How to detect bronchitis in children in time: the main symptoms. All causes of frequent bronchitis in a child

Should be a concern for parents. It may indicate the onset of such a respiratory disease as acute bronchitis, in which the bronchi are involved in the inflammatory process.

The development of acute bronchitis can occur due to the influence of various factors (infectious, allergic, chemical and physical). Bronchitis is more common in children under 3 years of age and in preschoolers (4-6 years of age). Also, infants can suffer from the disease.

In the medical literature, acute bronchitis is classified into the following forms:

1. Simple. The course of this form of the disease is the easiest, and there are no symptoms of bronchial obstruction.
2. Obstructive. This form of the disease is characterized by obstruction and wheezing.
3. . Small bubbling rales and obstruction are the main symptoms of this form of acute bronchitis.

The peak incidence of bronchitis occurs in autumn and spring, which is associated with hypothermia, temperature fluctuations and high humidity.

The disease itself, if no complications appear, is not particularly dangerous for the baby, because it does not violate the organic integrity of the bronchi, and getting rid of symptoms occurs after a maximum of 2 weeks. Parents should also know that acute bronchitis in a child can manifest itself as a result of measles and whooping cough.

There are several factors that provoke the development of the disease. And first of all, they are associated with the specific structure of the respiratory system of children:

1. The children's respiratory tract is narrow, which provokes swelling of the bronchial walls.
2. Children have hyperplasia. ⇒
3. Immunoglobulin A, which resists the penetration of infections, is contained in mucosal cells in small volumes.
4. Weakness of the respiratory muscles and small lung capacity.
5. Frequent tonsillitis.

IMPORTANT! In infants, bronchial obstruction and bronchospasm develop very quickly. Consequently, the baby is critically lacking oxygen in the blood.

Symptoms of acute bronchitis in children

Each form of the disease in question in a child has its own characteristics, however, the disease begins with the manifestation of cold symptoms, and only then the main symptoms of the disease itself join.

Symptoms of a simple form of acute bronchitis:

1. An infant develops a strong cough, the body can rise sharply to 40 ° C. When breathing, wheezing is heard.
2. Elevated body temperature can last 3-4 days, or maybe more: it all depends on the type of infection.
3. Initially, there is a dry and exhausting cough, which eventually becomes wet.
4. During a medical examination of the child, catarrhal phenomena are visible. ⇒
5. Coarse rales are heard in the air tubes of medium and large size, which is associated with violations of their ventilation.

In the acute type of the disease, the symptoms of bronchial obstruction are clearly visible. Moreover, this form of the disease is inherent in children of the 2nd and 3rd year of life.

Symptoms of acute obstructive bronchitis

The main symptoms of acute include:

• noise and whistling when breathing;
• prolonged exhalation;
• refusal to eat;
• anxiety and fear;
• expiratory dyspnea (difficulty exhaling);
• rapid breathing.

IMPORTANT! Acute obstructive bronchitis occurs with subfebrile temperature (up to 38), and sputum may contain a small amount of pus.

Unlike other forms of the disease, bronchiolitis develops in infants and has the following distinctive symptoms:

• in the absence of treatment, rapidly increasing symptoms of respiratory failure;
• hyperthermia (high body temperature - above 38);
• exhausting cough with a large amount of sputum, sometimes with an admixture of blood;
• dyspnea;
• rales are heard from the bronchi of small size;
• bronchial spasm, characterized by a wheezing dry wheeze.

The difference between the symptoms of acute bronchitis in children regarding its forms

Basic principles for the treatment of acute bronchitis in children

When treating a disease in a child, a strict bed rest is prescribed - this helps to eliminate hyperthermia and speedy recovery. For babies, the number of feedings is increased by 1-2. In other cases, the daily volume of food should be 50-60% of the normal volume.

At the same time, food should be high-calorie, balanced with vitamins and microelements, but at the same time hypoallergenic. The daily volume of drinking should be increased by 1.5 times. The correct mode will quickly put the child on his feet, regardless of his age.

If we are talking about bronchitis of viral origin, then the child begins to be treated with antiviral drugs. often do not bring any results of treatment and are not suitable for children, so you need to see a doctor in a timely manner, especially when it comes to a baby.

Bronchitis can occur in various forms and degrees of severity. After its chronic form, it may develop. Do not ignore a child's long-term cough: it can cause dangerous diseases. It is better to hurry to see a doctor, because the sooner the disease is diagnosed, the sooner the baby will become healthy.

A frequently ill child is a concept that does not exist in official medicine, but all doctors and parents know it. It is mainly used in relation to respiratory diseases. Why does a child often develop bronchitis, and what to do in this case?

In a healthy state, the bronchi are covered from the inside with a thin layer of mucous membrane.

It performs a protective function: envelops the respiratory tract and retains small particles of dust that enter with the breath.

With the help of a cough reflex and contraction of the muscle layer, the bronchi remove from the body all foreign particles that have settled on the mucosa.

When an infection enters the body, inflammation, swelling appear in the bronchi, and degenerative changes may occur.

The lumen of the path narrows due to excessive production of mucus, which is difficult to expectorate. The same happens with an allergic course, when the provoking factor constantly irritates the respiratory mucosa.

The causes of inflammation can be different. The form of bronchitis, its course and the rate of recovery of the patient depend on the duration of their exposure.

Causes of bronchitis

Inflammation in the bronchial tree can be caused by:

1. infection. Viruses enter through the respiratory tract much more often than you think. Due to the protective properties of the body, only a small part of them is activated and causes disease. The causes of frequent bronchitis may be a violation of the immune defense, when it is not able to defeat the infection at the initial stage.
2. Toxins. Irritation of the mucous membrane, for example, with toxic poisoning, leads to an inflammatory process. If the action of toxins has stopped, then the airways begin to heal, and the symptoms subside. However, the recovery process is accompanied by increased sputum production, due to which a person may still complain of a cough. In adults, persistent bronchitis can occur, for example, due to the peculiarities of working with chemicals.
3. Allergens. Every time you come into contact with an allergen, your body reacts in a certain way. For example, with hay fever, coughing can bother you every time you go outside in the spring. In this case, it is important to distinguish an infectious course from an allergic one.

Correctly identifying the cause of bronchitis is very important, since the treatment regimen may vary.

Recurrent bronchitis

Doctors call frequent bronchitis in children recurrent bronchitis. Its characteristics:

1. Occurs against the background of a respiratory viral infection.
2. Rhinitis and redness of the throat in a patient pass much faster than a cough.
3. It is more common in children under 4 years of age.
4. Symptoms last 2 weeks or longer.
5. Acute episodes appear 4 times a year or more.

The cause of recurrent bronchitis is the increased sensitivity of the mucosa, which begins to actively respond to the slightest hit of the virus. This feature is observed in children prone to allergies, as well as non-observance of healthy climatic conditions in the room. For example, children may often get sick when:

1. Hereditary predisposition to allergies, especially respiratory ones (hay fever, animal hair).
2. Passive smoking.
3. Congenital pathologies of bronchial tissue (dysplasia).
4. Chronic overdrying of the mucosa due to dry and hot air.

If the child has frequent bronchitis, it is recommended to take care of his lifestyle, and not treat with pills. Komarovsky says that the optimal air temperature is 20 degrees, and humidity - 60%. Maintaining these parameters will help to significantly reduce the frequency of relapses.

Treatment

With frequent recurrent cough treatment is in:

• Eliminate the cause of the acute condition.
• Relief of the patient's symptoms.
• Identification of the causes of frequent relapses and their prevention.

Standard therapy for acute bronchitis includes the following groups of drugs:

1. Antivirals.
2. Antibiotics. Doctors may prescribe them to prevent the development of pneumonia.
3. Immunostimulants. Raise the body's own defenses and prevent relapses.
4. Mucolytics. Liquefies mucus and makes it easier to expel.
5. Expectorants. Promotes expectoration and cleansing of the respiratory tract.
6. Antihistamines. Effectively relieve swelling in any etiology of the disease.

With recurring bronchitis, which "are treated for six months", it is necessary to adhere to the following rules:

1. Lots of outdoor walks.
2. Maintain humid and cool indoor air.
3. In the summer, during the heat, use an inhaler with saline daily to prevent the mucosa from drying out.
4. Lead an active lifestyle and eat right.
5. Avoid smoky and dusty areas.

Such activities will help strengthen the cardiovascular and immune systems so that the child does not get sick. They are also the basis for the prevention of many respiratory diseases..

During an illness, patients are often interested in the following questions:

Doctors are allowed to walk on the street if the child feels well, and he no longer has a temperature.

Smoking only aggravates the course of the disease. Chronic bronchitis in adults is often triggered by smoking.

The warming effect of pepper and other folk remedies should extend to the focus of inflammation, so they glue it on the back and chest, avoiding the heart area.

Treatment of recurrent bronchitis should be aimed at raising general and local immunity.

Residual cough

Residual is a cough that continues after recovery. It appears as a result of damage to the mucous membrane during an illness. Recovery may take up to three weeks, during which time the cough may persist. As a rule, it is not accompanied by sputum discharge..

The recovery period depends on the strength of the immune system. The bronchi are irritated and easily infected. Again, humidified air and a diet rich in vitamins will help speed up the healing of the mucosa.

Doctor Komarovsky will talk about bronchitis

The doctor will tell you about the causes of obstructive bronchitis and how to treat it.

Bronchitis is a common disease that affects children from 3 to 8 years of age the most. At this age, the respiratory system continues to actively form, so it is very vulnerable to infections. The sooner you detect the symptoms of the disease in a child, the easier and faster you can overcome it. Medicines, traditional methods of treatment and special massage will help you with this.

Bronchitis is an inflammatory process of the bronchial mucosa.

Bronchitis and its causes

Bronchitis is inflammatory process covering the mucous membrane of the bronchial tree. It rarely develops on its own. In 99% of cases, this is a consequence of a viral disease - SARS or influenza. And only 1% is due to bacterial and fungal infections.

Stages of development of bronchitis:

1. Contact with a sick person and infection from him by airborne droplets. It is easy to catch an infection, as the activated microbes scatter within a radius of 10 meters when coughing or sneezing.
2. The development of acute respiratory disease, accompanied by runny nose, sore throat and fever.
3. With improper treatment or its absence the infection passes from the upper respiratory tract to the lower: first, the inflammation is localized in the throat, then in the trachea, and then descends into the bronchi.

With untimely treatment, the disease can descend from the upper respiratory tract to the lower ones.

The mechanism of infection with bacterial or fungal bronchitis is different. Conditionally pathogenic microorganisms always live on the mucous membranes of a person, but in small quantities that do not harm health. And only under certain conditions, they begin to actively multiply, leading to the disease. This could be motivated by:

• stress;
• hypothermia;
• weakening of the immune system.

Important! Bronchitis caused by fungi or bacteria is not contagious to others. Exactly the same microorganisms live on the mucous membranes of other people, but their growth is restrained by the immune system.

But the viral form remains contagious until the symptoms of the disease disappear completely.

The child remains contagious throughout the illness.

Bronchitis symptoms

You can determine that a child has bronchitis by the following signs:

• elevated body temperature (from 37.1 to 39 ° C and above), decreasing in a day (may be normal if the course of the disease is mild);
• strong dry cough, passing over several days into;
• expectoration of clear, yellow or green sputum;
• wheezing and / or whistles during breathing, heard at a distance;

Pay attention to the noise and whistling when breathing.

• pain in the chest (usually manifests itself at the time of the transition of the disease from the trachea to the bronchi);
• heart palpitations (from 100 beats per minute);
• shortness of breath (rapid and shallow breathing);
• general malaise, weakness and lack of appetite.

With a viral disease, medications are often prescribed:

• : , . Give when the temperature rises above 38 degrees.

Ibuprofen has analgesic, anti-inflammatory properties, has a moderate antipyretic effect.

• : Libexin, Tusuprex. It is allowed with severe bouts of dry cough that does not allow you to fall asleep.
• and:, herbal breast fees. They enhance the secretion of mucus, contribute to its liquefaction and excretion.

ACC is a drug for the treatment of wet cough.

• : Viferon, Interferon. They help the body fight the pathogen by accelerating the production of antibodies.

Attention! Antibiotics do not help in 99% of cases, as viruses usually cause the disease. But pediatricians often prescribe antibiotics “just in case,” and this can only be done after a sputum test, which shows the presence of a bacterial infection.

In other cases, the drugs will not bring benefits, but harm, killing the beneficial microflora.

Galina writes in a review:

“My daughter got sick at the age of 2. And a few days later she coughed so much that she began to choke. I called an ambulance and we were hospitalized with obstructive bronchitis. In the hospital, they administered a course of antibiotic therapy and released him, and 3 days later he had to go to the doctors again. They made the same diagnosis. She refused the hospital, but gave antibiotics to the child at home. Two months later, the cough continued. I went to another pediatrician, and he suggested that the disease was not caused by an infection, but by an allergic reaction. The reason was also found out - this is a new washing powder.

Relief of obstructive bronchitis

If blockage of the bronchial lumen could not be avoided, inhalations with the following drugs will help eliminate the obstruction:

• Ventolin;
• Flexotide.

The method is good because the medicine enters immediately into the bronchi, contributing to the expansion of the branches of the bronchial tree and the removal of sputum from them. The effect comes a few minutes after the procedure.

Important! If the child begins to choke, call an ambulance immediately. In the meantime, you are waiting for her, try to help him with inhalations yourself.

Treatment with folk remedies

Before you start treating your baby with folk remedies, listen to Komarovsky's advice:

• Do not use steam inhalation. This procedure increases the risk of the disease becoming obstructive due to blockage of the bronchi with a swollen lump of mucus (this does not apply to medicinal inhalation solutions).
• Thermal procedures should be done only at normal body temperature. Do not put warm compresses on the heart area, so as not to increase the already large load on the organ.
• Honey, propolis and herbs are strong allergens. Make sure your child is not sensitive to them.

Folk remedies will help relieve a painful cough.

• Keep drinks warm. Hot drinks can burn you, and it does not speed up your recovery.

You can watch the entire issue of Dr. Komarovsky's school about bronchitis in children here - https://www.youtube.com/watch?v=UdnChZSgfgk

To relieve dry cough will help:

• Boiled milk with the addition of honey, butter or soda.
• Freshly squeezed lingonberry juice with sugar or honey.
• Decoctions of blackcurrant leaves, coltsfoot, viburnum or linden flowers. To prepare them, brew a tablespoon of dry raw materials in a glass of boiling water and let cool.

If body temperature is normal:

• before bedtime. After the procedure, wipe them dry and put on warm socks.
• Wrap the chest with gauze soaked in warm vegetable oil. The dressing is covered with wax paper and fixed with a diaper.
• Put a potato cake on your chest. To do this, boil a few potatoes in their skins and mash them with the addition of honey or iodine with vegetable oil. Form a cake, wrap in gauze and place on the chest. Remove after cooling.

For older children, procedures such as mustard plasters and banks are suitable.

With bronchitis, distraction therapy can be effective: mustard plasters, mustard wraps, warming compresses.

Prevention

Bronchitis can recur again, and if it was poorly cured, then the disease will often recur, gradually turning into a chronic form. To protect the child from a new disease, carry out prevention. It includes:

• hardening. Gradual addiction to cold procedures helps to strengthen the immune system. First, do a contrast shower (dousing), alternating warm water with cool water (4-5 degrees lower). Then gradually lower the degree of cold water.
• Clothes according to the weather. Do not wrap the baby, otherwise he will sweat and start to freeze, which will lead to hypothermia. If you dress too lightly, the result will be the same.
• Preventive and during the period of mass destruction of SARS and influenza.
• A diet rich in vitamins and minerals. Helps to strengthen the body's defenses, normal growth and development of the baby.

A balanced diet has been and remains an effective measure to prevent colds.

Bronchitis is a common disease, usually of a viral nature. Therefore, there is no magic pill that would make a child recover in one day. Until the child's body copes with the disease on its own, you can only help it by preventing the sputum from drying out. So you speed up recovery and minimize the risk of complications.

Alisa Nikitina

- 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 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 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

The second most severe respiratory pathology in young children, after pneumonia, is bronchitis. Parents are sometimes very frightened by this diagnosis, and they ask the doctor a lot of questions. I will say right away - bronchitis at the present stage is quite successfully treated and passes without a trace - if everything is done correctly.

Bronchitis is an inflammation of the bronchial mucosa. This disease can occur in an acute or chronic form (which is much less common in children than in adults). Most often, acute bronchitis in children begins after a viral infection (for example, influenza), which causes damage to the mucous membrane of the lower respiratory tract. Among the viral pathogens, the most common are influenza, parainfluenza, adenoviruses. First, the child's throat becomes inflamed, and then the infection spreads further, affecting the bronchi. As a rule, large bronchi are affected first, then smaller ones. This is the first reason for the development of bronchitis.

The second cause is less common and is a bacterial infection. Streptococcus, Haemophilus influenzae and Moraxella are currently leading among bacterial pathogens. We are also talking about microbes, which, most often, are “transported” into the respiratory tract along with foreign bodies. A small child, talking while eating, can inhale a piece of carrot, apple or seed. In addition, young researchers are very fond of pulling everything into mouth, and they can accidentally breathe in small parts of toys.Foreign bodies, of course, come out of the respiratory tract, and the infection can remain.Bronchitis then develops.

The third reason for the diagnosis of "bronchitis" is mixed. That is, first a viral and then a bacterial infection enters the respiratory tract.

The fourth reason is the defeat of the bronchi under the influence of irritating chemical or physical factors. For example, when inhaling gasoline vapors, polluted smoke.

The fifth reason is allergic. Some children are sensitive to certain allergens, whether it's tree or flower pollen, house dust, laundry detergent or soap odors. All this can cause a reaction of the bronchial mucosa.

Symptoms of bronchitis in children

The term "bronchitis" refers to lesions of the bronchi of any caliber; "bronchiolitis" - mainly small bronchi and bronchioles, "tracheobronchitis" - trachea in combination with bronchi. In the classification adopted in Russia, acute bronchitis, acute obstructive bronchitis, bronchiolitis (including obliterating) are distinguished.

Acute bronchitis against the background of an acute viral infection in most cases does not require any specific treatment. The main direction of treatment in this case is the control of symptoms of the disease and general patient care. The main symptoms of acute bronchitis are fever, cough, feeling of weakness. As it became clear, the majority of cases of "cold" are characterized by the same symptoms. It is important to note, however, that with an uncomplicated course of acute bronchitis, an increase in body temperature and a feeling of weakness are moderate, while in severe forms of ARVI, the patient is in a serious condition.

The main manifestations that allow the doctor and parents to suspect bronchitis in the baby are cough, diffuse dry and various wet rales in the lungs. The main symptoms of inflammation of the bronchial mucosa are cough (dry or hacking), fever, chest pain, wheezing. During coughing, sputum may be produced. In acute bronchitis, it looks like a clear liquid without pus, in chronic bronchitis it has pus.

An X-ray completes the picture - when examining specific signs (as, for example, with pneumonia), there are no, usually an increase in the pulmonary pattern, expansion and non-structurality of the roots of the lung in the absence of infiltrative and focal shadows in the lung tissue.

In young children, bronchitis can occur with a syndrome of bronchial obstruction (blockage of small parts of the bronchi) - because of this, the main function of the respiratory system is disturbed - gas exchange and hypoxia develops. The bronchi of different calibers are affected, this occurs against the background of an acute respiratory viral infection, which causes characteristic clinical symptoms. Broncho-obstructive syndrome usually develops on the 3-4th day of SARS and is manifested by expiratory (on exhalation) shortness of breath, noisy wheezing, scattered dry and various wet rales in the lungs. X-ray revealed an increase in the lung pattern, signs of swelling of the lung tissue (increased transparency, horizontal position of the ribs, high standing and flattening of the domes of the diaphragm) in the absence of infiltrative and focal shadows in the lungs. Relapses, that is, repeated episodes of obstructive bronchitis, are always associated with SARS and usually stop by the age of 3-4 years.

With a primary lesion of the small bronchi and bronchioles, acute bronchiolitis occurs. It develops, as a rule, in children of the first year of life against the background of acute respiratory viral infections and is manifested by a pronounced broncho-obstructive syndrome and respiratory failure. Severe expiratory dyspnea (difficulty in exhaling only) or mixed (difficulty in both inhalation and exhalation) is characteristic, with the participation of auxiliary muscles - the tummy and intercostal muscles, retraction of compliant places of the chest, swelling of the wings of the nose, cyanosis (blue). When listening to the chest, the doctor will hear diffuse, moist, finely bubbling and crepitating (as if crackling) rales. The radiograph revealed a sharp swelling of the lung tissue, depletion of the vascular pattern.

Repeated episodes of acute bronchitis, diagnosed 2-3 times a year or more against the background of respiratory viral infections, are defined as recurrent bronchitis. Clinical and radiological manifestations during the period of the disease correspond to the signs of acute bronchitis. It occurs mainly in children of the first 4-5 years of life.

Timely diagnosis of various forms of bronchitis is necessary for the selection of adequate therapy and a monitoring system for babies.

How to treat bronchitis in children?

First of all, I draw your attention to the fact that you can not self-medicate. Parents should definitely consult a doctor who will give recommendations based on the cause of the disease. Treatment is prescribed depending on the age of the patient, and on the characteristics of the course of the disease. For example, not all acute bronchitis needs antibiotic therapy. Such measures are mainly needed only when there is a threat of the transition of a bacterial infection into pneumonia. However, only a doctor can determine this.

A doctor can recommend treating a child with bronchitis at home. But if symptoms of intoxication appear, high temperature in the evenings (up to 38 degrees), shortness of breath, then hospitalization is necessary. This is especially true for young children (up to 3 years). If the child is older, treatment can be carried out at home.

The basic principle of treating children with infectious bronchitis, with all their diversity, is to suppress the infectious onset, improve bronchial cleansing and general therapy. The leading role belongs to antibiotic therapy. Adequate antibiotic therapy can not only stop the symptoms of acute inflammation, but also lead to the removal of the pathogen, reduce the duration of treatment and speedy recovery.

The choice of the starting drug is carried out taking into account the likely etiology (cause) and the sensitivity of the alleged pathogen to antimicrobial drugs. In this case, it is always preferable to take one drug and through the mouth. Currently, three groups of antibiotics, the so-called "gold standard" drugs: penicillins (amoxicillin, inhibitor-protected penicillins), II-III generation cephalosporins) and macrolides are most widely used as first-choice antibacterial drugs.

With mild and moderate exacerbation of chronic inflammation, more often in school-age children, treatment can be carried out only with oral (by mouth) antibiotics.

With a pronounced activity of inflammation, antibiotic therapy is carried out in the "step" therapy mode. In this case, antibiotics are first prescribed parenterally (intravenously, intramuscularly). When the patient's condition improves (usually after 3-5 days), they switch to oral antibiotics.

If the child's condition improved during therapy, the temperature decreased, the symptoms of intoxication disappeared, appetite appeared, the child became more active, then the choice of antibiotic was made correctly and treatment should be continued. If there is no improvement or it is insignificant, the antibiotic should be changed. Indications for changing the antibiotic or connecting the second drug is the clinical failure of therapy (preservation of fever, respiratory failure, intoxication, development of complications). In this case, the correction of therapy should be carried out taking into account the results of microbiological examination (sputum culture) of sputum. Antibiotics must be used very carefully, because later, if a more serious inflammatory disease occurs, they may lose their effectiveness. The fact is that over time, the drug becomes addictive, and then it can no longer be used. You have to turn to other drugs, which, accordingly, are more expensive. It is necessary to treat bronchitis in a complex, using, if necessary, antibiotic therapy with physical methods, including a special diet and home care.

The duration of antibacterial treatment, as a rule, is 7 days (with acute bronchitis) and 10-14 days (with exacerbation of chronic bronchitis).

In recent years, in addition to oral and parenteral administration of antibiotics, administration of antibiotics through a nebulizer has been used.

In the treatment of children with bronchitis, agents are necessarily used, the action of which is aimed at improving the drainage function of the bronchi. Widely used in pediatric practice are mucolytic (sputum-thinning) drugs of direct action - cysteine ​​derivatives - thiolics (acetylcysteine). However, it must be borne in mind that these drugs should be prescribed only with significantly increased sputum viscosity, since they can make the secret too liquid, as a result of which there is a risk of developing bronchorrhea and flooding the lungs with liquid sputum.

Mucoactive drugs of indirect (secretolytic) action include derivatives of the alkaloid vasicin - bromhexine and its metabolites (ambroxol) and mucoregulators based on carbocysteine. These drugs normalize the rheological parameters of the secretion, accelerate mucociliary transport, have an anti-inflammatory effect, while liquefaction of sputum is practically not accompanied by an increase in its volume.

Herbal preparations (ipecac roots, licorice, marshmallow, elecampane, thermopsis herb, thyme), which have an expectorant effect of reflex action, continue to be widely used in the practice of complex therapy of bronchitis.

Important elements of the complex therapy of patients with bronchitis are physiotherapy, massage, postural drainage, exercise therapy.

Usually, bronchitis goes away in 2-3 weeks. But such a period is typical only with timely treatment. Unfortunately, in recent years, the course of bronchitis and pneumonia has changed somewhat. The main difference is the long duration of the disease - up to 3-4 weeks. In addition, all the symptoms now began to manifest themselves more intensely. For example, sometimes children have pain in the region of the heart. The severity of neurosthenic reactions becomes more frequent: the child becomes irritable.

Often, under the mask of bronchitis, other diseases can be hidden. For example, congenital malformations of the lungs and bronchi. Therefore, all children who are diagnosed with chronic bronchitis need to be examined and treated in specialized institutions.

Bronchitis after a "cold"

Sometimes, even with good care for a sick child, a cold is complicated by bronchitis of varying severity: from mild bronchitis, which occurs even without fever, to severe forms with high fever, with the addition of asthmatic syndrome. The main symptom of bronchitis is coughing. At the onset of the disease, the cough is usually dry. The so-called “resolution” gradually sets in, sputum appears and accumulates in the bronchi, and even without a phonendoscope wheezing can be heard.

When sputum appears in the bronchi (wheezing becomes wet), we can assume that the disease has turned towards recovery. The main concern now is that the child coughs in time. It is clear that when the child is old enough, it can be explained to him that it is necessary to cough up and spit out sputum. With a small child it is more difficult. With every breath, with every exhalation, he wheezes - it seems that he himself would have cleared his throat for him ... Sometimes in such cases, a change in the position of the child contributes to coughing. For example, your baby was lying on his right side, and you turned him to the left; at this time, sputum, under the influence of its own weight, begins to move along the walls of the bronchi, irritates them and can provoke a cough - which is what was required.

Bronchitis in children older than 1 year.

Depending on the severity of the process, only the mucous membrane of the bronchus or its entire wall can be affected. As a rule, bronchitis occurs in spring and autumn, following diseases such as rhinitis, pharyngitis, laryngitis, acute respiratory infections (acute respiratory disease); practice shows that children with adenoid growths and with chronic tonsillitis suffer from bronchitis more often than other children. The causative agents of acute bronchitis can be respiratory viruses, and staphylococci, and streptococci, and pneumococci, etc.

The onset of the disease is acute. There is a runny nose, then a dry cough. The child complains of general malaise. Body temperature rises to 38-39 ° C and can last two to three days. After these days, the nature of the cough changes; cough ceases to be dry and persistent (even exhausting), sputum begins to separate, which also changes over time - at first it is mucous, then mucopurulent. Wheezing may be heard at a distance; the child clears his throat, and these rales disappear. Recovery occurs in 7-8 days. In young children, acute bronchitis can occur with an asthmatic component, along with manifestations of exudative diathesis; such bronchitis sometimes lasts for several weeks and ends with complications - pneumonia.

Treatment of bronchitis at home

Regardless of the severity of your child's bronchitis, treatment should be prescribed by a doctor. Of course, parents gain experience over time and already seem to know how to deal with colds and bronchitis (and even grandmothers suggest), but the child's doctor needs to be shown. In addition to the fact that he will make an accurate diagnosis, he will also prescribe the correct complex treatment, advise the most modern medicines. At the same time, you will show the doctor your first aid kit: perhaps something from your first aid kit will be used.

So, you will discuss particulars with your doctor. Here are some general tips...

Treatment of bronchitis is mainly symptomatic; a sick child is given antipyretics, expectorants; distracting procedures are widely used (mustard plasters, warming compresses, foot baths, etc.). Antimicrobial treatment (antibiotics) is prescribed only in cases of prolonged bronchitis and with the threat of complications. Sulfonamides are not currently prescribed.

If the child is ill with bronchitis, bed rest is necessary. Although the child has bed rest, the child should not lie still. He can sit in bed, play; he needs to change position from time to time - this will eliminate the possibility of congestion in the lungs.

An increase in temperature with bronchitis is a protective reaction of the body. Many microbes feel great at a temperature of 36.6 ° C, but already at 36.7 ° C they “resign”. If the child's temperature is below 38 ° C, let it get a little warmer, if it is higher, bring it down.

If a child has bronchitis, and even more so with an asthmatic component, it is important that there is always fresh air in the room ... It's cold outside, and you need to ventilate the room. Cover the child with a blanket (possibly with a head) and ventilate. You can even make a draft for a couple of minutes.

You will not harm a child with bronchitis if you start giving him coltsfoot tea. Drink plenty of warm water. Milk with butter and honey works quite effectively. Do not forget about inhalations, soda inhalations. When the wheezing becomes moist, resort to distraction therapy. Steam your child's legs. With bronchitis, distraction therapy can be very effective: mustard plasters, mustard wraps, warming compresses, foot and general baths, etc. Try these treatments, but only if the child does not currently have a high fever. Learn to alternate them: today you put mustard plasters on your child, tomorrow - a warming compress.

Massage once or twice a day.

Rubbing the feet (soles) with turpentine ointment gives a good effect: this is done at night; put a little ointment on the sole and rub it very, very hard with your palm (you will feel how your palm is baked), then put on woolen socks for the child. And, of course, mustard plasters. You already know that mustard plasters are placed through the diaper for small children, and for older children - with the reverse side. You can not put mustard plasters on the area of ​​\u200b\u200bthe heart. Pepper patch is very easy to use. Now in pharmacies there are many warming ointments for children. If a child has acute bronchitis, decoctions and infusions of pine buds (10 grams of dried buds per glass of water), as well as decoctions and infusions of thermopsis grass (0.5-0.8 grams of dried grass per glass of water) have a good healing effect.

At the onset of bronchitis, the child's cough is dry and painful. The doctor will prescribe expectorants for the child. For your part, give your child warm milk with Borjomi, soda and honey.

If the child began to cough up sputum during a cough, it means that things are on the mend. Now it is important to remove this sputum regularly. Explain to your child the importance of a good cough. The lumen of small bronchi is released and breathing becomes much easier.

Now the child's cough occurs shortly after changing the position of the body. The child turned on the other side and - there is a cough. This is good. This helps to clear the bronchi. Phlegm, flowing onto the walls of the bronchi, irritates them and provokes a cough. Let the child change position more often.

You can even ask the child to lean out of the bed so that the legs remain on top, or arrange an inclined plane (legs up, head down). This contributes to the flow of sputum from the bronchi.

The sputum which has departed as a result of expectoration should not be swallowed. Explain to the child that sputum should be spit out.

The air in the room of a child suffering from bronchitis should not be dry. You will do the right thing if you hang wet towels in the room or turn on the humidifier.

Regular inhalations are very conducive to coughing. Especially alkaline (breathe soda vapor if you don't have an inhaler).

In acute bronchitis, the child is recommended the following fees:
Sheet coltsfoot - 1 part
Plantain leaf - 2 parts
Horsetail herb - 3 parts
Primrose grass - 4 parts
Pour 5-6 grams of the mixture with a glass of boiling water, leave for two hours. Depending on age, take 50-100 ml three times a day before meals.

Licorice root - 2 parts
Marshmallow root - 2 parts
Sheet coltsfoot - 2 parts
Fennel fruit - 1 part
Pour 5 grams of the dried mixture with a glass of boiling water, leave for up to three hours. Take 20-30 ml three times a day before meals.

With frequent bronchitis, it is recommended to use the following fees:
Thyme herb - 1 part
Sweet clover grass - 1 part
Fennel fruit - 1 part
Peppermint leaf - 1 part
Plantain leaf - 2 parts
Marshmallow root - 2 parts
Lungwort herb - 4 parts
Sheet coltsfoot - 4 parts
Pour 3 grams (about one teaspoon) of the dried mixture with a glass of cold water, leave for up to two hours, then boil for five minutes, strain. Take a sip during the day (you can 7-8 times).

Ledum herb - 1 part
Oregano herb - 1 part
Alder cones - 1 part
St. John's wort - 2 parts
Sage herb - 2 parts
Rowan fruits - 3 parts
Pour 1-1.5 teaspoons of the dried mixture with a glass of water, boil over low heat for 15-20 minutes, strain. Take 20-40 ml three times a day before meals.

Carrot juice with honey. Prepare a glass of fresh carrot juice, add three teaspoons of honey, mix. Take two to three tablespoons several times a day.

Cabbage juice. Sweetened juice from fresh cabbage, take one tablespoon three to four times a day as an expectorant (you can use honey instead of sugar).

Plantain juice. Mix plantain juice and honey in equal amounts and give the child one teaspoon three times a day as an expectorant and emollient.

Althea root infusion. Grind dried marshmallow root into powder. pour 5 grams of powder a glass of cold water and leave for 6-8 hours. Take two to three tablespoons three times a day.

Infusion of linden flowers. Pour one table spoon of dried raw materials with a glass of whale to insist under the lid (it is possible under the folded sheets several times) for an hour, pour it. Take half a glass three times a day.

Breathing exercises for bronchitis

Toddlers usually perform this set of exercises with pleasure, because it resembles a game!
Crow. The child, sitting on a chair, raises both hands up through the sides while inhaling. As he exhales, he says: “K-a-r-r!” and lowers his hands.

Bug. The kid sits on a chair, and holds his hands on his belt. On inspiration, he turns the body to the right, moving his right hand to the side and slightly back. After that, he exhales, saying "W-w-w-w-w." Then he returns to the starting position, takes a breath and repeats a similar movement to the left side.

Geese. The baby leans forward from a sitting position, hands should be raised to shoulder level. Simultaneously with the exhalation, he says: "Gaaaaa."

Stork. The kid does this exercise while standing. Invite him to portray a stork - arms raised to the sides, raise one leg, bend at the knee, at the same time take a breath. On exhalation, the baby slowly lowers his arm and leg, while saying: "Shhhh."

Crane. During inhalation, the arms of the crumbs rise up, while exhaling with the sound "Uuuuu" they go down along the body.

Flying. At the very end of the complex, the baby should quickly walk around the room, waving his arms like a flying bird. The movement ends with walking with a mandatory slowdown in pace.

All exercises must be repeated 4-5 times (the last time at least an hour before bedtime). The child should pronounce sounds loudly and clearly. The main thing is that hissing sounds must be pronounced on the exhale.

Acute (simple) bronchitis- inflammatory lesions of the bronchial mucosa without clinical signs of bronchial obstruction, predominantly of a viral or viral-bacterial nature. The main symptom of this type of bronchitis is a cough, at the beginning of the disease it is dry, and after 1-2 days it is wet with an increasing amount of sputum. Bronchitis is also accompanied by tracheitis (inflammation of the trachea), in which there is a feeling of pressure or pain behind the sternum. Sputum often has a mucous character, on the 2nd week it may acquire a greenish color, which is not a sign of microbial inflammation. The cough usually lasts up to 2 weeks. A longer cough is observed in infants with RS-viral infection, and in older children with mycoplasma and adenovirus. With tracheitis and tracheobronchitis with fibrinous overlays, coughing can be disturbing for 4-6 weeks in the absence of other symptoms.

With bronchitis, diffuse dry and coarse and medium bubbling, less often fine bubbling rales are heard, changing with coughing. Hematological changes (in the general analysis of blood) are unstable; with mycoplasmal infection, ESR may increase against the background of a normal number of leukocytes.

Bronchitis with SARS usually develops without signs of toxicosis at subfebrile - 37 ° C-37.5 ° C (or febrile in the first 1-2 days) temperature, but with adenovirus infection it can remain high for up to 7-10 days. Shortness of breath, even in children of the first year of life, is moderate (up to 50 breaths per minute).

Mycoplasma bronchitis(caused by M. pneumoniae) is more common at school age. It, as a rule, proceeds with a high temperature, contrasting with a slightly disturbed general condition and the absence of signs of toxicosis. Inflammation covers the small bronchi, which is manifested by crepitus, fine bubbling wheezing, increased small elements of the pulmonary pattern on the radiograph. Unlike viral bronchitis, mycoplasmal bronchitis is characterized by asymmetry of wheezing. These signs, in combination with "dry" conjunctivitis (without effusion), make it possible to suspect bronchitis of this particular etiology.

Chlamydial bronchitis(caused by Chi. trachomatis) in children of the first six months of life often proceeds without obstruction, severe shortness of breath, toxicosis and hematological changes, it is diagnosed when chlamydial antibodies of the IgM class are detected in any titer or IgG class in a titer above 1:64 (the diagnosis is considered reliable if the titer of lgG antibodies in the mother is lower than in the child). Chlamydial bronchitis (caused by Chi. pneumoniae) may be suspected by co-occurring angina and/or cervical lymphadenitis. In adolescents, it often occurs with obstruction, sometimes being the debut of bronchial asthma with a late onset.

Bronchitis is very dangerous for babies, especially if you do not pay attention to it in time.

Acute simple bronchitis

What is acute bronchitis?

Recently, there has been an increase in the incidence of bronchitis among children. At the same time, pathogens are increasingly atypical: chlamydia and mycoplasmas (Chlamidia trachomatis, Mycoplasma pneumoniae, C. Pneumoniae). We note right away that infections of this type can be very dangerous and require specialized diagnosis and treatment.
In other cases, the treatment of acute bronchitis is symptomatic.

Do I need to take antibiotics for acute bronchitis?

The use of antibiotics in acute bronchitis is justified only in the case of a proven bacterial infection. Most often, the addition of a bacterial infection is manifested by the following symptoms: the second wave of fever (on the 5-7th day of illness), the appearance of abundant purulent sputum, and the deterioration of the general condition of the patient.
The problem of whether or not to take antibiotics in the treatment of acute bronchitis should be decided by the attending physician. It should be noted that taking antibiotics unnecessarily can be even more harmful than not taking them when they are actually recommended.
Due to the increase in the incidence of mycoplasmal and chlamydial bronchitis in children and adults, in addition to such classical antibiotics as penicillins and cephalosporins, antibiotics from the macrolide group began to be used: erythromycin, azithromycin. The type of antibiotic, dose and route of administration are determined by the attending physician.

What should be paid attention to in the treatment of acute bronchitis in children?

I would like to draw the attention of parents to the fact that in some cases acute bronchitis can cause some serious complications (pneumonia, bronchiolitis) in such cases, home treatment should be stopped, and the baby should be urgently hospitalized. Here are some signs that indicate an unfavorable course of the disease and the need to see a doctor:

The temperature is above 38 ° C for more than 3-4 days and the baby's general condition is severe.
- Severe shortness of breath in a child: in newborns and children under 2 months, more than 60 breaths per minute, in children aged 3 months to a year, more than 50 breaths per minute, in children from 1 to 3 years, more than 40 breaths per minute.
- Noticeable retraction of the skin at the intercostal spaces when inhaling.

Clinical criteria for the diagnosis of acute simple bronchitis:

The general condition of the child is usually relatively satisfactory, and the symptoms of intoxication are moderate, the subfebrile body temperature usually does not rise above 38 ° C, respiratory failure is not pronounced. The baby has a cough with scanty, and then more abundant sputum discharge. The doctor, when listening to the chest, can detect scattered dry rales (less often, intermittent wet medium and coarse bubbling).

X-ray data consist in strengthening the pulmonary pattern in the basal and basal sections of the lungs. In the blood test, minor inflammatory changes (significant leukocytosis is not typical), moderate acceleration of ESR.

The duration of the disease in uncomplicated cases ranges from 1 to 1.5-2 weeks. Bronchitis caused by adenovirus, mycoplasma and chlamydial infection is more protracted.

Basic principles of treatment of acute simple bronchitis

Treatment is usually carried out on an outpatient basis at home, with the exception of severe concomitant manifestations of SARS. The regime against the background of acute manifestations of ARVI is semi-bed, and then home - the baby can get out of bed, do his usual activities.

Plentiful drinking is recommended, it is possible in the form of herbal teas or infusions, fruit drinks, juices. The volume of fluid is 1.5-2 times higher than the daily age requirement of the child. The diet is mainly lacto-vegetarian with a restriction of extractive spicy dishes, seasonings, and a restriction of highly allergenic foods.

Antiviral therapy: intranasal interferon 5 drops 4-6 times a day or in aerosols using an ultrasonic inhaler. If adenoviral etiology of bronchitis is suspected, RNase, deoxyribonuclease. With influenza etiology, rimantadine, ribavirin, immunoglobulin against the background of acute manifestations of ARVI.

Antibiotics are not indicated in most cases. Indications for prescribing antibiotics are obvious foci of bacterial infection, pronounced inflammatory changes in the hemogram, a tendency to a protracted course of the disease.
Antibacterial therapy is prescribed individually by a doctor. Systemic antibiotic therapy is carried out only for mycoplasmal and chlamydial bronchitis (macrolides are used), it is possible to prescribe local antibiotic therapy, for example, Bioparox, which in this case has an additional anti-inflammatory effect.
Depending on the nature of the cough, antitussives (codelac, codeine), (mucolytics) expectorants (erespal, lazolvan, gedelix, mucoltin) are prescribed. Antitussive drugs of central action suppress painful obsessive dry cough in the initial phase of bronchitis. Peripheral antitussives are indicated for dry cough associated with mucosal irritation, which usually accompanies tracheitis. Expectorants are designed to have an effect that stimulates coughing. The anti-inflammatory agent fenspiride (Erespal) can contribute to the reduction of inflammatory changes in the bronchial mucosa. Fenspiride acts both directly on the inflammatory process in the respiratory tract, and on the processes accompanying infectious and allergic inflammation, which is combined with the prevention of bronchoconstriction.
Aerosol inhalations - soda, soda-salt. With attacks of obstruction, nebulizer therapy. With a long-lasting cough (whooping cough, whooping cough with persistent tracheitis), inhaled steroids (pulmicor, salbutamol) are effective.

Postural drainage with vibration massage for profuse expectoration.

Antihistamines. Antihistamines are used in children with allergic manifestations, their drying effect can be used in patients with abundant secretion. Active motor mode for the drainage function of the lungs after normalization of temperature.
At normal body temperature - chest massage.

Therapy should be complex in combination with immunocorrective treatment.
Criteria for discharge to a children's institution: normalization of body temperature, reduction of catarrhal phenomena from the nasopharynx.

Obstructive bronchitis

In domestic practice, it is customary to distinguish between acute bronchitis and bronchiolitis, but this distinction is to a certain extent conditional and is not recognized by many foreign pediatricians.

The terms "obstructive bronchitis" and "bronchiolitis" refer to almost the same form of bronchitis, with only clinical differences. These terms apply mainly to children of the first 4 years of life, in which most obstructive forms of bronchitis are caused by PC-viral and parainfluenza infections. In older children, mycoplasma infection and Chi also play a role in the development of obstructive bronchitis. pneumoniae.

The peculiarity of the clinical picture in infants, the rarity of the development of pneumonia, allow us to consider bronchial obstruction as a reaction that protects the lungs from bacteria from the upper respiratory tract.

Obstructive bronchitis is manifested by severe shortness of breath due to bronchospasm, prolongation of exhalation, against which wheezing wheezes are heard, heard during auscultation and often at a distance. Fine bubbling wet rales, crepitus are heard in half of the cases.
Obstructive bronchitis is characterized by a dry, rare cough, subfebrile temperature, and the general condition often suffers little. Respiratory rate - 50, less often 60-70 per 1 min. Blood gas levels do not change dramatically. On the radiograph, swelling of the lungs is determined, in the general blood test - indicators characteristic of a viral infection.

Clinical criteria for the diagnosis of obstructive bronchitis:

Elongated whistling exhalation, often heard remotely.
On examination, a swollen chest (horizontal arrangement of the ribs) is revealed.
participation in the act of breathing of the auxiliary muscles with the retraction of the most compliant parts of the chest.
cough dry, paroxysmal, long-lasting.
auscultatory, against the background of an elongated expiration, there is an abundance of dry, whistling, and in later stages of the disease - medium and large bubbling moist, muffled rales.

X-ray: horizontal arrangement of the ribs on the diaphragm, lengthening of the lung fields, strengthening of the roots of the lungs, low standing of the flattened domes of the diaphragm, increased transparency of the lung fields.
Changes in the blood test correspond to a viral infection (leukopenia, lymphocytosis).

An episode of obstructive bronchitis differs from an asthma attack mainly in the gradual development of obstruction. Upon subsequent observation of the child, it may turn out that this was the beginning of bronchial asthma, the attacks of which also often occur against the background of SARS.

Current and forecast.

Although an episode of obstructive bronchitis may resemble an asthmatic attack, in most children, obstruction does not recur or recurs 1-2 times only on the background of SARS. Risk factors for the recurrence of episodes of obstruction and the development of bronchial asthma are:
the presence of allergies in the child or his parents.
IgE level above 100 IU/l.
the development of an episode of obstruction upon contact with a non-infectious allergen.
paroxysmal nature of the development of obstruction.
recurrence of obstruction - 3 or more episodes.

In these cases, it is appropriate to talk not about the "transition of obstructive bronchitis to bronchial asthma", but about its early onset. In this regard, all children with obstructive episodes, especially those with allergies, are recommended to create an allergenic environment and use a hypoallergenic diet, and in case of recurrence of obstruction, treatment with ketotifen for 3-6 months is recommended.

Considering the high risk of recurrence of acute obstructive bronchitis and the formation of bronchial asthma, children who have had acute obstructive bronchitis at least once and have foci of chronic ENT or bronchopulmonary infection are recommended to undergo immunocorrective therapy with a bacterial vaccine.

bronchiolitis

Bronchiolitis is an inflammatory lesion of the terminal sections of the bronchial tree (small bronchi and bronchioles) in acute respiratory diseases, mainly in young children, accompanied by severe and often difficult to treat respiratory failure

Clinical criteria for the diagnosis of bronchiolitis:

A characteristic sign of bronchiolitis is pronounced expiratory (on exhalation) shortness of breath up to 80-90 per minute. Draws attention to the general cyanosis (cyanosis) of the skin. Auscultatory over the lungs mass of scattered fine bubbling rales. Respiratory failure clearly prevails over manifestations of infectious toxicosis. With significant respiratory failure, there is a pronounced tachycardia, a weakening of the heart tones.

Criteria for the diagnosis of bronchiolitis according to Ogerro et al. (1983).
Symptom / Score
Shortness of breath more than 40 per minute. / one
Whistling noise on expiration / 2
Intercostal retraction / 1
Diffuse fine bubbling rales / 1
Dry cough / 1
Increase in body temperature / 1
Increasing the transparency of the lung pattern on the radiograph / 2
Note: To make a diagnosis, the sum must exceed 6 points

Basic principles of treatment of obstructive bronchitis

Although the basic principles of treating children with obstructive bronchitis basically coincide with those for acute simple bronchitis, at the same time, there are the following features of therapeutic tactics associated with the characteristics of the clinical course of the disease (mainly with the degree of severity of obstructive syndrome).

Treatment of children with obstructive bronchitis and bronchiolitis with severe heart failure is carried out in a hospital, if necessary, oxygen therapy is required.

1. Bed rest in a position with a raised head end.
2. Given the significant loss of fluid with perspiration (increased breathing), considerable attention is paid to adequate hydration (if necessary, parenteral).
3. Fractional feeding (liquid food is preferred). The diet is dairy and vegetable.
4. Removal of mucus from the upper respiratory tract with an electric suction.
5. Inhalation therapy, humidified oxygen in severe respiratory failure
6. Bronchodilators intravenously and inhalations (eufillin, b-agonists). With bronchiolitis, the effect of bronchodilator drugs is negligible.
7. Corticosteroid drugs.
8. Antiviral drugs interferon, amantadine, ribaverin.
9. Antibiotics for concomitant acute otitis, pneumonia or other bacterial infection.
10. Mucolytic drugs.
Much attention is paid to the additional use of immunotropic drugs, antiviral agents.
Measures aimed at improving bronchial conduction.
With bronchospasm, mucolytics, bronchodilators, local corticosteroids (beclomet, becotide, etc.) are prescribed.

Recurrent bronchitis

Recurrent bronchitis is bronchitis without pronounced clinical signs of bronchospasm that recurs at least 3-4 times a year for 2 years.
Etiology - viral and viral-bacterial infection. The critical period is 4-7 years.
The clinic of recurrent bronchitis during an exacerbation is almost similar to acute simple bronchitis. However, the course of the disease is protracted, sometimes up to 2-3 months.
Paraclinical data:
Characteristic "areactive hemogram" (no change in the blood).
X-ray changes are nonspecific.

Basic principles of treatment of recurrent bronchitis

In the period of exacerbation, they are treated like acute bronchitis. Much attention is paid to the additional use of immunotropic drugs, anti-oviral drugs, aerosol therapy. With bronchospasm, mucolytics, bronchodilators, local corticosteroids (beclomet, becotide, etc.) are prescribed.

In the remission phase - dispensary observation and rehabilitation in the clinic - local and climatic sanatoriums (stage 2).
Dispensary observation is stopped if there were no exacerbations within 2 years.

Folk remedies for bronchitis

Folk home remedies are used only in the treatment of school-age children and only in parallel with treatment prescribed by a doctor or for prevention.

• Boil two or three leaves of coltsfoot in half a liter of fresh milk. Add a small amount (at the tip of a knife) of fresh pork fat. Take one coffee cup in the evening before bedtime.
• In case of severe wet cough, when sputum comes off with difficulty or does not go away at all, 2-3 drops of almond oil in sugar syrup should be given several times a day.
• If bronchitis progresses and the child begins to choke, a doctor is urgently needed, as this is already very dangerous.
• For pneumonia, bronchitis, tracheitis and persistent cough, Vanga recommended a decoction of oats, prepared as follows: mix 2 tablespoons of oats with the same amount of raisins and pour 1.5 liters of cold boiled water. Cook over very low heat or simmer in the oven covered over low heat until half of the liquid has evaporated. Cool slightly, strain, squeeze, add 1 tablespoon of natural honey to the expressed liquid and mix thoroughly. Give children a teaspoon several times a day.
• Cut the radish into small cubes, put in a saucepan and sprinkle with sugar. Bake in the oven for two hours. Strain, discard the radish pieces, and drain the liquid into a bottle. Give your child two teaspoons 3-4 times a day before meals and at night before bedtime.
• Collect violets, snowdrop early in the morning, while the sun is still sleeping. Store in a dark place, dry in the shade. Brew 1 tablespoon of dried flowers in a glass of boiling water and keep in a water bath for 15 minutes. After it has cooled, strain. Give the child to drink 3 times a day, 1 tablespoon. Small children can add syrup, sugar. This is an excellent anti-inflammatory agent. It can be used for gargling.
• Garlic drink: five medium-sized garlic cloves, cut into small pieces or crushed, boil well in a glass of unpasteurized milk and give to children to drink several times a day.

Herbs and preparations for the treatment of bronchitis

When using any herbs, you must be sure that the child is not allergic to them!

The crushed angelica leaf is poured with boiling water at the rate of 10 g per 1 cup of boiling water, boiled for 5 minutes and infused for 2 hours. Ready infusion is suitable for use within 2-3 days. It can be replaced with powder: 1-3 pinches per day. Angelica infusion eliminates mucus in the lungs, chest and bronchi, relieves heartburn.

Prepare a tincture of yarrow: pour 30 g of grass with 0.5 cups of alcohol or 1 cup of vodka. Drink 3-4 times a day, 30-40 drops before meals for bronchitis.

Nasturtium leaf infusion is effective in chronic bronchitis. 10 g of the leaf is brewed with 1 liter of boiling water, insisted for 10 minutes and filtered. Drink during the day for 0.5 cups.

For bronchitis with viscous sputum, brew 0.5 liters of boiling water 4 tablespoons of crushed plantain leaf and leave for 4 hours. Drink 0.5 cup 4 times a day.

Boil 2-3 leaves of coltsfoot in 0.5 liters of milk and add fresh lard to the broth at the tip of a knife. Drink at bedtime 3 tablespoons for bronchitis. Health portal www.site

Mix in equal proportions grass and lungwort flowers plucked in early spring. Brew 4 tablespoons of the mixture in 0.5 liters of boiling water and leave for 2 hours. Drink 0.5 cup 4 times a day for bronchitis.

Mix in equal proportions leaves and bark or young shoots of ash. Brew 1 cup of boiling water 1 tablespoon of the mixture and heat over low heat for 20 minutes. Take 1 tablespoon 3 times a day for bronchitis.

Pour 1 glass of milk into an enamel bowl and put 1 tablespoon (without top) of finely chopped Icelandic moss. Cover the pan with a saucer or non-metal plate and boil for 30 minutes, then strain. Drink hot decoction before going to bed.

Pour 1 tablespoon of crushed oregano herb with 1 cup of boiling water, insist, wrapped for 1 hour, strain. Take 1 tablespoon 5-6 times a day 30 minutes before meals. Strong oregano tea causes profuse sweating. It is drunk for colds, convulsive cough, acute and chronic bronchitis as a means of increasing the secretion of the bronchial glands.

Powdered marshmallow root diluted with warm boiled water, bringing to the consistency of thick sour cream. The resulting mixture is taken 1 tablespoon 4 times a day before meals for coughs, chronic bronchitis.

Take 3 parts of licorice (roots) and blue cyanosis (roots), 4 parts of chamomile (flowers) and peppermint (herbs), 2 parts of valerian officinalis (roots), common motherwort (herbs), St. John's wort (herbs) ). Pour 1 tablespoon of the collection with 1 cup of boiling water, soak in a closed enamel bowl in a boiling water bath for 15 minutes, cool at room temperature for 45 minutes, strain through 2-3 layers of gauze, squeeze and bring the volume of boiled water to the original. Take 0.25-0.3 cups 4-5 times a day after meals for bronchial spasms.

home remedies for bronchitis

In acute bronchitis, 100 g of ground flax seeds, 20 g of anise fruit powder, 20 g of ginger root powder are thoroughly mixed with 0.5 kg of garlic-honey mixture. Take 1 teaspoon 3 times a day 30 minutes before meals.

Peel 3 heads of garlic and, together with 5 lemons with peel, but without seeds, pass through a meat grinder or rub on a fine grater, pour them with 1 liter of boiled water at room temperature and keep in a closed jar for 5 days, strain, squeeze the rest. Take as a resolving agent for diseases of the lungs and bronchi 3 times a day, 1 tablespoon 20 minutes before meals.

Take 5-6 large cloves of garlic, grind into a pulp, mix with 100 g of butter and a bunch of finely chopped dill. Spread the mixture on bread morning, afternoon and evening. This oil will help with bronchitis, as well as pneumonia.

Boil finely chopped garlic (1 head) in fresh milk until it becomes quite soft. Grind in the same milk, add 1 teaspoon of mint juice and 2 tablespoons of linden honey. Take 1 tablespoon every hour for the whole day, the cough will become softer.

An excellent recipe for treating bronchitis: grind 1 kg of ripe tomatoes and 50 g of garlic in a meat grinder, grate 300 g of horseradish root. Mix, salt to taste. Divide into glass jars and store tightly closed in the refrigerator. To consume: children 1 teaspoon before meals 3 times a day, adults - 1 tablespoon before meals 3 times a day. Warm to room temperature before use.

Mix in the ratio by weight 1:1:2 grated onion, apples, honey. For the treatment of bronchitis in children accompanied by a cough, take at least 6-7 times a day, regardless of food intake.

Carrot juice, boiled hot milk and honey in a ratio of 5:5:1 insist 4-5 hours and drink warm, 0.5 cups 4-6 times a day for bronchitis.

Fresh carrot juice mixed with warm milk in a ratio of 1:1, take 0.5 cup 4-6 times a day for bronchitis.

Mix 1 cup of freshly made carrot juice with 2 teaspoons of honey. Take 1 tablespoon 4-5 times a day for bronchitis.

Mix 300 g of honey and 1 leaf of finely chopped aloe, pour them with 0.5 liters of boiled water, put on fire, bring to a boil and keep on low heat for 2 hours, then cool and mix. Store in a cool place. Take 1 tablespoon 3 times a day for bronchitis.

Several times a day, chew until completely crushed 1 clove of garlic with 1 teaspoon of flower honey for bronchitis.

Take 1.3 kg of linden honey, 1 cup of finely chopped aloe leaves, 200 g of olive oil, 150 g of birch buds and 50 g of linden flowers. Before preparing the medicine, put aloe leaves plucked and washed with boiled water for 10 days in a cold and dark place. Melt honey and put crushed aloe leaves into it. Steam the mixture well. Separately, brew birch buds and lime blossom in 2 glasses of water and boil for 1-2 minutes. Pour the strained and squeezed broth into cooled honey, stir and pour into 2 bottles, adding olive oil equally to each. Store in a cool place. Take with bronchitis 1 tablespoon 3 times a day. Shake before use.

To facilitate the separation of sputum, it is useful to drink lingonberry juice with sugar syrup or honey. The remedy should be taken 1 tablespoon as often as possible. At the same time, it is recommended to drink tea from a strawberry leaf.

Prepare fresh cabbage juice, add sugar (2 teaspoons per 1 cup). Take 2 times a day for 1 glass as an expectorant.

Before using folk remedies, consult a doctor.