False croup (stenosing laryngotracheitis) in children for information! False croup - causes of the disease, main symptoms, emergency care for a child, medications Treatment of false croup in children Komarovsky

Croup is not an independent disease and is a syndrome that accompanies various respiratory diseases.

In pediatrics, this condition is not uncommon. When an infection occurs in a child, spasm of the laryngeal muscles and narrowing of the lumen of the larynx.

Lack of timely diagnosis and proper treatment can cause serious complications endangering the life of the baby. We will talk about the symptoms and treatment of croup in children in the article.

Concept and features

Croup is a syndrome that is provoked infectious and inflammatory diseases of the upper respiratory tract.

In this condition, swelling of the mucous membranes of the larynx and narrowing of its lumen occurs.

Croup always appears in the form characteristic cough in combination with additional symptoms.

In a broad sense, this syndrome is an inflammation of the larynx or a consequence of laryngitis.

Peculiarities diseases:

• croup can be true or false (in the first case, the disease develops against the background of diphtheria, in the second, it is provoked by diseases of other categories);
• in otolaryngology, croup has a second name - stenosing laryngitis;
• at risk are children from three months to five years;
• croup can be a complication of tracheitis or bronchitis.

Causes

Can provoke the development of croup certain types of bacteria and viruses. In rare cases, the pathological process has a fungal etiology. Infection agents enter the child's body mainly by airborne droplets.

Increases the risk of developing croup, weakened immunity of the child and the presence of concomitant diseases.

The tendency to this syndrome increases in the presence of such factors as birth trauma of the baby, fetal hypoxia, development of rickets or the presence of chronic respiratory diseases.

Causes the occurrence of croup in children are complications of the following diseases:

• damage to the body by bacteria;
• pharyngitis;
• laryngotracheitis;
• ARI and SARS;

Symptoms and signs

Some symptoms of croup are common and appear regardless of the stage or etiology of the infectious process.

The main symptom of the syndrome is characteristic, indicating a violation of the supply of oxygen to the lungs.

The presence of this symptom is cause for immediate medical attention. Croup can develop at a rapid pace and within a short period of time the lumen of the child's larynx will narrow to critical levels.

Symptoms croup in children are the following conditions:

• voice dysphonia;
• swelling of the mucous membranes of the larynx;
• "barking" or "whistling" cough;
• difficulty breathing;
• increase in body temperature;
• noisy breathing;
• difficulty swallowing;
• inspiratory dyspnea;
• symptoms of intoxication of the body;
• restlessness or lethargy;
• increased salivation;
• pallor of the skin;
• signs of tachycardia;
• dyspnea;
• headache;
• a significant decrease in appetite;
• blue tint of lips and nails;
• increased fatigue;
• general sluggish state of the body.

Forms and stages

Croup is a combination of several pathological processes. First, laryngeal edema develops, provoking reflex contraction of her muscles. Then a significant amount of mucus and sputum accumulates in the lumen.

The consequence of such processes is stenosis of the larynx. When air is inhaled, less oxygen enters the lungs. In the absence of timely treatment, there is a risk of complete blockage of the lumen of the larynx and the death of a small patient.

Classification groats:

• due to the occurrence of croup, it can be bacterial, viral or fungal;
• according to etiology, the syndrome is further subdivided into spasmodic and croup with stridor (in the first case, the pathological process is accompanied by spasms, in the second - by noisy breathing);
• true and false croup (differences in the progression of symptoms);
• true croup develops in three stages - catarrhal, stenotic and asphyxic stage;
• false croup progresses in four stages - compensated, subcompensated, decompensated stenosis and the terminal stage of the syndrome.

How to treat whooping cough in children? Learn about it from ours.

Can there be complications?

The main and most dangerous complication of croup is death child. There may be a risk of such a condition if the baby is treated incorrectly or untimely.

If the child’s cough does not go away for a long time, does not reduce its symptoms when using medicines, or has acquired a “barking” character, you should immediately contact a medical institution for a comprehensive examination of the baby.

Complications croup can become the following states:

• chronic conjunctivitis;
• pneumonia;
• meningitis;
• sinusitis;
• otitis;
• bronchitis.

How to confirm the diagnosis?

Diagnosis of croup in a child can pediatrician or otolaryngologist. In some cases, it may be necessary to consult a pulmonologist to assess the complications of a bronchopulmonary disease.

If diagnosis is difficult, doctors give referrals to other specialized specialists. Confirmation of the diagnosis is carried out on the basis of a visual examination of the child, the collected anamnesis, data from laboratory and instrumental studies.

At diagnostics croup in children, the following procedures are used:

• laryngoscopy;
• otoscopy;
• lumbar puncture;
• PCR study;
• auscultation of the lungs;
• blood gas analysis;
• serological studies;
• ELISA and RIF diagnostics;
• X-rays of light;
• general analysis of blood and urine;
• bacterial culture of swabs from the pharynx;
• pharyngoscopy;
• x-ray of the paranasal sinuses and larynx;
• biochemical analysis of blood and urine.

Treatment

When diagnosing a child's croup, it is imperative placed in a hospital(infection department).

Methods of therapy for the syndrome depend not only on the age and individual characteristics of the baby's body, but also on the degree of progression of the pathological process.

Most procedures are carried out intravenous or intramuscular injections.

In this case, antidiphtheria solutions, glucose, glucocorticosteroids and other drugs can be used. After discharge, the child is prescribed drugs for symptomatic treatment.

Preparations

List of drugs needed to treat croup depends on the clinical picture the health status of the child and the trend towards recovery after a stay in the hospital.

Only a specialist should compile a list of medicines. Cough with croup has some features and involves complex treatment with certain types of medicines.

Incorrect selection of them will reduce the effectiveness of therapy and increase the risk of complications.

With croup the following drugs can be used:

• antiviral agents (Proteflazid, Interferon);
• means to eliminate laryngeal edema (Epinephrine);
• drugs to eliminate spasm of the laryngeal muscles (Salbutamol);
• broad-spectrum antispasmodics (Baralgin);
• drugs of the mucolytic group (Ambroxol, Carbocysteine).

Inhalations

It is possible to use the inhalation method for croup in a child only after a full examination of the baby and consultation with a specialist.

In the presence of elevated body temperature, such procedures are strictly prohibited.

If the doctor approves the conduct of inhalations, then they can be carried out by the steam method or with the help of nebulizer.

In the first case, the child needs to breathe steam herbal decoctions(chamomile, calendula, St. John's wort), Furacilin solution or baking soda. For the nebulizer, special oily and alkaline liquids can be used.

Folk remedies

Alternative medicine prescriptions can be used as an adjunct to basic therapy cereals, but they cannot be used as independent means.

Examples of folk remedies:

1. Brine to prevent blockage of the nasal passages (dilute a teaspoon of salt in one glass of water, instill the remedy several times a day in each nasal passage, one or two drops).
2. Medical fee for gargle(Three parts of oak bark, sage leaves and one part of fennel are combined in one container, a tablespoon of the resulting mixture is placed in a thermos and pour boiling water, use the gargle several times a day).
3. Gargling peppermint solution(Pour one teaspoon of the dry mixture with a glass of boiling water, after infusion and cooling, use the agent to rinse or irrigate the throat several times a day).

The doctor clearly explains how to distinguish laryngitis from a dangerous syndrome.

In the first case, an inflammatory process develops, which only leads to a narrowing of the larynx, in the second - the lumen narrows to a critical state. Croup is a consequence of laryngitis.

1. With croup, in no case should you use antitussive drugs on your own.
2. Therapy of the syndrome should be accompanied by additional preventive measures (wet cleaning of the room, ventilation of the room, etc.).
3. Croup can be provoked by the wrong actions of parents in the treatment of acute respiratory infections or acute respiratory viral infections (for example, it is strictly forbidden to use drugs and folk remedies for such diseases that have the ability to provoke laryngeal edema - honey, mustard plasters, improper inhalations, etc.).
4. During the period of infection, it is necessary to actively strengthen the baby's immunity (with a diet or special preparations).
5. Antibiotics in the treatment of the syndrome are used only in rare cases (this category of drugs is characterized by low efficiency in the treatment of croup and helps to get rid of only secondary infections).

Forecast

Forecasts for croup directly depend on the individual characteristics of the child's body, the level of its protective functions and timely treatment measures syndrome.

If all the recommendations of doctors are followed, then complications may not occur.. Otherwise, there is a risk of the child developing severe pathological processes in the respiratory organs (pneumonia) or their chronic diseases (bronchitis).

Prevention

The main measure for the prevention of croup is the timely treatment of diseases that can provoke this syndrome.

If the symptoms of such pathological processes do not go away for a long time, then there is a need for a mandatory re-examination of the baby by a specialist.

Parents should pay attention to strengthening the immunity of the child from the first days of his life.

Prevention croup in children includes the following recommendations:

• monitoring the nutrition of the baby at any age (balanced diet);
• full and timely treatment of any diseases;
• timely appeal to specialists to diagnose existing violations of internal systems;
• exclusion of self-medication when coughing (or different methods of therapy are implied);
• timely implementation of mandatory vaccination (routine vaccinations).

Lethal outcomes with croup in medical practice are isolated cases.

If the syndrome is not fully cured, then there will be a risk of developing chronic respiratory diseases and the addition of a secondary infection.

In addition, croup is a dangerous condition that occurs in most cases at night and suddenly. An attack is a reason to call an ambulance.

Dr. Komarovsky on the treatment of croup in children in this video:

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My son is 5 years old. From the age of 2, we are often worried SARS With rough barking cough(4-6 times a year in autumn and winter). As a rule, the diagnosis of doctors: " Acute stenosing laryngotracheitis 1-2 tbsp. on the background SARS". I read a piece of the book presented on the Internet, but could not find an answer to the question of whether there are any measures prevention of this disease.

Responsible

The situation you described in the most detailed way with the smallest chewing of all the details is set out in the book, which can be fully downloaded and studied. For a non-medic, this can be difficult, so I will note the main thing. If it is constantly repeated, and even so often, croup, then this is not only an infection, but also a congenital anatomical feature of the larynx. The child will definitely outgrow it. This cannot be avoided, but it can be greatly facilitated. Those. you can suffocate, you can breathe noisily, or you can just sip for a couple of days, but how it turns out - it already depends on the mother. For any SARS, cold, malaise three main rules:
1. Do not remember about food until he asks.
2. Liters to drink, optimally - dried fruit compote.
3. Clean cool moist air, maximum outdoor experience. In the children's bedroom there should not be anything that cannot be dusted (carpets, books not behind glass, upholstered furniture, etc.).
Preparations: always calcium gluconate 3 tab. per day; and any lozenges for resorption (bronchicum or Dr. Mom) - constantly suck. Rinse your nose with saline.
In no case: do not inhale with steam, do not soar your legs, God forbid, mustard in any form, do not give drugs such as diphenhydramine, suprastin, tavegil, broncholithin; antibiotics and any biseptols are contraindicated.

False croup in children is a dangerous condition and requires proper parental action. Any child can develop croup, and therefore the well-known pediatrician and TV presenter Yevgeny Komarovsky strongly recommends that all parents study the signs and rules for helping babies with false croup.

About illness

Speaking of croup, many people think of the dangerous diphtheria croup, which claimed many children's lives before diphtheria vaccination was put on a grand scale. Such a croup is called true. And it is precisely the reason that distinguishes it from the false, which leads to a narrowing of the larynx.

With diphtheria, the larynx narrows due to the accumulation of diphtheria films. False croup can develop against the background of a variety of typical childhood and not only viral diseases that are accompanied by respiratory symptoms.

Croup is a complication of SARS, influenza, which develops due to swelling of the tissues of the larynx due to inflammation. The larynx in children and in the normal state is always much narrower than in an adult, but during croup it narrows even more, and in a certain place - in the vocal cords.

There is no vaccination against such a complication, it is almost impossible to predict in which of the children a common viral seasonal infection will cause croup, and in which everything will be limited to a runny nose and cough. In the absence of timely proper assistance, the child may suffocate.

Most often, cases of false croup are recorded in childhood: from birth to three years. The risks decrease by the age of 6-7 years, and after 9-10 years the likelihood of developing croup is generally minimal, because the trachea, vocal cords and larynx grow with the child, which reduces the likelihood of stenosis.

The reasons

If we talk about the diseases in which the state of croup most often develops, then infections caused by the parainfluenza virus should be put in the first place. It is followed by influenza viruses of strains A and B, adenoviruses.

In the vast majority of cases, this is not an independent disease, but a complication.

The weaker the baby's immunity, the more often the baby gets sick, the higher the likelihood that another viral infection will be complicated by a false croup. More than others, children who were born prematurely (premature), children suffering from rickets and having any other congenital or acquired chronic diseases are more susceptible to the disease.

At first, the body of any child tries to somehow compensate for the inconvenience that has arisen (in this case, stenosis), and in a compensated form, the disease is not too dangerous. But the croup tends to intensify, and therefore, simultaneously with the growth of puffiness, the decompensated stage begins, when the child's body begins to suffer from oxygen deficiency. Death can occur from asphyxia or heart failure.

Classification

About what specific pathogen led to inflammation and swelling of the larynx, experts speak as secondary information. It is much more important to distinguish the type according to the symptomatic picture, depending on the degree and severity of the symptoms.

It is this information that will be the answer to the question of what and how to do, go to the hospital or be treated at home.

• Croup of the initial degree- always compensated, the child begins to suffer from shortness of breath only after he actively moves, experiences certain loads. Breathing in is harder than breathing out.
• Croup of the second degree called medium. With it, the compensatory abilities of the body are reduced, shortness of breath is noticeable not only after physical exertion, but also in a calm state.
• False croup of the third degree- heavy. It already has signs of systemic oxygen deficiency: the child's lips turn blue, shortness of breath is strong and constant, the skin becomes poor, the breaths are difficult for the baby.
• Complications of the fourth degree- the most dangerous and difficult, with it hypoxia becomes systemic, capable of becoming lethal at any moment. Organs and systems experience oxygen starvation, especially the nervous system and brain, and therefore there may then be certain consequences of a neurological nature, even if the child survives.

Signs and symptoms

Dr. Komarovsky urges parents to focus on the triad of symptoms that always accompanies the state of false croup: difficult breathing, barking cough and hoarseness.

If all three signs are present, it is highly likely that the baby has croup.

If a child gets sick with a viral infection, this does not mean at all that this dangerous threatening condition will necessarily appear. Most often, the first symptoms of laryngeal edema begin to make themselves felt on the second or third day after the onset of a viral infection. The first is usually a dry cough that gets worse at night. Then comes the hoarseness of the voice. If the child starts crying, then the barking cough will become stronger - and this is an important diagnostic sign.

Inhalations and exhalations become noisy. At first, the changes are hardly noticeable, but then, depending on how narrow the larynx has already become, the whistling during breathing will become more noticeable.

If the false croup passes into the extreme fourth degree, two of the diagnostic signs disappear - cough and wheezing when breathing. But the pressure decreases, a convulsive syndrome may develop. In the absence of help, a hypoxic coma begins.

If the child feels bad in the evening, Komarovsky emphasizes, then at night it will certainly become even worse, since it is during the dark time of the day that the most severe attacks of croup occur. Parents should be ready to help.

How to help?

In a state of attack, the child needs urgent help.

Parents should immediately call an ambulance, not forgetting to tell the dispatcher by phone that the child has a false croup - this will speed up the arrival of the brigade.

Next, you need to take the child in your arms, try to calm him down - now he does not need unnecessary excitement, since it leads to spasms of the larynx. It is enough that the baby is already frightened by his very unusual condition, in which he cannot, as always, take a normal deep breath.

The apartment urgently needs to organize air access - to open everything that can be opened, regardless of the weather and season. If possible, it is better to take the child outside and wait for the ambulance to arrive with him.

In case of severe edema, an age-appropriate dose of an antihistamine may be given. Suitable "Suprastin". For a while, the swelling of the larynx will decrease.

You need to understand that repeated attacks are usually more severe and faster, and therefore the help of a doctor is required.

What to treat?

All over the world, according to Yevgeny Komarovsky, they try to treat false croup at home. Hospitalization as such is a great stress for a child, especially if he is taken to a hospital without a mother, and the baby is shown calm. In Russia, there is a slightly different approach, although recently it has begun to change, getting closer and closer to world practice.

Yevgeny Komarovsky argues that doctors in our country prescribe too many unnecessary drugs, sometimes ignoring those that are really needed.

Thus, the use of antibiotics, antiviral drugs is unreasonable and ineffective, and expectorants do little to help. But anti-inflammatory hormonal agents in the form of drops for inhalation help very well. Very effectively, in just a few minutes, you can remove the stenosis of the larynx by inhalation with adrenaline.

An acute inflammatory process in the organs of the respiratory tract, accompanied by edema and narrowing of the larynx, is called stenosing laryngotracheitis or, in other words, false croup. The severity of the disease is characterized by the degree of narrowing of the larynx and reaches its peak at night, when the baby is sleeping.

False croup in children is characterized by the following triad of symptoms:

• dry, ringing and continuous cough, called as croaking or barking;
• difficult, noisy breathing, shortness of breath, caused by a narrowing of the lumen of the larynx, through which air enters the lungs;
• hoarse, rough voice.

False croup does not occur as an independent disease, but as a consequence of infectious diseases. Therefore, it is often accompanied by increased body temperature. Depending on the causative agent of the disease, its indicator varies from 37 to 40 degrees Celsius.

The disease may be accompanied by an increase in lymph nodes, sore throat and swallowing. There is agitation and anxiety of the child, lack of appetite.

Symptoms of false croup in children vary depending on the degree of narrowing of the larynx. There are four degrees of development of stenosis:

• Stage 1 - compensated. Breathing is difficult only in the process of physical activity or excitement of the child. When listening to breathing, wheezing is heard as single, mainly on inspiration. There are no signs of hypoxemia. The duration of stenosis of the 1st degree is from one to two days. The body compensates for breathing difficulties and the gas composition of the blood remains normal.
• Stage 2 - subcompensated. Symptoms characteristic of false croup are intensified. Inspiratory dyspnea becomes permanent. The noisy breathing of a child can be heard in the distance. The body compensates for the supply of oxygen at the expense of the respiratory muscles, increasing its work. Additional signs of the disease appear: cyanosis around the mouth, pallor of the skin, agitation and anxiety of the child. There is tachycardia during coughing fits. The duration of stage 2 is 3-5 days.
• Stage 3 - decompensated. The increased work of the respiratory muscles cannot compensate for the lack of breathing. Blood circulation is disturbed, hypoxemia, hypercapnia and hypoxia may develop. Previously restless state is replaced by lethargy and lethargy. The pulse quickens. Breathing becomes arrhythmic, frequent and superficial due to the strong constriction of the larynx. Cough - weak and quiet. With an increase in oxygen starvation, cyanosis of the skin is noted. The general condition is assessed as severe.
• Stage 4 - asphyxia (suffocation). Breathing becomes barely audible, coughing almost stops. A deep combined acidosis develops. Hypoxemia and hypercapnia are expressed to extreme values. The child falls into a coma. The condition is assessed as extremely serious. Lethal outcome is not excluded.

At stages 1 and 2, medical symptomatic treatment is carried out. At stages 3 and 4 - hospitalization is required. Surgery may be required.

What to do with a false croup in a child?

How to relieve an attack of false croup in a child?

• It is necessary to remove clothing from the child that constrains the chest. If he is lying, raise him to a semi-sitting position.
• Give warm alkaline liquid to drink to soothe an irritated throat and relieve coughing. For this, warmed milk with the addition of soda or warm mineral water without gas is well suited.
• Attach mustard plasters to the calves of the legs. Thus, redistribution of blood from the larynx to the lower part of the body will occur.
• Give antihistamines to reduce swelling. In case of elevated temperature - antipyretic.
• If the child begins to choke, try to induce vomiting. This will help stimulate the respiratory center and clear the airways of phlegm. To do this, with a teaspoon, you should lightly press on the root of the tongue.

False croup in children: symptoms and treatment of the disease

The diagnosis of false croup is made by an emergency doctor, an otorhinolaryngologist, or a pediatrician. False croup is diagnosed very easily. But in order to find out what caused it, additional examinations may be required.

What is needed for diagnosis:

• Collecting an anamnesis (against the background of what disease arose croup).
• Examination of the patient (visual, assessment of the nature of breathing, cardiac activity, blood pressure).
• Taking a swab from the throat, followed by seeding on nutrient media to identify the pathogen.
• Blood test for the study of gas composition and acid-base state.
• Laryngoscopy to assess the condition of the mucous membranes of the respiratory tract.

The main task of treating false croup in children is to relieve the symptoms of the disease by stopping attacks of stenosis, reducing inflammation and swelling of the larynx. For this, appropriate medicines and inhalations are used.

Medical treatment includes the following drugs:

Depending on the symptoms characteristic of each stage of the development of false croup in children, appropriate treatment is prescribed.

• 1 stage. Plentiful warm drink, alkaline steam inhalations, antispastic therapy (papaverine, atropine), antihistamines, vitamins are recommended. If there is no effect, then to reduce the swelling of the larynx, an intranasal novocaine blockade is done.
• 2 stage. Hormonal (hydrocortisone), cardiac (digoxide, strophanthin), diuretics and antipsychotics (promazine, chlorpromazine) are added to the above funds.
• 3 stage. Cardiac agents and antibiotics are more widely used. If necessary, laryngoscopy and bronchoscopy are performed. As a result of the procedures, mucus, pus, dry bloody crusts are removed. If these procedures do not help, then more complex ones are performed - intubation and tracheostomy.

Symptoms of false croup in children may coincide with symptoms of other diseases:

• True croup. Occurs against the background of diphtheria. It does not develop rapidly, but gradually. A distinctive symptom is a white coating on the tonsils.
• laryngospasm. Occurs suddenly, for no reason. The child begins to choke and turn blue.
• Foreign body larynx and. There is no concomitant infectious disease. Spasmodic cough.
• Allergic edema of the larynx. There is also no infectious nature of the disease. Like false croup, it develops rapidly.

Inhalation is widely used for home treatment. For a child, inhalation with a nebulizer will be the best option. In order to moisturize the respiratory tract and reduce swelling, you can use ordinary mineral water. It is poured into a nebulizer, and the child uses a mask to breathe moist air for 10 minutes.

Well relieve symptoms and treat false croup in children such means as:

• berodual (bronchodilator);
• flemoklav (antibiotic);
• fenistil (antibiotic).

Attention

You should not do steam inhalation for young children. If you put a child in front of a hot pot and cover with a blanket, then he can not only get burned, but also get scared. Fright and excitement only increase the attacks, causing uncontrollable spasms.

If there is no nebulizer, then a thermos can be used for inhalation., in which the liquid does not cool for a long time and there is no need to cover yourself with anything. Or use a kettle with a kitchen funnel on the spout. If there is a cosmetic inhaler, then it will do.

An infant with attacks of false croup should be applied to the chest more often. For older children, avoid hot, cold and spicy foods. Talk to your doctor about foods that may cause allergies.

One of the important points in the treatment is a calm emotional and psychological state of a sick child. Therefore, parents need to take the baby with something that does not require emotional outbursts and physical stress.

Komarovsky on the treatment and symptoms of false croup in children and emergency care before the arrival of an ambulance

A well-known doctor in Russia, Komarovsky, believes that in order to cure false croup in children, the symptoms and treatment must match. In other words, he speaks out against the widespread use of antibiotics, as well as a host of other drugs, and suggests treatment with an appropriate regimen in conditions appropriate for recovery. At the same time, it recognizes that antibiotics should be used in case of a bacterial etiology of the disease.

Speaking about hospitalization, Komarovsky draws attention to the fact that if the symptoms of the disease increase in the evening, then at night it can definitely become even worse. In order to prevent a serious condition, an ambulance must be called in the evening.

To relieve the symptoms of false croup in children, Komarovsky makes the following recommendations:

• strict bed rest;
• psychological peace of the child;
• fresh air (airing the room);
• humidification of the air in the room (to exclude dryness of the mucous membranes of the larynx);
• drinking plenty of fluids (to thin sputum);
• alkaline inhalations;
• timely intake of antitussives.

False croup in children, emergency care for an attack

If the child has an attack and home treatment does not relieve it within 30 minutes, then you need to call an ambulance. If the condition worsens, you should immediately provide emergency care yourself.

What should be done?

Causes of false croup in children and prevention of the disease

Most often, the development of false croup occurs due to a common cold. This usually happens during the off-season. The weather in autumn and spring can be deceptive, and a child who is not dressed too warmly or not enough can catch a cold easily. In addition to acute respiratory infections, there are other diseases of viral etiology, which can also cause false croup in children.

Among them are such as:

• flu;
• measles;
• rubella;
• adenovirus infection;
• scarlet fever;
• chicken pox.

Along with the infectious nature of the onset of the disease, the bacterial flora also becomes the cause. It can be activated during SARS or be attached through infection.

The development of a false croup is likely as a result of damage to the larynx by the following bacteria:

• staphylococcus;
• streptococcus;
• Pseudomonas aeruginosa;
• coli;
• hemophilic bacillus;
• enterococcus.

How does false croup occur?

A virus or bacterium enters the mucous membrane of the respiratory tract and causes inflammation. There is swelling of the larynx and the formation of excess mucus in the region of the trachea of ​​the subglottic space in the region of the vocal cords. Due to the structural features of the respiratory tract and the imperfection of the nervous system that regulates reflex activity, it becomes possible to develop stenosis of the larynx (mainly at night). And what is regarded as a sore throat for an adult, becomes deadly for a small child.

Anatomical factors as the cause of false croup in children:

• funnel-shaped larynx;
• narrow lumen of the larynx;
• highly located vocal cords;
• loose connective and fatty tissues of the subglottic space;
• respiratory muscle weakness.

Most often, false croup develops in children at 2-3 years of age. Rarely occurs in the second half of the first year of life and from 5 to 6 years. Never occurs in infants under 4 months of age.

Not all children are equally susceptible to stenosing laryngotracheitis.

In addition to the anatomical and physiological features of the structure of the larynx and trachea in childhood, there are other factors that form the risk group:

• male sex (sick more often than girls 2 times);
• narrow airways (congenital stridor);
• frequent and prolonged colds;
• paratrophy (obesity in children under 3 years old);
• food or drug allergies;
• birth trauma.

To exclude laryngotracheitis with the dangerous development of laryngeal stenosis in young children, it is necessary to take preventive measures. What to do in order to avoid false croup?

1. Prevent colds:
   • exclude communication of the child with sick people;
   • if there is a sick acute respiratory disease in the house, carefully follow the rules of hygiene;
   • dress according to the weather;
   • provide proper and nutritious nutrition;
   • if you catch a cold often - give vitamins;
   • carry out promotional activities.
2. Timely and correctly treat colds:
   • observe bed rest;
   • often ventilate the room and do wet cleaning;
   • make sure that the air in the room is not dry;
   • give cough medicines in a timely manner;
   • do not use essential oils for inhalation;
   • do not smoke in the room where the child is.

Prevention of the disease is necessary if the child has been ill with false croup, as relapses are possible.

All, without exception, parents dream of their children growing up strong and healthy. But, unfortunately, these dreams do not always come true. Sick, periodically, and adults and children. But, you see, childhood illnesses can excite mom and dad much more than their own ailments. Especially if the child is still very small, and the disease proceeds rapidly, leaving no time for reflection and decision-making. For example, as it happens when false croup is diagnosed in children. An attack of this disease can unbalance anyone. And panic, in this case, is not the best helper. So it turns out that it would be most reasonable to arm yourself with information on how to act if inflammation of the mucous membrane of the larynx, or false croup, develops in your baby. After all, you can’t call this rare disease in any way. Especially in young children.

What is OSLT?

If a child in the middle of the night (there are also attacks during the day, but less often) suddenly starts to cough, and his cough is barking or croaking, and breathing is difficult on inspiration and is accompanied by wheezing, it can be assumed that he has - attack of false croup .

Croup, in its classic form, is seen in diphtheria. A false croup has similar symptoms, but the reasons for its development are different.

With diphtheria, airway patency is impaired due to the formation of specific dense films in the upper part of the duct. And with false croup, the child’s breathing becomes difficult due to swelling of the mucous membrane and loose tissue of the larynx and trachea.

In the depths of the larynx, under the vocal cords, the connective tissue is quite richly supplied with lymphatic and blood vessels. Therefore, the larynx tends to react very actively with edema to any irritants: be it or.

False croup is popularly called stenosis of the larynx. Depending on its localization, there is acute stenosing laryngitis (ASL) and acute stenosing laryngotracheitis

Due to the fact that in young children the lumen of the larynx is still not at all large, it is they who are most often subject to attacks of false croup. And the older the child, the less likely it is to develop this disease.

False croup (stenosis of the larynx) or subglottic laryngotracheitis, or ASL (acute stenosing laryngitis), or OSLT (acute stenosing laryngotracheitis) - depending on the location of inflammation and edema - this is inflammation of the mucous membrane of the upper respiratory tract (larynx, trachea), resulting in a narrowing of the lumen of the larynx.

Such inflammation develops due to a viral or bacterial infection entering the baby's respiratory tract. It is the infection that causes an inflammatory process, swelling and an increase in the production of mucous secretions in the area of ​​the subglottic space, vocal cords and trachea.

The cause of laryngeal edema can also be allergic reactions of the crumbs to various irritants that enter his body from the outside.

That is, it is not entirely correct to consider OSL (OSLT) as an independent disease. Rather, it is a group of diseases, or a consequence of allergies, acute respiratory viral infections, acute respiratory infections, parainfluenza, adenovirus infection, tonsillitis, scarlet fever, etc.

But an important role is also played here by the factor of the child's physiological predisposition to.

False croup is rather a consequence or complication of an infectious disease or an allergic reaction of the body.

When can a child get false croup?

It is the anatomical and physiological characteristics of the respiratory tract of young children that explains the fact that they are most often subjected to attacks of false croup.

• Short vestibule, funnel-shaped and small diameter of the lumen of the larynx.
• The softness of the cartilaginous skeleton.
• Disproportionately short vocal folds, located, moreover, too high.
• Hypersensitivity, hyperexcitability of the muscles that close the glottis.
• Functional immaturity of the respiratory organs, etc.

All these are objective factors in the development of OSLT. Subjective reasons include:

• IUGR (intrauterine growth retardation).
• Prematurity.
• Birth trauma.
• Childbirth by caesarean section.
• constitutional anomalies.
• SARS, acute respiratory infections and other infectious diseases.
• Allergic reactions.
• post-vaccination period.
• Entry of foreign bodies into the respiratory tract.
• Laryngeal injuries.
• Laryngospasm.

Most often, false croup occurs in children in the 2nd - 3rd year of life. In infants (6-12 months) - somewhat less often. Very rarely - after 5 years. And never - in the first 4 months after the birth of a child.

Stenosis of the larynx can be of varying severity and is characterized by a paroxysmal course

Degrees of subglottic laryngotracheitis

Stenosis of the larynx, depending on the severity of its course, is:

I degree or compensated. Lasts from several hours to 2 days. There is an increase in the depth and frequency of breaths during exercise or anxiety. There are no signs of excess carbon dioxide in the blood. The gas composition of the blood is maintained due to the compensatory efforts of the body.

II degree or subcompensated. Lasts up to 3-5 days. There is constant shortness of breath, increased clinical symptoms of stenosis of the larynx. Compensation for the lack of oxygen occurs by increasing the work of the respiratory muscles by 5-10 times. The child is restless and agitated. The first signs of oxygen deficiency appear: blue nasolabial triangle, pallor of the skin, tachycardia.

III degree or decompensated. The increased work of the respiratory muscles no longer compensates for oxygen starvation. There is constant shortness of breath. Rough rales are heard over the lungs. The voice is hoarse. Signs of hypoxia intensify: tachycardia, arterial hypotension, loss of a pulse wave on inspiration.

IV degree or asphyxia. Extremely difficult condition. Obstructive respiratory failure leads to toxicosis of the body. Breathing becomes frequent and superficial. Convulsions may occur, body temperature drops. There is bradycardia. The child may go into a coma. A deep combined acidosis develops.

As you can see, subglottic laryngotracheitis is a very serious disease. So, it needs to be taken seriously. Immediately after detecting the first symptoms of OSLT, call an ambulance and provide first aid to the baby.

Symptoms of false croup in children: barking cough, hoarse voice, shortness of breath, restlessness

False croup in children: symptoms

• False croup, as a rule, develops against the background of colds or infectious diseases, allergic reactions.
• The attack of ASLT, more often, begins at night. When the child is in a horizontal position, sputum accumulates in his airways, which irritates them, causing a cough.
• Body temperature may rise.
• The cough is dry, like a crow or a dog barking.
• The child's voice is hoarse or disappears altogether.
• The baby begins to breathe often and noisily. On inspiration, rough wheezing can be heard.
• The baby is worried and scared. Why the symptoms of the disease only intensify.
• Due to a lack of oxygen, a blue nasolabial triangle and pallor of the skin are observed.

During an attack of false croup, a child can take up to 50 breaths per minute. At a rate of 25-30 (for children aged 3 to 5 years).

So the body tries to compensate for the lack of oxygen that has arisen due to the narrowing of the lumen of the larynx. If help is not provided to the baby in time, then he may lose consciousness or even suffocate.

What should be done if signs of false croup are found in a child?

Even if you know how to help the baby during an attack of ASLT, an ambulance team must be called

First aid

1. The very first thing you should do when you notice the symptoms listed above in a baby is to call an ambulance. Attacks of ASLT usually last no more than 30-40 minutes. And, if you know what to do in such cases, then you can help the child yourself. But sometimes the disease develops very rapidly. And qualified medical actions may be required. With a strong narrowing of the lumen of the larynx, in order to restore the patency of the airways and ensure the flow of air into the lungs of the crumbs, doctors do intubation.
2. The baby should be placed in a semi-sitting position. Make sure that nothing prevents him from breathing. Release the child from clothing that constrains the chest.
3. Give the baby a warm alkaline drink (milk with soda, Borjomi, etc.). It thins phlegm and prevents dehydration.
4. Puffiness of the loose fiber of the larynx is well helped to remove antihistamines: Claritin, Cetrin, Suprastin, etc. Give the child one of them, observing the age dosage indicated in the instructions for use.

   The room where the baby with stenosis of the larynx is located should be well ventilated.

5. If the temperature of the peanut is above normal, antipyretics can be used.
6. While waiting for the ambulance to arrive, try to calm and distract the baby. Try to keep your peace of mind too. Remember, the child feels your fear. And excitement and, especially, crying are categorically contraindicated for him.
7. Due to the fact that during an attack of false croup, the baby experiences oxygen starvation, it is necessary to provide fresh air access to the room where he is.
8. Take care, also, to humidify the air in the room. If you do not have a special humidifier, boil water in a wide saucepan and place it next to the baby. Let him breathe in the steam, but the steam should not be hot. You can hang wet towels around the room.
9. If you have an inhaler, give your baby a soda solution.

   Humidify the air in the room by any means available to you.

10. Warm foot baths or mustard plasters on the calf muscles will help activate the outflow of blood from the swollen larynx to the feet. And also calm and distract the child.
11. To clear the airways of the crumbs from viscous sputum, press a teaspoon on the root of his tongue. This is how you stimulate the cough center. But in the same way, you can make a baby vomit. This is not bad at all: mucus will also come out with vomit, which, in fact, you achieved with your actions.

Remember, only a doctor can accurately determine the severity of laryngeal stenosis. And if the doctors of the ambulance team insist on the hospitalization of the child, you definitely need to listen to their opinion. After all, OSLT is characterized by a wave-like course, which means that attacks of the disease can be repeated again and again.

Inhalations with a solution of baking soda help relieve spasm and dilute sputum

What can not be done?

Some of your actions during an attack of false croup can only worsen the child's condition. Although it will seem to you that you are helping the baby. Such assistance is effective for acute respiratory viral infections or acute respiratory infections, but not for subglottic laryngotracheitis. What is this about?

1. It is forbidden wrap the baby, thereby exacerbating breathing problems.
2. It is forbidden give him cough suppressants. The child must cough in order to expectorate sputum, which prevents the passage of air into the lungs.
3. It is forbidden use rubbing or mustard plasters with essential oils. Pungent odors can cause spasm of the larynx.
4. It is forbidden offer crumbs tea with honey, raspberries, medicinal herbs. To avoid allergic reactions in the child. This will only increase the swelling of the larynx.

Only a doctor can accurately determine the severity of stenosis

Treatment of the disease

Medical treatment of false croup is determined by the severity of the disease, the presence of concomitant pathologies and the risks of complications.

It includes distraction therapy, alkaline inhalations, sedatives, antihistamines and antispastic drugs, and, in case of co-infections, antibiotics.

At the fourth degree of stenosis of the larynx, intubation or tracheostomy is indicated. But these are extreme measures, to which it comes very rarely. Usually, medical treatment is sufficient.

Very often, false croup entails complications such as sinusitis, otitis media, tonsillitis, bronchitis, pneumonia, and even purulent meningitis. Therefore, in no case should you neglect preventive measures to prevent the onset of the disease.

With subglottic laryngotracheitis, taking antihistamines helps to relieve swelling of the mucous membrane and loose fiber of the larynx

Prevention

• Healthy eating, long walks in the fresh air, compliance, sports. All this helps to increase the resistance of the child's body to any diseases.
• Devices such as an inhaler (preferably a nebulizer) and a humidifier will prove to be useful acquisitions for the whole family.
• It is desirable to show the child to an immunologist and an allergist. Preventive measures prescribed by these specialists can reduce the likelihood of repeated attacks of ASLT at times.

A humidifier will be a useful purchase not only for a child suffering from bouts of false croup, but also for all members of your family.

Hardening and restorative measures for children who often suffer from colds and respiratory infections are mandatory. Pay more attention to prevention, and you will not have to deal with treatment later ...

Video "Laryngitis and croup" (Komarovsky)