more than 14 days, however, in infants, cough can persist for up to a month, as well as in older children with atypical mycoplasmal bronchitis. If suddenly bronchitis in a child is delayed, a number of diseases should be excluded:

• food aspiration
• pneumonia
• cystic fibrosis
• foreign body in the bronchi
• tuberculosis infection

The pediatrician prescribes a full range of treatment. In addition to following all the recommendations of the doctor, you should provide the child with special nutrition and quality care. It is desirable to create optimal humidity and cleanliness in the room, for this it is convenient to use a humidifier and air purifier, often ventilate the room and carry out daily wet cleaning in the room in which the child is located. And:

• Plentiful drink

Provide plenty of warm fluids. To soften the cough, warm milk with butter or Borjomi mineral water helps well, you can replace it with honey.

• Heat

With fever, temperature only above 38C should be taken.

• Antibiotics

• Cough medicines

With a dry cough, a child, as prescribed by a doctor, can be given antitussive medicines, and when he becomes wet, they can switch to funds that can be combined (). If the cough is wet, then Bromhexine, Gedelix, Altai syrup, Thermopsis herb infusion or its dry extract, Bronchicum, Eucabal, Prospan, are shown.

• Inhalations

Almost always, obstructive bronchitis is associated with a virus or mycoplasmal infection, relapses of obstructive bronchitis in children most often spontaneously stop by the age of 4 years.
If bronchioles and small bronchi are affected, then this is already acute bronchiolitis.

Oobstructive bronchitis in children differs from asthma attacks in that the obstruction develops slowly, and in asthma the child suddenly begins to choke. Although the first attacks of bronchial asthma in children also begin during SARS. If the obstruction occurs several times a year, this is a signal that the child is at risk for developing bronchial asthma in the future.

Obstructive bronchitis in a child may be due to passive smoking, it can be distinguished by a strong cough with a whistle in the morning, while the child's condition is quite satisfactory. Obstruction in allergies occurs upon contact with an allergen, and recently it has become a very common manifestation in children prone to allergies, such bronchitis are recurrent and are threatened by the development of bronchial asthma.

Allergic and obstructive bronchitis in children - treatment

Hospitalization

With obstructive bronchitis in children under one year or 2 years old, treatment should be carried out in a hospital under the supervision of a pediatrician, in other cases at the discretion of the doctor and parents. Treatment is best done in a hospital if:

• In addition to obstruction, the child has symptoms of intoxication - loss of appetite, high fever, nausea, and general weakness.
• Severe signs of respiratory failure. This is shortness of breath, when the respiratory rate increases by 10% of the age norm, it is better to count at night, and not during games or crying. In babies up to 6 months, the respiratory rate should not be more than 60 per minute, 6-12 months - 50 breaths, 1-5 years 40 breaths. Acrocyanosis is a sign of respiratory failure, manifested by the cyanosis of the nasolabial triangle, nails, that is, the body is deficient in oxygen.
• It is not uncommon for obstructive bronchitis in children to disguise pneumonia, so if the doctor suspects pneumonia, hospitalization should not be refused.

Bronchodilators

Bronchiolytics dilate the bronchi, so they are designed to relieve obstruction. Today, they are presented in the pharmaceutical industry market in various forms:

• In the form of syrups (Salmeterol, Clenbuterol, Ascoril), which are convenient to use for young children, their disadvantage is the development and heartbeat.
• In the form of solutions for inhalation (see) - this is the most convenient way for young children, diluting the medicinal solution with saline, inhalation is carried out 2-3 times a day, after improvement it can only be used at night. The multiplicity and dosage, as well as the course of treatment, is determined only by the pediatrician.
• Aerosol inhalers can only be used for older children (Berodual, Salbutamol).
• Such tablet forms of bronchodilators as theophylline (Teopek, Eufillin) are not indicated for the treatment of children with obstructive bronchitis, they have more pronounced side effects, are more toxic than local inhaled forms.

Antispasmodics

Can be used to reduce bronchospasm. This or . They can be taken with an inhaler, orally as tablets, or intravenously in a hospital.

Cough remedies

In order to better sputum, various mucoregulatory drugs are used, they help to thin the sputum and accelerate its excretion:

• These are preparations with the active substance Ambroxol (Lazolvan, Ambrobene). These funds should not be taken for more than 10 days, it is most convenient to use them in the form of inhalations, as well as carbocysteine ​​preparations (Flyuditek, Bronhobos, Mukosol).
• After the cough has become wet, the attacks have become less intense, the sputum thins, but does not come out well, Ambroxol should be changed to, which should be given no more than 5-10 days, these include Gedelix, Bronchikum, Prospan, Bronchosan, Gerbion (see. ), Tussin, Bronchipret,.
• Codeine-containing drugs are not recommended for children to take if the child has a paroxysmal obsessive cough, as prescribed by a doctor, you can use Sinekod, Stoptusin Fito, Libeksin (with caution in childhood), Bronchikum, Broncholitin.
• Erespal - helps to relieve obstruction and reduce sputum production, and it also has anti-inflammatory activity, is used from the first days of the disease, reduces the risk of complications, is contraindicated in children under 2 years of age.

Draining massage

To facilitate the discharge of sputum, parents themselves can give their child a massage of the collar zone, chest, and back. Especially strong massage should be done for the back muscles along the spine. Postural massage is useful for obstructive bronchitis in children - that is, tapping the back of the baby in the morning, you should hang the child upside down from the bed (put a pillow under the tummy) and tap with palms folded in a boat for 10-15 minutes. For older children, when massaging, ask the child to take a deep breath, and tap on the exhale. Useful and additional exercises such as inflating balloons, blowing out candles or).

Antihistamines

Antihistamines are prescribed for children with a predisposition to allergic reactions. Allergy medicines such as Erius in syrup can be taken by children from 1 year old, from six months it is possible to use Claritin and Zirtek, from 2 years old in syrups and drops of Tsetrin, Zodak, Parlazin (see). Such 1st generation antihistamines as Suprastin and Tavegil are used less frequently today, only for drying with abundant liquid sputum.

Allergy or virus

If the obstruction is caused by an allergy or a virus, antibiotics cannot be used, and even dangerous (see). The appointment of antibiotics is possible only with a proven infectious origin of bronchitis in children.

When antibiotics are indicated

Treatment of bronchial obstruction with antibiotics is not indicated, only if the child has a high temperature for more than 4 days, or there was a second jump in temperature up to 39C 4-5 days after the onset of the disease, accompanied by severe intoxication, severe cough, if, with adequate treatment, the child suddenly becomes apathetic, lethargic, refuses to eat, he has weakness, nausea, headaches and even vomiting. In such cases, the use of antibiotics is justified. They are prescribed only by a pediatrician based on the clinical picture, the presence of purulent sputum (indicative of bacterial bronchitis), inflammatory changes in the blood test, as well as other signs of bacterial bronchitis or pneumonia (wheezing, x-ray signs).

Antivirals

hormone therapy

Hormonal drugs such as Pulmicort are indicated only for severe or moderate obstructive bronchitis (usually with the help of a nebulizer), they quickly stop obstruction and inflammation, they are prescribed only by a doctor.

What Not to Do

With obstructive bronchitis in children - treatment by rubbing and spreading the child's body with various warming ointments (Doctor Mom ointment, ointments with medicinal plants, essential oils), the use of mustard plasters is unacceptable, because they cause an even greater allergic reaction and bronchospasm, especially in children under 3 years old. It is also categorically impossible to carry out inhalations with bronchitis with various medicinal herbs and essential oils. It is only possible to use such folk remedies for warming up - thermal compresses with potatoes, salt, buckwheat.

Physiotherapy

Physiotherapeutic procedures in the acute period are contraindicated when the obstruction is already stopped, it is possible to carry out UHF, electrophoresis or laser.

Hypoallergenic diet and plenty of fluids

Any natural drinks - mineral water with milk, tea, should be drunk by the child as often as possible. The diet should be hypoallergenic, but at the same time as vitaminized as possible, complete in terms of protein and fat content. Eliminate from the child's diet anything that can cause an allergic reaction:

• citrus, red and orange fruits
• purchased spices, sweets, milk curds, yogurts, carbonated drinks, sausages and sausages - everything that contains dyes, flavors, preservatives and flavor enhancers
• honey and other bee products
• fish grown on fish farms, broiler chickens - as they are stuffed with hormones and antibiotics, which causes allergies.

When caring for a child, you should ventilate and humidify the room where the child is located daily. It should not be hot in the apartment, it is better to have cool, fresh, clean air. After recovery, the child should be registered with an allergist.

Mothers are especially wary of diseases of a newborn. For example, bronchitis in children under one year is more severe than in adults and is accompanied by dangerous symptoms.

How to cure it in an infant as quickly and safely as possible, and how to understand that bronchitis is going away?

Bronchitis can be caused by:

1. Viruses.
2. bacteria.
3. Allergens or toxic substances.

Most often, bronchitis develops as a consequence of acute respiratory infections and is of a viral nature.

Bacterial bronchitis appears as a complication of viral bronchitis as a result of the addition of bacterial flora.

It is very important to understand what type of bronchitis the baby has in order to start the correct and effective treatment.

Diagnostics

The doctor knows. Don't try to diagnose yourself little child. The doctor will determine the correct diagnosis based on:

1. Listening to the child with a phonendoscope.
2. Sputum analysis. Sowing and give an answer about the pathogen.
3. Clinical blood test data.

Classification

According to the clinical course, there are such types of bronchitis:

1. Spicy. Symptoms quickly increase, including general malaise and fever. The treatment is effective, the symptoms disappear in 2-3 weeks.
2. obstructive. Bronchitis, in which the lumen of the bronchi narrows and leads to respiratory failure. It is very important to diagnose this form in infants in time, because treatment is carried out mainly in a hospital.
3. Chronic. Can't be in babies.

Symptoms

Bronchitis symptoms:

1. May begin with common manifestations of a viral infection: elevated temperature, redness of the throat, weakness.
2. Appears first dry frequent cough, which causes anxiety to the child and can be episodic. The cough then turns into wet, however, sputum is usually separates badly.
3. Rattling and whistling may listen without a phonendoscope.

Dangerous symptoms are:

1. Blue nasolabial triangle.
2. Dyspnea.
3. Shortness of breath, difficult breathing.

In such cases, you need to call an ambulance and continue treatment in a hospital under the supervision of doctors. If a child has an asthma attack, humidified air will help to wait for the doctors. You can do it with a humidifier or an open hot water faucet in the bathroom.

The danger of obstructive bronchitis

and infectious bronchitis in children younger than a year is recommended to be carried out in a hospital. The fact is that coughing and sputum secretion often lead to life-threatening attacks. The respiratory tract of infants is much narrower, than adults, so any inflammatory edema or accumulation of sputum causes narrowing of the lumen of the bronchi and respiratory failure.

How to recognize bronchitis

Possible for an infant, taking into account the age of one month, are described below. However, this is only a guideline, an accurate diagnosis is made based on the results of the blood and listening to the child.

At the age of 1-3 months the baby receives immune protection with mother's milk, so viral infections rarely provoke any disease. The cough of a child at this age may be associated with an allergic component or insufficient humidity in the room.

Parents should pay more attention to ventilation, wet cleaning and maintaining the right climatic conditions.

At the age of 4-6 months babies begin to cut their first teeth. This is often accompanied by increased salivation, which the child tries to cough up. Such a cough, as a rule, is wet, the sputum comes out well and is accompanied by rhinorrhea. An accurate diagnosis should be made by a doctor after listening to the bronchi and examining the baby.

6 to 12 months children meet with the first infections and begin to get sick. At this age, infectious bronchitis is most likely. You can recognize it by typical symptoms: fever, decreased activity of the baby, wheezing.

Treatment

Many medicines are prohibited for use in children under one year old. Come to the fore alternative treatments:

1. Mode. It is necessary to provide the child with peace, reduce active games, do not force him to eat. In the child's room, a humidity parameter of 60% and a temperature of 20 degrees should be maintained.
2. Diet. Children who are already on solid foods should not be forced to eat. During bronchitis, it is better to give them more fluids so that the sputum leaves easier and faster.
3. Massage. Drainage massage will help remove stubborn sputum. For this, the child is placed on the stomach and lightly tapped with fingers on the back in the area of ​​the bronchi.
4. Folk remedies. Treatment of bronchitis in children under one year old is often carried out with folk remedies. The most popular are steaming, inhalation, herbal decoctions. Mustard plasters are not recommended for small children. allowed only from the age of three.
5. Medical treatment. Viral bronchitis is preferably treated symptomatically. For this, antipyretics (paracetamol, ibuprofen), saline solution for moisturizing the respiratory tract (or mineral water), mucolytics (ACC. Fluimucil) are used. For a bacterial infection, the doctor prescribes antibiotics, taking into account the age and weight of the child. Antibiotics (macrolides, cefasloporins, aminopenicillins) can be used even in the smallest children, but strictly according to the doctor's indications and in the age dosage.

In case of obstructive form of bronchitis, the following procedures are added to the treatment:

1. Inhalation with bronchodilators.
2. Electrophoresis, UHF.
3. Therapeutic gymnastics.

The weakening of symptoms will help the mother understand that the bronchitis in the child is passing. First, the temperature returns to normal, then breathing. Sputum will begin to be more easily expectorated, and coughing will occur less frequently and bring relief.

Complications

Treatment of bronchitis should be carried out to the end, without interrupting treatment. Otherwise, you can get the following complications:

1. Pneumonia.
2. The transition of inflammation to a chronic form.
3. Bronchial asthma.
4. Respiratory failure.

bronchiolitis

This is a disease in which the smallest sections of the bronchial tree are affected - bronchioles. Such a diagnosis is very dangerous., irreversible tissue changes can take place in the bronchioles, which will lead to impaired blood circulation and respiration. Symptoms:

1. Dyspnea.
2. Weakness.
3. Lack of air.
4. Cyanosis.

Prevention

Considering the importance of the respiratory system for the human body, it is better to take care of its health constantly. Preventive measures will keep the child healthy and prevent many diseases:

1. Eliminate any potential allergens from the home.
2. Daily wet cleaning and airing.
3. Maintaining the optimal temperature (20 degrees) and humidity (60%) in the room.
4. Your baby is drinking enough fluids.
5. Hardening, walks in the fresh air.
6. Rest on the sea.

When planning, mom must first cure her disease. Why is bronchitis dangerous during pregnancy? The infection can be transmitted to the baby and provoke a miscarriage or malformations.

How to recognize the signs of bronchitis, we discussed above. The earlier treatment is started, the more likely it is to be carried out at home.

Treatment of bronchitis in children

Dr. Komarovsky will tell you how to properly treat bronchitis in children.

- non-specific inflammation of the lower respiratory tract, occurring with damage to the bronchi of various calibers. Bronchitis in children is manifested by cough (dry or with sputum of a different nature), fever, chest pain, bronchial obstruction, wheezing. Bronchitis in children is diagnosed on the basis of an auscultatory picture, X-ray data of the lungs, complete blood count, sputum examination, respiratory function, bronchoscopy, bronchography. Pharmacotherapy of bronchitis in children is carried out with antibacterial drugs, mucolytics, antitussives; physiotherapy treatment includes inhalations, ultraviolet radiation, electrophoresis, cupping and vibration massage, exercise therapy.

General information

Bronchitis in children is an inflammation of the mucous membrane of the bronchial tree of various etiologies. For every 1,000 children, there are 100-200 cases of bronchitis every year. Acute bronchitis accounts for 50% of all respiratory tract infections in young children. Especially often the disease develops in children of the first 3 years of life; most severe in infants. Due to the variety of causally significant factors, bronchitis in children is the subject of study in pediatrics, pediatric pulmonology and allergology-immunology.

Causes of bronchitis in children

In most cases, bronchitis in a child develops after a viral illness - influenza, parainfluenza, rhinovirus, adenovirus, respiratory syncytial infection. Somewhat less often, bronchitis in children is caused by bacterial pathogens (streptococcus, pneumococcus, Haemophilus influenzae, Moraxella, Pseudomonas aeruginosa and Escherichia coli, Klebsiella), fungi from the genus Aspergillus and Candida, intracellular infection (chlamydia, mycoplasma, cytomegalovirus). Bronchitis in children often accompanies the course of measles, diphtheria, whooping cough.

Bronchitis of allergic etiology occurs in children sensitized by inhaled allergens entering the bronchial tree with inhaled air: house dust, household chemicals, plant pollen, etc. In some cases, bronchitis in children is associated with irritation of the bronchial mucosa by chemical or physical factors: polluted air, tobacco smoke, gasoline vapors, etc.

There is a predisposition to bronchitis in children with a burdened perinatal background (birth trauma, prematurity, malnutrition, etc.), constitutional anomalies (lymphatic-hypoplastic and exudative-catarrhal diathesis), congenital malformations of the respiratory system, frequent respiratory diseases (rhinitis, laryngitis, pharyngitis, tracheitis), impaired nasal breathing (adenoids, deviated nasal septum), chronic purulent infection (sinusitis, chronic tonsillitis).

In epidemiological terms, the most important are the cold season (mainly the autumn-winter period), seasonal outbreaks of SARS and influenza, the stay of children in children's groups, and unfavorable social and living conditions.

The pathogenesis of bronchitis in children

The specificity of the development of bronchitis in children is inextricably linked with the anatomical and physiological characteristics of the respiratory tract in childhood: abundant blood supply to the mucosa, looseness of the submucosal structures. These features contribute to the rapid spread of the exudative-proliferative reaction from the upper respiratory tract to the depth of the respiratory tract.

Viral and bacterial toxins inhibit the motor activity of the ciliated epithelium. As a result of infiltration and edema of the mucosa, as well as increased secretion of viscous mucus, the “flickering” of the cilia slows down even more - thereby turning off the main mechanism of self-purification of the bronchi. This leads to a sharp decrease in the drainage function of the bronchi and difficulty in the outflow of sputum from the lower respiratory tract. Against this background, conditions are created for further reproduction and spread of infection, obturation with a secret of the bronchi of a smaller caliber.

Thus, the features of bronchitis in children are the significant length and depth of the lesion of the bronchial wall, the severity of the inflammatory reaction.

Classification of bronchitis in children

By origin, primary and secondary bronchitis in children are distinguished. Primary bronchitis initially begins in the bronchi and affects only the bronchial tree. Secondary bronchitis in children is a continuation or complication of another pathology of the respiratory tract.

The course of bronchitis in children can be acute, chronic and recurrent. Taking into account the extent of inflammation, limited bronchitis (inflammation of the bronchi within one segment or lobe of the lung), widespread bronchitis (inflammation of the bronchi of two or more lobes) and diffuse bronchitis in children (bilateral inflammation of the bronchi) are isolated.

Depending on the nature of the inflammatory reaction, bronchitis in children can be catarrhal, purulent, fibrinous, hemorrhagic, ulcerative, necrotic and mixed. In children, catarrhal, catarrhal-purulent and purulent bronchitis is more common. A special place among the lesions of the respiratory tract is occupied by bronchiolitis in children (including obliterating) - bilateral inflammation of the terminal sections of the bronchial tree.

According to etiology, viral, bacterial, viral-bacterial, fungal, irritant and allergic bronchitis in children are distinguished. By the presence of an obstructive component, non-obstructive and obstructive bronchitis in children are distinguished.

Symptoms of bronchitis in children

Development acute bronchitis in children, in most cases, signs of a viral infection precede: sore throat, coughing, hoarseness, runny nose, conjunctivitis phenomena. Soon there is a cough: obsessive and dry at the beginning of the disease, by 5-7 days it becomes softer, moist and productive with the separation of mucous or mucopurulent sputum. In acute bronchitis, a child has an increase in body temperature up to 38-38.5 ° C (lasting from 2-3 to 8-10 days depending on the etiology), sweating, malaise, chest pain when coughing, in young children - shortness of breath. The course of acute bronchitis in children is usually favorable; the disease ends with recovery in an average of 10-14 days. In some cases, acute bronchitis in children can be complicated by bronchopneumonia. With recurrent bronchitis in children, exacerbations occur 3-4 times a year.

Obstructive bronchitis in children it usually manifests in the 2-3rd year of life. The leading symptom of the disease is bronchial obstruction, which is expressed by paroxysmal cough, noisy wheezing, prolonged exhalation, remote wheezing. Body temperature may be normal or subfebrile. The general condition of children usually remains satisfactory. Tachypnea, shortness of breath, participation in breathing of auxiliary muscles are less pronounced than in bronchiolitis. Severe obstructive bronchitis in children can lead to respiratory failure and acute cor pulmonale.

Chronical bronchitis in children it is characterized by exacerbations of the inflammatory process 2-3 times a year, occurring sequentially for at least two years in a row. Cough is the most constant sign of chronic bronchitis in children: during remission it is dry, during exacerbations it is wet. Sputum is coughed up with difficulty and in small quantities; has a mucopurulent or purulent character. There is a low and intermittent fever. Chronic purulent-inflammatory process in the bronchi may be accompanied by the development of deforming bronchitis and bronchiectasis in children.

Diagnosis of bronchitis in children

Primary diagnosis of bronchitis in children is carried out by a pediatrician, specifying - by a children's pulmonologist and a children's allergist-immunologist. When establishing the form of bronchitis in children, clinical data are taken into account (the nature of cough and sputum, the frequency and duration of exacerbations, course features, etc.), auscultatory data, and the results of laboratory and instrumental studies.

The auscultatory picture in bronchitis in children is characterized by scattered dry (with bronchial obstruction - whistling) and moist rales of various sizes.

In the general analysis of blood at the height of the severity of the inflammatory process, neutrophilic leukocytosis, lymphocytosis, and an increase in ESR are detected. Eosinophilia is characteristic of allergic bronchitis in children. The study of the gas composition of the blood is indicated for bronchiolitis to determine the degree of hypoxemia. Of particular importance in the diagnosis of bronchitis in children is sputum analysis: microscopic examination, sputum culture, AFB analysis, PCR analysis. If it is impossible for the child to independently cough up bronchial secretions, bronchoscopy with sputum sampling is performed.

X-ray of the lungs with bronchitis in children reveals an increase in the pulmonary pattern, especially in the root zones. During the FVD, the child may have moderate obstructive disorders. During an exacerbation of chronic bronchitis in children with

Bronchitis occurs when inflammation of the lining of the bronchi caused by viruses or bacteria. In infants - as a complication of SARS or diseases of the upper respiratory tract. It manifests itself primarily as a cough - first dry, then wet.

A pediatrician should make a diagnosis and prescribe treatment. What does it consist of, and how else can parents help the child?

Features of the treatment of bronchitis in infants

In young children (up to a year), bronchitis is dangerous because it can quickly become chronic from acute and even be complicated by pneumonia.

The most dangerous form of bronchitis in infants is bronchiolitis - spread of inflammation to small bronchi due to viral infection . The condition of the crumbs deteriorates sharply, his shortness of breath increases and cyanosis occurs.

In no case should you hesitate to call a doctor if the baby is less than a year old or has a fever (above 38 degrees), shortness of breath, cyanotic lips and nails, and a strong unproductive cough. In such a situation, immediate hospitalization is necessary.

Until the ambulance arrives, the parents' help will consist of relieving the symptoms of a cold

1. It is necessary to create the optimal temperature and humidity using heaters and humidifiers, ventilate the room by going out with the child to another room.
2. At a low temperature and the absence of allergic reactions to facilitate breathing crumbs can be lubricated legs with warming creams and ointments.
3. You can hold your baby in your arms over the steam to alleviate a cough. from a container with a hot weak solution of salt (but this is if the child does not have a fever!).
4. Give your baby plenty to drink to avoid dehydration . If you refuse breast or bottle, drink clean water from a teaspoon - little by little, but often.

In the hospital, the child will be prescribed a number of medications and procedures.

• Inhalation and oxygen breathing to get rid of signs of respiratory failure.
• Preparations with interferon.
• Antihistamines to relieve swelling and avoid allergic reactions to drugs.
• Rehydrants for dehydration.
• Antibiotics — only if there is a need for them. Augmentin, Sumamed, Amoxiclav, Macropen, Cefotaxime, Ceftriaxone are usually prescribed.

How to treat acute bronchitis in children after a year?

In severe cases, the disease will also require hospitalization. It is possible to treat children older than a year on an outpatient basis with mild forms of the disease in compliance with the regimen and recommendations of the doctor.

To successfully overcome the disease, you will need to take a number of necessary measures.

• Neutralize the cause of the infection - viruses, bacteria or allergens.
• Remove puffiness respiratory tract.
• Reduce the viscosity of sputum for her best escape.
• Relieve dry cough .

Parents should know what can and should be done at home

1. The basis of the treatment of bronchitis is the observance of bed rest, and a plentiful warm drink every 30-40 minutes (teas, fruit drinks, herbal decoctions, boiled milk with honey and butter, Borjomi, rosehip infusion).
2. The room where the baby is located should be warm (20-220 C), but well ventilated. To maintain the required humidity of 70%, it is necessary to carry out frequent wet cleaning without products containing chlorine, use a humidifier or wet towels with batteries. Avoid passive smoking. Continue walking only after the heat has subsided; you can also “walk” at home, wrapping the baby in a blanket, sitting at an open window or window for 10-15 minutes.
3. All medicines assigned solely on an individual basis.
4. Additional activities (distracting and soothing) can be used only if there are no contraindications and discomfort in the baby. A good help in the treatment will be a tapping massage and baths with decoctions of anti-inflammatory herbs (in the absence of fever). Again, all this is done only in the absence of a high temperature and on the recommendation of a doctor!
5. During the illness, it is recommended adhere to a strict dairy and vegetable fortified hypoallergenic diet. The food is fractional, the food should be enough high-calorie.

What will the doctor prescribe

1. Medications to relieve a wet cough (may be given but not required)

• Mucolytics to loosen mucus- Ambroxol (Fervex, Lazolvan), Acetylcysteine, Bromhexine; required when antibiotics are prescribed.
• Expectorants for the removal of sputum from the bronchi- Pertussin, Mukaltin, herbal products (they use marshmallow, anise, elecampane, thermopsis, licorice, plantain). Infants are not prescribed because of the possibility of a gag reflex and increased cough.

2. Medications to relieve dry non-productive cough : Stoptussin, Sinekod.

3. Broad-spectrum antibiotics if needed . They are prescribed with caution, if a bacterial origin of the infection is suspected and for babies up to six months old - to prevent pneumonia. In other cases, according to the well-known pediatrician E. Komarovsky, they do not reduce, but increase the risk of various complications - allergies, dysbacteriosis and the formation of resistance of microorganisms to the drug.

4. Paracetamol Syrups to Reduce Inflammation and Fever - at elevated temperatures.

5. Preparations to increase immunity and fight viruses - vitamin C, echinacea, Bronchomunal, Aflubin, Umckalor, Anaferon, products with interferon.

Pharmaceutical preparations should be given according to the schedule at the same time of day. You should not mix several drugs - start a diary and mark the intake of all medications.

• Inhalation using specially designed devices - steam, oil inhaler or nebulizer. For procedures, saline solution, mineral water, soda solution, essential oils are used.
• Steaming the legs and rubbing them with warming ointments - if there is no temperature and allergies.
• Warm compresses with sunflower oil on the back and right side of the chest. Put in the evening in the absence of temperature.
• Vibrating chest massage . It is prescribed when a wet cough appears, it is not used in the acute period of the disease and with fever. The child is laid on the tummy so that the head is lower than the legs. The skin is stroked, and then beaten from the bottom up towards the spine for 8-10 minutes. After the procedure, the child must clear his throat, so very young children cannot be massaged.
• Turning babies more often from one side to the other - this will cause the movement of sputum and a reflex cough.
• Breathing exercises : "Blow up the balloons" and "Blow out the candles".

Obstructive bronchitis in young children, what to do?

If, with bronchitis, a significant accumulation of mucus caused blockage of the bronchi, the cough became hoarse, and the breath "whistles", then the child's condition is already quite serious and requires urgent treatment.

The primary task is to restore the patency of the bronchi

1. Try to calm yourself and calm the baby , because with excitation, respiratory failure increases. Age-appropriate sedatives can be used.

2. Do not refuse hospitalization, the hospital will help the child!

• Make an inhalation using a nebulizer or ultrasonic inhaler Effectively and quickly stop obstruction with a mixture of salbutamol and glucocorticoid hormones. It is possible to use mineral water, alkaline soda solution, essential oils and medicinal herbs (if there is no allergy), drugs for sputum thinning. Up to 2 years, inhalations are used only in cases where the child is not afraid of the device, does not cry and does not break out of his hands.
• They will give you a “breathe” with humidified oxygen.
• With severe dehydration and intoxication prescribe infusion therapy with intravenous bronchodilators.
• Conduct medical therapy according to the basic scheme with the use of antibiotics, expectorants, antihistamines, antipyretics, immunostimulating and antiviral drugs, physiotherapy and vibration massage.

Important! Antibiotics are prescribed only for bacterial origin of the infection. Antibiotics are contraindicated for obstruction due to allergies or a virus.

Mode, hygiene, diet, drinking plenty of water and additional actions of parents - breathing exercises, vibration massage to facilitate mucus discharge, compresses - are the same as in acute bronchitis.

An additional postural massage will be useful - tapping on the back of the child in the morning. The baby is laid on the tummy (the head should be lower than the legs) and tapped with the ribs of the palms folded in a boat for about 10 minutes. Then the child needs to clear his throat.

Besides, allowed to walk for an hour a day, dressing for the weather , away from roads (so as not to breathe dust and exhaust gases) and places where many children play (so as not to provoke excessive excitement).

Folk remedies for the treatment of bronchitis in children

Rubbing can be applied with baked onions and bear or badger fat , cabbage-honey cakes, steam legs with mustard or infusions of sage, chamomile, St. John's wort, mint in water with a temperature not exceeding 40⁰С.

Prohibited methods of treatment for bronchitis in children under 2 years of age

Bronchitis in children under 2 years of age requires a balanced and responsible approach to treatment from parents. It should be remembered that some actions can lead to a sharp deterioration in the child's condition.

What can't be done?

1. Unauthorized change in drug dosages and to carry out treatment longer than the appointed time.
2. Use untested "folk remedies" especially for infants and children with a tendency to allergic manifestations. External agents are tested by applying with a cotton swab or disk on the skin behind the ear or in the elbow bend, internal ones - at the tip of a teaspoon. In case of any negative reactions in a child during the day, it is forbidden to use the remedy.
3. Bathe the baby in the bath . The respiratory muscles in children are immature, the process of coughing is difficult. When steaming, sputum clots in the bronchi “swell” even more and it becomes much harder to cough them up - the baby wheezes and chokes, choking on liquid.
4. At elevated body temperature is contraindicated wrapping, rubbing with ointments with a warming effect and baths. Such procedures increase the fever and can be harmful.
5. Perform physiotherapy procedures during the acute period of the disease.
6. Use rubbing any warming ointment or balm, inhalation with essential oil and other products with pungent odors, put mustard plasters. In children under 2 years of age, they can lead to allergic reactions and bronchospasm.
7. Giving a child up to a year of expectorants . These funds dilute sputum, but act only in the upper respiratory tract, not reaching the bronchi. The baby's larynx and nose are additionally clogged, it becomes even more difficult for him to breathe.
8. Give infants codeine-containing drugs.
9. Use medicines in the form of aerosols - this can lead to a spasm of the glottis, the baby will begin to choke.

Timely treatment will surely give a quick result, and the baby will delight you with good health and cute pranks.

Bronchitis is a pathological inflammatory process that develops in the wall of the bronchus under the action of provoking factors - viral or bacterial agents. Due to the total action of provoking factors and the emergence of favorable conditions for the further growth, reproduction and spread of microbes in the bronchial tree, bronchitis appears.

The main symptoms of the disease are the presence of intoxication of the child's body (fever, headache, nausea, lack of appetite, weakness, lethargy, apathy, drowsiness), the appearance of a dry cough, unproductive or wet with sputum and shortness of breath.

Favorable conditions for the development of the inflammatory process in the bronchi are:

• hypothermia of the body;
• malnutrition;
• lack of vitamins (hypovitaminosis, beriberi);
• decreased immunity;
• frequent acute inflammatory diseases in other organs of the child;
• exacerbation of chronic processes.

Treatment of bronchitis is reduced to the appointment of several groups of drugs, which are selected based on the action of the provoking factor (virus or bacterium) and the presence of relevant symptoms (fever, dry or wet cough and shortness of breath). Conservative treatment in conditions of improved well-being should be supplemented by physiotherapy, courses of which are carried out for another 1-2 weeks after the cessation of the main symptoms.

Also, to alleviate the condition of the child, alternative treatment is prescribed with the use of decoctions and infusions of herbs, applications on the chest area and rubbing using badger, goose or pork fat.

Conservative therapy

It is worth treating bronchitis with drugs on the first day of the onset of the disease. The choice of drugs depends on the manifestations of the disease themselves.

In the presence of high body temperature (up to 40 0 ​​C), severe symptoms of intoxication and meager manifestations of damage to the bronchial tree - a slight dry or unproductive cough with clear or whitish sputum discharge, antiviral drugs are prescribed, since presumably, according to the child's symptoms, this bronchitis was provoked viral infection.

The most effective antiviral drug in children with bronchitis is human recombinant interferon - Laferobion, which has an immunostimulating and immunomodulatory effect by stimulating an increase in the level of immunocompetent cells (mast cells, leukocytes, lymphocytes, plasma cells, basophils, antibodies) in the blood. It is prescribed for children up to a year at 150,000 IU 3 times a day in the form of rectal suppositories, for children from 1-2 years old, 500,000 IU 3-4 times a day. It is best to treat with this drug for 3 to 5 days.

If there is a slight body temperature, a relatively good and active condition of the child, along with severe symptoms of bronchial tree damage, which are characterized by an intense cough with yellow or greenish viscous sputum with an unpleasant odor and shortness of breath, they indicate the presence of bronchitis of a bacterial nature and in this case antibiotics are prescribed wide spectrum of activity.

Azithromycin (Sumamed) is the drug of choice for bacterial bronchitis, as it is a broad-spectrum antibiotic and additionally affects protozoal and intracellular infection. The drug is available in tablets and syrup, which allows it to be prescribed even to infants. It is necessary to take the medicine 1 time per day. Treat with the drug for no more than 3 days.

Bronchitis in a child is often accompanied by severe manifestations of intoxication, which can be stopped and help to improve well-being such drugs as:

Ibuprofen (Nurofen), which has antipyretic, analgesic and anti-inflammatory effects. It is prescribed for children under 2 years old in rectal suppositories, 1 suppository 2 times a day, for children from birth and up to 12 years old in syrup:

For children over 12 years of age, chewable tablets or capsules. It is allowed to treat with this drug for no more than 7 days.

Children's paracetamol (Panadol) has an antipyretic and anti-inflammatory effect, improves the well-being of a child with bronchitis. It is prescribed in drops, rectal suppositories and syrup for children under 12 years old, over 12 years old in capsules. This remedy must be taken 3-6 times a day. You can treat the drug for no more than a week.

Citrulline malate (Stimol) is a general tonic that has detoxifying activity and normalizes metabolic processes in the child's body. It is prescribed 1 sachet, which must first be dissolved in ½ cup of boiled water, taken 2 times a day for 10 days.

In order to relieve cough and improve sputum discharge, mucolytic drugs are prescribed.

Mucolytic drugs are prescribed when a child has a dry or wet cough. Cough is a reflex to foreign bodies (dust, pollen, food, water) entering the bronchi or excessive accumulation of mucus (sputum) in them. The drugs eliminate cough by acting on the cough center in the brain, as well as by thinning sputum and stimulating the motor activity of cilia on the surface of the bronchial epithelium, which additionally helps to clear the lumen. The cough first becomes unproductive, then productive, and after 5-7 days of taking the drugs completely disappears.

Ambroxol (Ambrobene, Flavamed, Lazolvan) in drops and syrup are prescribed from 1 year old, in tablets from 12 years old 3 times a day. Treat for at least 10 days. There is also a children's Lazolvan, adapted only for inhalation using a nebulizer. It can be used by children from birth.

Acetylcysteine ​​(ACC) is used to thin sputum in children over 4 years of age who have a cough. The drug is available in tablets and sticks with a dosed powder, which must be dissolved in ½ cup of boiled water. Acetylcysteine ​​200 mg is taken 4 times a day, 400 mg - 2 times a day and 800 mg - 1 time per day for 10 days. One of the pronounced and common side effects of this drug are stomach pain and heartburn, since the drug contains acid in its composition.

If a child develops choking (shortness of breath at rest) or shortness of breath, which is associated with minor and moderate physical exertion, bronchodilator drugs are prescribed.

Salbutamol - has a relaxing effect, which is directed to the smooth muscles of the bronchi. It is used in children from one year old in the form of aerosols, in children under one year old in the form of nebulizer inhalations only on demand, that is, at the time of suffocation. The medicinal effect of the drug lasts from 30 minutes to 2 hours, and begins its action immediately after the erosol has hit the walls of the bronchial tree.

Plentiful drinking helps to reduce the manifestations of intoxication. For children, it can be teas, warmed fruit drinks, milk, compotes and herbal decoctions. Some herbs, along with detoxifying activity, help eliminate the cough reflex and improve sputum production.

St. John's wort, succession, chamomile, sage and plantain are taken in equal proportions. Herbs are ground with a coffee grinder or blender to a powder. 2 tablespoons of herbs are poured with a glass of boiling water and infused for 10 minutes. Children should be given this remedy warm 1/3 cup 3 times a day. One dose of tea leaves is enough for a day. You can treat with these herbs for 1 - 2 weeks. Cough in children on average goes away after 4 to 5 days.

Licorice root, marshmallow root, cranberries, viburnum and wild rose are crushed in a meat grinder. 4 tablespoons of the resulting mixture is poured with a liter of boiled water and brought to a boil over a fire. The broth is allowed to boil over low heat for 15 minutes and then covered with a lid and allowed to brew. It is recommended to take this remedy 2 times a day for ½ cup. For a child, add 1 tablespoon of honey to the decoction before drinking. Honey is used to improve taste and is a natural antioxidant, the purpose of which is to strengthen the protective properties of the body (immunity) of the child. Cough becomes much less after 3 to 5 days of taking the decoction.

Milk, especially cow's milk, is used in children when a severe, debilitating cough occurs. Milk can calm the cough reflex, which in patients with bronchitis is exacerbated in the evening and at night, making it difficult to rest and disturb sleep. Milk also contains a large amount of protein, fats and vitamins that nourish the child in conditions of poor appetite during intoxication and thereby strengthen the body and help fight pathological microbes.

Boiled cow's milk is well heated, but not brought to a boil, ½ teaspoon of baking soda and the same amount of butter are added to 1 glass of milk. To improve the taste of the resulting mixture, use honey, 1 teaspoon per 1 cup. In the absence of cow's milk, goat's milk can be substituted.

Give this remedy to a child with bronchitis should be at night, already in bed. It is necessary to drink in small sips for 5 to 10 minutes. After taking the remedy inside, the cough completely calms down after 5 minutes.

One of the methods of alternative treatment is rubbing the chest. Rubbing stimulates blood flow in the lung tissue and, as a result, cleanses the bronchial tree from microbial agents, which significantly speeds up the healing process of children. Rubbing also has a warming effect, which gives them the opportunity, albeit for a short time, to save children from coughing.

The most effective among rubbing in children with bronchitis is a remedy such as badger fat.

Badger fat is a subcutaneous fat that is rich in organic and inorganic amino acids, unsaturated fats and vitamins.

Badger fat has anti-inflammatory, antioxidant and immunostimulatory effects.

The versatility of this tool lies in the fact that it can be used both externally and taken internally.

Outwardly, badger fat is used in children who are tormented by a dry or unproductive cough with a warming function. Badger fat also stimulates blood circulation in the lung tissue and eliminates congestion in the bronchi of medium and small caliber.

Badger fat for external use is applied at night, on the skin of the chest and back with light massaging movements in a thin layer and rubbed into the skin until a film forms on it. After that, the body of the child is wrapped in a blanket.

Inside, badger fat is used to increase immunity, which is also important for children with bronchitis.

The remedy should be given 1 dessert spoon (10 ml) 2 times a day. Badger fat is best taken with food, as the predominance of the substances contained in it are fat-soluble, and the therapeutic effect is thus more pronounced.

Badger fat can be used externally in children over 1 year of age and internally over 6 years of age. Badger fat, according to the observations of doctors, did not give pronounced side effects when taken orally or externally.

Applications on the chest

Applications or lozenges on the chest and back are used to calm coughs and improve blood circulation in the bronchi of children.

A cake with honey is used for children over 1 year old. Honey, sunflower oil and flour are mixed in equal quantities. The mixture is applied to the skin of the chest and back, then wrapped in polyethylene or tracing paper, covered with a terry towel on top.

Mustard tortilla is used for children over 6 years old. Mustard powder is mixed with warm boiled potatoes and laid out on the skin of the back, covered with tracing paper and a terry towel.

Applications are performed at night. The child is treated like this for no more than 3-4 days.

Physiotherapy

• inhalations with aromatic oils;
• chest massage;
• electrophoresis - the introduction through the skin of the chest using an electric current
• medicines;
• heating with the use of low-frequency electric currents and magnetic fields.

Video: Bronchitis, bronchitis in children, acute bronchitis in children