Bronchiolitis in children: a serious blow to a small body. How to recognize and treat bronchiolitis in a child? bronchiolitis in infants

The child's immune system is not fully developed, so they susceptible to various diseases. Bronchiolitis in children occurs and develops for certain reasons.

This disease affects the respiratory system of the body, affects negatively not only the respiratory system, but the work of the whole organism. To help the child, it is necessary to start treatment as early as possible.

Concept and characteristics

Bronchiolitis is acute inflammatory disease affecting the lower respiratory tract. First of all, the bronchioles, which are the smallest end bifurcations of the bronchi in the lung lobules, suffer.

The disease is characterized by symptoms of respiratory failure, impaired pulmonary ventilation.

Most often, the disease occurs in autumn and winter, when the child's immunity is weakened.

Causes of development and risk group

The main causes of the onset and development of the disease are:

1. Viral infection. Penetrates into the body of the child, begins to actively influence the body, which leads to pathology.
2. low immunity. If the child's body is weakened, unable to resist, the disease develops quickly.
3. An incompletely developed respiratory system child. The protective properties are poorly developed, so the virus easily enters the body and develops.
4. The child's tendency to Increases the likelihood of bronchiolitis several times.
5. Unfavorable living conditions for the child's body: dampness, cold, lack of hygiene, dirt. Significantly increase the likelihood of disease.
6. Artificial feeding. Reduces the protective properties of the child's body and increases the likelihood of bronchiolitis.

The risk group includes newborns, babies whose immune system is just being formed.

Children at this age are vulnerable to infections, viruses. If harmful microorganisms have entered the baby's body, the reaction will occur instantly.

The child will immediately fall ill. Newborns and babies tolerate the disease very hard Therefore, they need increased attention from parents and doctors.

What are the causes of bronchiolitis in young children? At an early age, pathology appears due to an immature immune system. The body is weakened, so it is easily attacked by infections.

Often the disease occurs in premature babies whose respiratory system is not fully developed. In this case, it is easier for pathogens to enter the body and have a negative impact.

Forms and classification

Specialists distinguish two forms of pathology:

• acute. Appears due to infection, develops rapidly. Lasts up to five months, then disappears or becomes chronic;
• chronic. There are qualitative changes in the bronchioles and lungs. The lumen is greatly narrowed, blockage may occur, which greatly complicates breathing, which can lead to a lack of oxygen.

Depending on the pathogen, there are several types of the disease:

How is bronchopulmonary dysplasia treated in premature babies? find out right now.

Obliterating features

The features of the pathology include:

1. Dyspnea. It can occur even at rest.
2. The presence of dry unproductive cough. Sometimes there is mucus.
3. Rattling, whistling when breathing.
4. There is a narrowing of the lumen of the small bronchi and bronchioles. It leads to impaired pulmonary circulation, which leads to the development of the pathological process in the lungs.

Bronchiolitis obliterans is a chronic form of bronchiolitis. It is difficult to tolerate, leads to serious diseases not only of the respiratory system, but also of the cardiovascular system.

Clinical picture and symptoms

Experts refer to the symptoms of the disease:

Consequences and complications

If the disease is not treated, it may develop complications and side effects:

• cardiovascular insufficiency;
• pulmonary hypertension;
• emphysema;
• prolonged pauses in breathing;
• kidney failure;
• pneumonia.

Treatment Methods

How to treat bronchiolitis in children? To eliminate the pathology, different methods of treatment are used. First of all, drugs are prescribed:

• Ribavirin;
• Anaferon.

These medicines are antiviral. They fight harmful microorganisms, stop the development of the disease. Give them to the child should be one tablet 2-3 times a day. The duration of the medication is prescribed by the doctor.

If the disease is caused by pathogens bacteria must be taken:

• Macrofoam;
• Clarithromycin.

These medicines are very effective, so the dosage is determined by the doctor. Usually patients take one tablet 1-2 times a day.

It is taken one teaspoon 2-3 times a day. With its help, it is possible to relieve swelling, cough, stop the development of the disease. The duration of the drug prescribed by a doctor.

Folk remedies

You can treat a child not only with medicines, but also with folk remedies, which are no less effective..

Help to recover carrot juice. To do this, fresh carrots are washed, peeled, chopped on a grater.

Juice is extracted from the pulp. It is diluted in equal parts with warm boiled water. Add to the solution two teaspoons of honey. The finished medicine is taken one tablespoon 3-4 times a day before meals.

Fighting disease coltsfoot infusion. To do this, mix a few leaves of the plant and a glass of boiling water. The solution is infused for thirty minutes, then filtered. The finished product is consumed two tablespoons 2-3 times a day.

To do this, fatty and fried foods, sweets and pastries are excluded from the diet. You need to add more fruits, vegetables, vegetable soups, vitamin teas to the menu. If the chest is sick mother follows the diet.

Prevention

This disease causes harm to the child's body, accompanied by unpleasant symptoms. Treat the child as soon as possible, otherwise there will be complications, negative consequences.

Lecture on bronchiolitis in young children in this video:

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A child who has recently been born has incompletely formed immunity, which explains his tendency to all kinds of diseases of the respiratory system. Among the possible diseases, bronchiolitis is quite common in infants. During this disease, the lower respiratory tract is affected, namely, the inflammatory process begins in the bronchioles.

Most often, children from 1 to 9 months suffer from bronchiolitis. According to statistics, 80% of cases fall into this category of patients. This disease is difficult to tolerate by children under 2 years old, because then the child grows stronger and can independently fight infections.

As a rule, bronchiolitis occurs due to ingestion of a child. In 50% of cases, the respiratory syncytial virus is the provocateur, approximately 30% belongs to the parainfluenza virus, and there are also rhinovirus, adenovirus and influenza virus.

Also, one should not lose sight of such factors that can contribute to the development of bronchiolitis in children: the ingress of tobacco smoke, dust or other harmful substances into the respiratory organs, the ingestion of certain components contained in drugs (penicillin, cephalosporins, interferon and others).

Depending on the cause that provoked bronchiolitis in a child, the following types of disease can be distinguished:

Among other things, bronchiolitis in children can occur, like other diseases, in a chronic form. In an acute illness, all the characteristic symptoms appear very clearly. The period lasts about a week, and begins its development after three days after infection. the form of the disease in children occurs due to a long-term negative effect on the lungs. As a rule, this form is not characteristic of infants, but of older children.

How do you know if a child has bronchiolitis?

IMPORTANT! If any deviations from the normal state of the baby are detected, you should immediately seek medical help, because in the early stages the disease is treated much faster and without consequences.

When a child gets sick with bronchiolitis, the first thing to do is all the signs of a cold, i.e. the baby cannot breathe through the nose, a cough appears, the body temperature, as a rule, remains normal. A few days later, when the disease has reached the small bronchi, the following appear in the baby:

If the baby has shortness of breath, a blue tint of the skin, weakness, sputum is released when coughing, and the body temperature is not stable, constantly changing, then this is a clear sign of chronic bronchiolitis.

How is bronchiolitis diagnosed and treated in children?

The doctor makes a diagnosis of bronchiolitis on the basis of examining and listening to the patient. If there is a high probability of occurrence, the doctor gives directions for general and biochemical blood tests, urinalysis, as well as additional studies:

• examination of mucus from the nose and pharynx in infants for the presence of bacteria;
• CT scan;
• spirography;
• gas analysis of blood;
• x-ray.

IMPORTANT! In case of detection of bronchiolitis in infants, hospitalization is mandatory. Treatment is aimed at eliminating respiratory failure and destroying the infection.

In children with bronchiolitis, oxygen therapy is usually prescribed to eliminate respiratory failure. In severe cases of the disease, antiviral drugs are prescribed, and in the case of a bacterial cause of the development of the disease, antibiotics are indicated. For each patient, the doctor selects treatment according to the severity of the course of the disease and the condition of the baby.

Using a nebulizer or spacer, children are inhaled into the lungs with the necessary medications. This method is very convenient, because quickly, efficiently and painlessly, the medicine reaches the site of inflammation. Anti-cough preparations for infants are contraindicated, because they contribute to blockage of the bronchi with mucus.

With bronchiolitis in children, the respiratory condition, which consists of light pressure on the abdomen and chest of the baby during exhalation, and vibration massage will also favorably affect the general condition. For massage, the baby is laid in such a way that the head is lower than the torso. Then light taps are made with the edge of the palm from the bottom of the chest to the top.

The baby is discharged from the hospital if he has an appetite, body temperature has returned to normal and there is no respiratory failure.

Preventive measures

In order for the baby not to get sick with bronchiolitis, it is necessary to take all possible measures, namely:

1. Avoid contact of the baby with sick children, as well as adults.
2. During epidemics, do not visit crowded places.
3. Avoid hypothermia.
4. Follow the regimen for the baby.
5. Regularly clean the nose of crusts and mucus in children.

Bronchiolitis is considered a dangerous disease in children, because it can lead to respiratory arrest and other serious consequences. It is necessary to carefully monitor the baby and, if necessary, seek help from specialists. Take care of your children!

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

First warning signs

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

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

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

How to define a disease?

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

Acute bronchiolitis: symptoms

With a cold, treatment does not give a positive result for a long time? Perhaps this is manifested by acute bronchiolitis in children. Its symptoms:

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

It is important not to make a mistake!

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

Conditions for a small patient

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

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

These activities are prohibited

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

Obliterating bronchiolitis: symptoms

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

The following symptoms will help to recognize the disease:

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

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

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

Treatment methods

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

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

Preparations

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

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

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

Chronic bronchiolitis

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

• panbronchiolitis;
• follicular;
• respiratory.

Also, inflammation can be of the following types:

• constrictive;
• proliferative.

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

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

Treatment of a chronic disease

Chronic bronchiolitis obliterans in children is treated by two methods:

• drug therapy;
• auxiliary.

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

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

Effects

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

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

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

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

The body of a child can be exposed to a variety of diseases. Bronchiolitis occurs at any age, but most often it is diagnosed in infants in the first months of life. This lung infection, characterized by inflammation of the small bronchi and accumulation of sputum in them, is one of the most common reasons for hospitalization of newborns and children under two years of age. How to quickly recognize the disease and provide the child with competent assistance?

Description of the disease

Bronchiolitis in medical practice is usually called the inflammatory process in the bronchioles (small bronchi with a diameter of less than 2 mm, located in the lower respiratory tract). The walls of the bronchioles, unlike the bronchi, do not have cartilaginous plates. Inflammation in them is most often caused by viruses and is accompanied by symptoms similar to SARS.

Bronchiolitis is an inflammation in the bronchioles

The greatest spread of the disease is observed in the cold season. Currently, the diagnosis of the disease does not cause difficulties. The fundamental point in the examination of children is the combination of symptoms of acute respiratory viral infections with signs of bronchial obstruction (a form of respiratory failure).

Broncho-obstruction, or broncho-obstructive syndrome (BS) is a clinical syndrome in which pulmonary ventilation is disturbed and mucus discharge is difficult. The primary symptoms include a dry and obsessive cough, shortness of breath, and noisy breathing.

Classification of bronchiolitis

Depending on the cause, the following types of bronchiolitis are distinguished:

• post-infectious;
• obliterating;
• drug;
• inhalation;
• idiopathic.

Types of the disease and their features in children (table)

According to the nature of the flow, it is customary to distinguish:

• acute bronchiolitis;
• chronic.

In the case of the acute form, recovery can be achieved within five weeks from the moment the first clinical signs appear. In chronic bronchiolitis, the persistence of pathological symptoms is possible for more than three months.

Causes of the disease

As already noted, the main causative agent of bronchiolitis is the respiratory syncytial virus. Much less often, the cause of the disease can be the infection of a child with the influenza virus, parainfluenza, bocavirus, metapneumovirus. In 15–20% of sick children, more than one virus is determined.

Doctor's note: the disease develops as a result of virus damage to the wall of the bronchioles, as a result of which its edema occurs and the inflammatory process begins. In the lumen of the small bronchi, mucus accumulates, which significantly impedes the passage of air. Because of this, children experience wheezing and characteristic shortness of breath.

There are several factors that significantly increase the risk of developing the disease in children:

• the age of the child is up to twelve weeks;
• low weight of the newborn;
• prematurity;
• the presence of congenital malformations of the lungs and the cardiovascular system, cystic fibrosis, etc.;
• immunodeficiency states;
• forced contact with infected people (especially dangerous for newborns);
• inadequate treatment of respiratory diseases that have arisen in a child;
• hypothermia;
• second hand smoke.

Clinical symptoms

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

The first few days from the onset of the disease, the child has clinical symptoms similar to the typical manifestations of SARS:

• runny nose and nasal congestion;
• dry or wet cough;
• increase in body temperature is possible.

Since the baby is not able to express his complaints himself, parents should be alerted by his capriciousness, frequent crying, lethargy, refusal to eat. This behavior may indicate a general feeling of being unwell, pain in the throat or chest. If the child is interrupted during feeding to catch his breath, then he has a stuffy nose.

Later, the clinical picture described above is joined by typical signs of bronchiolitis - shortness of breath and wheezing, which can be heard even without a stethoscope. In infancy, the disease is often accompanied by the development of otitis media.

Diagnosis of bronchiolitis

In most cases, the diagnosis of bronchiolitis is made on the basis of a pronounced clinical picture after a physical examination and auscultation, in which obvious wheezing is detected. Differential diagnosis is important, since at the initial stages of development, bronchiolitis is easily confused with SARS.

Auscultation is a diagnostic method that consists in listening to sound phenomena that occur in the body. It is carried out directly (by applying the ear to the patient's body) or indirectly (using a stethoscope) method.

With an increased risk of complications, additional studies are prescribed:

• chest x-ray to rule out pneumonia;
• laboratory blood test;
• sputum analysis;
• pulse oximetry - measurement of the level of oxygen in the blood (prescribed for severe shortness of breath).

Based on the results of the research, the issue of hospitalization of the child is decided.

Treatment Methods

Hospitalization is required for all children, especially newborns and infants under the age of six months, who have signs of acute bronchiolitis with severe respiratory problems.

1. In the intensive care unit or resuscitation, oxygen breathing is prescribed to eliminate respiratory distress syndrome. Due to the contagiousness of the disease, infected children are isolated.
2. In a hospital, pulse oximetry is regularly performed to determine the gas composition of the blood. With severe hypoxemia (low oxygen content in the blood), oxygen therapy is immediately performed.
3. In the process of treatment, it is very important to control the child's fluid intake, since with the pathology under consideration, the synthesis of antidiuretic hormone, which is responsible for controlling the water balance in the body, decreases, resulting in fluid retention. The production of renin in the kidneys also gradually decreases, urination decreases, which only increases the swelling in the bronchioles. With limited fluid intake, the doctor may prescribe diuretics in small doses to the child, which will alleviate the condition.
4. Drug therapy for bronchiolitis in children includes:
   • taking bronchodilator drugs that relieve muscle spasms;
   • inhalation with corticosteroids;
   • antibiotic therapy. In the fight against the inflammatory process in the small bronchi, special attention is paid to the destruction of the main causative agent of the disease. Most often, macrolides are prescribed, which also have an anti-inflammatory effect (Clarithromycin, Roxithromycin). These drugs are allowed from the age of two months;
   • the use of the antiviral drug Ribavirin in small doses and short-acting bronchodilators (Epinephrine, Albuterol) - in severe cases of the disease;
   • the use of saline solutions to facilitate breathing. The drug Otrivin Baby is allowed to be used in children from birth for osmotic moisturizing and reducing the secretion of mucus.

The tactics of treatment for bronchiolitis is always selected strictly individually, taking into account the age of the child, the presence of concomitant diseases and other features. The effectiveness of therapy can be judged by the improvement in the condition of the baby, the disappearance of clinical symptoms, and the normalization of the gas composition of the blood.

Drugs for the treatment of disease (gallery)

Ribavirin - an antiviral drug Antibiotic Roxithromycin is allowed for children from 2 months Otrivin Baby - saline solution that makes breathing easier Clarithromycin - an antibiotic to destroy the pathogen

Possible Complications

In severe cases of bronchiolitis in young children, the following complications may occur:

• cyanosis (cyanosis of the skin) caused by a lack of oxygen;
• prolonged apnea (stop breathing);
• respiratory failure;
• severe dehydration;
• pneumonia, especially with the secondary attachment of a bacterial infection.

Bronchiolitis obliterans is especially severe in children. With this disease, in 50% of cases broncho-pulmonary pathology is formed in a chronic form.

Prevention measures

Prevention of bronchiolitis is important both for healthy children and for babies who have been treated for this disease. To prevent the development of the disease, it is necessary:

• completely exclude contact of the baby with infected people;
• take measures to strengthen the immune defense;
• organize a healthy daily routine and nutrition;
• timely treat infectious and viral diseases;
• take care of creating a hypoallergenic life;
• never smoke in the presence of a child.

After suffering bronchiolitis, it is necessary to be registered with a pulmonologist and pediatrician for a long time.

Cough in children (video)

Due to its complications, bronchiolitis can be considered a rather dangerous disease, especially for children under 3 months old. However, with timely and adequate treatment, adverse effects can almost always be avoided. Parents can only do everything possible to protect the baby from relapses in the future, strengthen the child's immunity and create conditions for his healthy development.

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

What is bronchiolitis

Bronchiolitis is an acute inflammatory disease of the lower respiratory tract, which affects the bronchioles - the final smallest bifurcation of the bronchi in the lung lobules. Pathology is accompanied by symptoms of respiratory failure, or bronchial obstruction, and clinical signs similar to those of acute respiratory viral infections.

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

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

Classification and causes of the disease

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

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

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

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

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

Causes and pathogens of the disease at an early age - table

Risk factors

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

• the age of the child is up to 3 months;
• prematurity;
• low weight of the newborn;
• improper treatment of respiratory diseases in a baby;
• the presence of other diseases of the lungs or pathologies of the cardiovascular system;
• immunodeficiency states;
• hypothermia.

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

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

Symptoms and signs

The first manifestations of acute bronchiolitis are:

• nasal congestion;
• cough.

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

• irritability;
• lethargy;
• rapid breathing;
• dry wheezing;
• weight loss associated with the refusal of the child to eat;
• shortness of breath, which greatly interferes with eating.

The patient's condition is rapidly deteriorating.

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

Features of the disease in infants and newborns

The most common cases of bronchiolitis are children under the age of one year. Infants carry this disease much harder, so when the first signs appear, you should seek medical help.

In babies, including newborns, the following symptoms are noted:

• attacks of asphyxia (temporary cessation of breathing);
• watery discharge from the nose;
• cough;
• difficulty breathing (a sick child makes considerable efforts to exhale);
• lack of appetite;
• retraction of a large fontanel (against the background of dehydration);
• an increase in body temperature up to 39 degrees;
• excessive arousal or, conversely, drowsiness.

Diagnostics

The diagnosis is made by a pulmonologist on the basis of a physical examination and auscultation (listening).

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

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

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

Treatment of bronchiolitis in children

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

Treatment of bronchiolitis requires an integrated approach and includes:

1. Bed rest (until body temperature returns to normal).
2. Limiting the amount of liquid consumed by the child.
3. Medical therapy, in particular:
   • antiviral agents (ribavirin);
   • expectorant drugs (Lazolvan, Bromhexine);
     

     Such drugs should not be used in the treatment of infants, as this can lead to blockage of the bronchi with mucus.

   • saline solutions (Otrivin Baby);
   • bronchodilators;
   • inhalation with corticosteroids;
   • antibacterial drugs (Sumamed, Macropen, Clarithromycin).
     

     Antibiotic therapy is indicated only if the bacterial nature of bronchiolitis is detected. Appointed at the discretion of the attending physician.

4. Breathing exercises. It is necessary to do light pressure on the chest and tummy of the baby as you exhale.
5. Vibration massage, which consists in light tapping movements with the edge of the palm in the direction from the lower part of the chest upwards. At the same time, the baby is laid in such a way that the butt is slightly higher than the head.
6. Oxygen therapy (for the elimination of respiratory distress syndrome).

Since bronchiolitis is transmitted by airborne droplets, the patient should be isolated. As a rule, when the baby's appetite is restored, body temperature returns to normal and there is no need for oxygen therapy, the child is released from the hospital home.

Drugs for the treatment of diseases - gallery

Prognosis and possible complications

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

• pulmonary hypertension;
• cardiovascular insufficiency;
• prolonged pauses in breathing;
• emphysema;
• kidney failure;
• bronchial asthma;
• pneumonia.

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

Prevention

To avoid bronchiolitis, you must:

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

Dr. Komarovsky about cough in children - video

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