Bronchial asthma in a 2-year-old child. Basic therapy of bronchial asthma in children. Symptoms of asthma in children

AT last years there is a noticeable increase in the number of patients with bronchial asthma in childhood and even infancy.
The course of bronchial asthma is chronic: it is accompanied by periods of exacerbations (attacks of difficult breathing) and relative well-being (interictal period).

You can suspect the disease if your child had:
- episodes of difficult wheezing;
- cough at night;
- and shortness of wheezing, a feeling of congestion in the chest after physical or emotional stress, during illness;
- coughing, wheezing after contact with a specific allergen (for example, contact with a cat);
- if these symptoms were relieved by anti-asthmatic drugs.
Diagnosis bronchial asthma usually put later than the onset of the first symptoms, so if you notice any of the above signs in your child, immediately consult a doctor.

The mechanism of development of the pathological process

There are special muscles in the human bronchi. The contraction (tension) of these muscles leads to a narrowing of the lumen of the bronchi, and their relaxation to expansion. It's normal physiological process, necessary for man. For example, during exercise, additional oxygen is required. To do this, a person needs to inhale as much air as possible. His breathing deepens and his bronchi expand.

With bronchial asthma, the mechanism of timely adequate contraction of the muscles of the bronchi stops working. The essence of the disease lies in the fact that any irritant (allergen, physical activity, psycho-emotional stress) causes a spasm (narrowing) of the bronchi at the wrong time and out of place. In addition, due to concomitant allergic inflammation, the bronchial mucosa swells and very thick, viscous "glassy" sputum is released. This further aggravates the situation.

Causes of the development of bronchial asthma

Most children with bronchial asthma have a hereditary predisposition to allergies: one of the relatives suffers from allergic diseases. Often, a child who has had an attack for the first time already has some kind of allergic background (hay fever, food allergies, etc.). These diseases can develop in parallel.
The trigger for the onset of the disease in most children is frequent acute respiratory infections, acute respiratory viral infections and. Bacteria and viruses, affecting the walls of the bronchi, change their structure and, thereby, facilitate the penetration of allergens into them. As a rule, the disease is preceded by a series of obstructive bronchitis. The diagnosis can also sound like " asthmatic bronchitis”,“ bronchial obstruction ”,“ broncho-obstructive syndrome". In principle, the mechanism of development of obstructive syndrome differs from the mechanism of development of bronchial asthma and, in fact, it is one and the same. Therefore, when frequent occurrence during acute respiratory infections bronchospasm (obstructive syndrome), the child can rightly be diagnosed with bronchial asthma. The pediatrician who encountered in his practice with similar situation, is obliged to send a child with frequent obstructive bronchitis to an allergist to confirm the diagnosis of bronchial asthma and conduct appropriate (free!) Treatment.
The most common cause of an asthma attack is the ingestion of an allergen into the body of a child. For bronchial asthma the leading ones will be allergies to house dust (more precisely, to mites and cockroach antigens contained in it), plant pollen, animal hair, food, fungal and medicinal allergens. In the first year of life, food allergies come to the fore, allergens enter the body through. Pollen allergy (hay fever) and allergy to house dust prevail among schoolchildren: allergens penetrate through Airways.
Asthma attacks can be triggered by various physical influences on the body (cooling, overheating, drastic changes weather, physical activity) and psycho-emotional stress (fear, stress, excitement). Sometimes the result of an unfavorable psychological situation in the family can be. Children sometimes consciously, and sometimes unconsciously (subconsciously) themselves can cause seizures. So they try to draw attention to themselves or to some family problem as if "blackmailing" adults.
The deterioration of the environmental situation, air pollution by industrial emissions and car exhaust fumes leads to a violation of the immune status of the child and creates a fertile ground for the development of the disease. An important factor in the development of bronchial asthma is also tobacco smoke.
Separately allocate special form- "Aspirin" asthma. With her, asthma attacks occur on aspirin (acetylsalicylic acid). Moreover, aspirin is not this case allergen. The fact is that aspirin can provoke the release of certain biologically active substances that cause bronchial constriction (bronchospasm). In the presence of aspirin bronchial asthma, the child is categorically contraindicated in taking aspirin, acetylsalicylic acid and all products containing them. In addition, such patients should not use food colorings, including drugs in colored capsules.
The course of bronchial asthma is aggravated by concomitant diseases of the digestive system: gastroduodenitis, pancreatitis, liver disease, biliary dyskinesia,. Sometimes the cause of nocturnal attacks of bronchial asthma can be.

Some diseases that arose in childhood can, as it were, “outgrow”. One of them - bronchial asthma. Sometimes it happens that severe, accompanied by frequent excruciating asthma attacks of early age by adolescence passes without a trace. This is a fact that is difficult to explain, but a fact known to medicine. True, such a miraculous self-healing does not always happen, about 30-50%.

Symptoms of bronchial asthma

Sometimes an attack of bronchial asthma may be preceded by "harbingers": anxiety, irritability, agitation, or, conversely, depression and drowsiness. A classic asthma attack looks like this:

The child has a feeling of lack of air, heaviness and congestion in the chest.
Breathing is noisy, audible at a distance, while exhalation difficulty is characteristic, accompanied by wheezing.
Excruciating cough, with difficult, thick sputum, or sputum does not go away at all.
Often the patient takes forced position: sits, leaning on his hands, his shoulders are raised and shifted forward, his head is retracted.

The severity of asthma is determined by the frequency of attacks and the possibility of preventing them with the help of inhaled anti-asthma drugs without injections.

If the attack cannot be removed within a few hours, then the child has developed asthmatic status. This is a dangerous condition that can end very sadly, up to death.

Asthmatic status can provoke uncontrollable, excessive frequent use bronchodilators, mainly aerosol inhalers. Their improper use leads to the fact that the bronchi cease to respond to the medicine. Therefore, if it is impossible to remove the attack on your own, you need to call an ambulance and urgently hospitalize the child.

The unpleasantness of the disease also lies in the fact that due to frequent attacks, accompanied by respiratory failure, the child's brain is constantly lacking oxygen and cannot develop normally. In addition to everything else constant fear attack threats. Having arisen at an early age, asthma leaves a certain imprint on the character of the child. Such children, as a rule, are disinhibited, easily vulnerable, emotionally labile, and may develop different kinds neuroses. With a long course, there is a lag in the physical, intellectual, sexual development of an asthmatic child compared to peers.

Treatment of bronchial asthma

Efficiency medical measures depends on the timely termination of the patient's contact with the allergen: climate change, daily wet cleaning in the apartment, elimination of indoor flowers, pets, aquarium, woolen carpets, etc. Important timely treatment foci of chronic infection: (carious teeth, adenoids, tonsillitis, etc.) and diseases of the digestive system (intestinal dysbacteriosis, liver and gallbladder diseases, gastroesophageal reflux, etc.).

Diet. In the diet of a patient with bronchial asthma, it is necessary to exclude allergens that can provoke attacks, limit the intake of carbohydrates (sugar, sweets, bakery products) and animal proteins. If a child has a food allergy, parents can be encouraged to keep a food diary. To do this, a record is kept for several months of what and when the child ate during the day. Comparing the information from the food diary with the onset of an exacerbation of the disease, it is possible to detect the dependence of the appearance of seizures on any food product.

Recommended diet for a patient with bronchial asthma:
- Reduce the amount of sugar, confectionery sweets, pastries, salt.
- Daily calorie content should be about 2800 kcal.
- Daily dairy products.
- Soups: cereals, vegetables, beef on the second broth.
- Oil: butter, sunflower, olive.
- Kashi: buckwheat, oatmeal, rice.
- Fresh vegetables and fruits: painted green (cucumbers, herbs, green apples, etc.).
- Meat: boiled lean beef.
- Bread: white, lean.
- Boiled potatoes.

Medical treatment. Modern traditional medicine offers a variety of drugs used for treatment of bronchial asthma. Conventionally, they can be divided into two groups:
Ambulance to relieve an attack. These drugs have a bronchodilatory effect. In pediatric practice, salbutamol, ventalin and berotek are used in the form of inhalers, eufillin in tablets or injections, as well as some other potent drugs.

Prophylactic drugs that relieve allergic inflammation. Experts call them "basic", necessary. There are several groups of them: antihistamine antiallergic drugs (suprastin, tavegil, claritin, etc.), membrane stabilizers (intal, tailed, ketotifen, etc.), hormonal drugs, antibiotics, etc. They are selected individually, taking into account the severity and characteristics of the course of bronchial asthma.

Unfortunately, the course of bronchial asthma is chronic, and in most cases, the drugs offered for treatment give a temporary and unstable result. Moreover, they appear side effects these drugs: addiction, dysbacteriosis, allergic reactions, dysfunction gastrointestinal tract, liver, kidneys, metabolism, heart, tachycardia, increased pressure, etc. It happens that a child experiences a fear of an attack and arbitrarily exceeds the dose of a bronchodilator drug tenfold, which can provoke status asthmaticus.

Treatment of bronchial asthma- a complex, time-consuming process that requires a comprehensive and individual approach. Doses of drugs, course of treatment, duration of taking drugs are selected by the doctor. Do not try to treat the child yourself, consult a specialist.

Inhalers. Patients with bronchial asthma often use inhalers (the medicine is inhaled from an inhaler). The inhaled drug can be in the form of an aerosol (a gaseous state of a substance) or in the form of a fine powder. Bronchodilators are administered by inhalation hormonal medications etc. However, when a sick child inhales medicine from an inhaler, only 10-20% of the medicine reaches his bronchi. Most of the drug settles along the way, on the back of the throat. In addition, children, especially young children, do not understand the instructions well and may inhale the medicine from the can incorrectly and ineffectively.

To improve the process of inhalation of the drug, use special devices: spacers, turbuhalers, nebulizers, " easy breath”, etc. In pediatric practice, their use is mandatory, as it allows you to use smaller doses, have less costs and reduce the risk of developing side effects. Usually such devices can be bought at a pharmacy, often they are sold together with an inhaler can or medicine for inhalation.

A spacer is an inhalation aid, a chamber that serves as an intermediate reservoir for an aerosol medication. The medicine from the inhaler balloon enters the spacer and is then inhaled by the patient. Thus, you can take not one breath, but several, while most of medicines will not enter the lungs. The spacer increases the percentage of drug reaching the lungs by up to 30%. The spacer is only applicable for aerosol, not for dry powder.

Turbuhaler, diskhalver, cyclohaler - devices similar to spacers, but for powder inhalers.

A nebulizer is a technical device that transfers medicine into an aerosol cloud. The ways of forming an aerosol cloud are different, depending on this, ultrasonic and compressor (pneumatic, jet) nebulizers are distinguished. With the help of a nebulizer, long-term inhalation of aerosol solutions can be carried out. medicinal substances.

The "easy breathing" system is activated by the patient's inhalation. The inhaler works automatically when the patient inhales, so there is no need to coordinate the inhalation and the moment of pressing the valve of the inhaler. Used in conjunction with a spacer. The release rate of the drug in the "easy breathing" system is 4 times lower than in conventional inhalers, and the created aerosol cloud does not hit the back of the throat. At the same time, penetration into the respiratory tract increases by 2 times.

Phytotherapy. Herbal medicine plays a positive role in the prevention of asthma attacks, prolongation of the interictal period, and reduction of side effects from drugs. This method perfectly complements the traditional drug treatment, increasing its efficiency.

Phytocollection No. 1 (for bronchial asthma):

rosemary herb - 5 parts,
nettle leaves - 3 parts,
coltsfoot leaves - 2 parts.

Phytocollection No. 2 (for bronchial asthma):

licorice roots - 4 parts,
roots of elecampane high - 4 parts,

wild rosemary herb - 12 parts,

nettle leaves - 6 parts,
coltsfoot leaves - 10 parts.

Rules for the preparation of medicinal decoctions.

In an enamel bowl overnight, pour 4 tbsp. l. collection 1 l cold water, close the lid and leave to infuse. In the morning, boil over low heat for 7-10 minutes from the start of boiling, leave for 1-2 hours, squeeze. Take warm or hot, adding 1 tbsp. l. milk, 5-6 times a day. The broth is not stored and a new one is prepared daily.

Doses:
children up to a year - 1 tbsp. l.;
children 1-3 years old - 2 tbsp. l.;
children 3-10 years old - 3 tbsp. l.;
children 10-12 years old - 50 ml;
children over 12 years old - 1/2 cup
and adults - 5-6 times a day.

Medicinal phytocollections No. 1 and No. 2 alternate every 3-4 weeks. Take a long time.

Apple vinegar. Dilute 1 tbsp. l. vinegar 10 tbsp. l. water, drink 3 times a day after meals.

Tincture of garlic. Peel and chop 10 heads of garlic, pour 500 ml of vodka, close tightly and leave for 3 days in a dark place. Extract and filter. Take in the amount of 1 drop per year of a child's life 1 time per day, starting with 1 drop and gradually increasing to full volume.

When coughing and shortness of breath during obstructive bronchitis and during an attack of bronchial asthma, plants are used that have an expectorant and sputum-thinning effect. These are dandelion, chamomile, St. John's wort, plantain, horsetail, knotweed, yarrow, nettle, coltsfoot, calendula, licorice root. They can be used in the form of decoctions, infusions, dry powder (tablets), poultices, lotions, etc.

After the process subsides, for the rehabilitation of a patient with bronchial asthma, phytopreparations containing licorice root (glycyram, dietary supplement "Lacrinate", infusion of licorice root, pertussin) are used in long courses of at least a month.

Aromatherapy. Essential oils are shown only in microdoses. Use essential oils of lavender, thyme, tea tree. Add to massage oil, rub the chest (5 drops essential oil per 10 ml base) or use an aroma lamp for 10 minutes a day.

Physiotherapy treatment. In the treatment, physiotherapy exercises are used, breathing exercises, massage, acupuncture, mountain air treatment, Spa treatment(especially useful highlands with rarefied air, Elbrus, Kislovodsk, southern coast of Crimea), etc.

Homeopathic treatment. copes well with bronchial asthma treatment. It is only important to find a competent homeopathic doctor who will select an individual treatment regimen for your child.

Working with a psychologist As noted above, the disease leaves its mark on the character of the child, so he needs the help of a psychologist or psychotherapist, as well as the creation of a favorable psychological atmosphere in the family.

In some cases, the child will need to consult a neurologist and prescribe drugs that improve brain function.

Asthma schools. The experience of specialists has shown that parents know very little about bronchial asthma and about the possibilities modern medicine in her treatment. Many parents, in an attempt to cure their child, turn to various charlatans, healers and psychics who promise "a quick and complete recovery." However, as we can see, there is a huge choice of completely official safe and effective therapies. In order to raise the awareness of patients in this area of medicine, special asthma schools have been established. It provides training for sick children and their parents. Parents are told about the features of the course of bronchial asthma, about allergens, they study the principles of providing emergency care, rehabilitation, exercise therapy ( physiotherapy exercises), massage, non-traditional methods treatment, affect the psychological aspects of the disease. Children learn how to use inhalers correctly, behave appropriately during an attack, psychologists work with them, etc.

Asthma schools help establish cooperation between doctors and young patients and their parents. The fight against the disease by joint efforts in a single direction contributes to an increase in the effectiveness of treatment and a significant improvement in the quality of life.

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Allergology V.A. Revyakina
Research Institute of Pediatrics Science Center children's health RAMS

Bronchial asthma is one of the most common childhood diseases. Epidemiological studies in recent years indicate that 5 to 10% of children suffer from this disease, and every year this figure increases. A serious concern is also caused by the increase in mortality from bronchial asthma and the number of hospitalizations in pediatric institutions.

This disease has been known since ancient times. The term "asthma" itself comes from a Greek word meaning shortness of breath or shortness of breath. The ancient Greeks treated asthma with respect, considering it a sacred disease caused by the gods. In the first century of our era, the Greek physician Aretaeus noted that women are more likely to suffer from bronchial asthma, and men are more likely to die from it, while children have the best prospects for recovery. In the second century AD, Galen described bronchial asthma as a spastic condition of the respiratory system. He correctly assumed that bronchial asthma is associated with obstruction of the bronchi and proposed to thin the mucus that clogs the bronchi. The famous physician van Helmont, who suffers from asthma, associated this disease with smoke and irritants. Thomas Sydenham defined bronchial asthma as a disease in which the bronchi are "clogged" and american doctor Eberle noted in 1830 important role heredity in the occurrence of bronchial asthma. In 1900, bronchial asthma was associated with hay fever. Further studies have shown that this disease is caused by many causes.

At present, bronchial asthma in children is considered as chronic illness, which is based on allergic inflammation of the respiratory tract and bronchial hyperreactivity. It is characterized by intermittent attacks of shortness of breath or suffocation due to bronchospasm, mucus hypersecretion and swelling of the bronchial mucosa. Based on typical asthma attacks, the doctor determines the diagnosis of bronchial asthma. Sometimes such a diagnosis is made even in cases where the child has a prolonged dry paroxysmal cough, which is worse at night or on waking.

Bronchial asthma is a disease with a hereditary predisposition and, as a rule, develops in children with a family history of patients with allergic diseases. Some children with asthma, with no apparent family predisposition, may have relatives who have had wheezing in the lungs, misdiagnosed as "chronic bronchitis" or "pulmonary emphysema." Recent studies indicate that bronchial asthma, which begins in the early childhood, is most likely hereditary.

It is now well known that the onset of asthma in most children is associated with exposure to various allergens, among which the most common is house dust. About 70% of children with bronchial asthma are sensitive to house dust. House dust is a complex mixture containing cotton fibers, cellulose, animal hair, and mold spores. The main component of house dust are mites, invisible to the naked eye (see figure). The favorite food of domestic mites is scales, which are peeled off from human skin and collected in mattresses, carpets and upholstered furniture. They can also be found in drapery fabric, bedding, soft toys, under skirting boards.
Rice. House dust mite (200x magnification).

The optimal conditions for their reproduction is a warm, humid climate. At a temperature of 10 ° C and 50% humidity, the mites die. A dead house dust mite does not lose its allergenicity, since its body particles have a pronounced allergenic activity. In patients sensitive to house dust mites, asthma attacks most often occur either at night or early in the morning. The occurrence of symptoms of the disease is possible when the bed is made, since the concentration of house dust mites in the air increases significantly.

The causes of bronchial asthma can be wool, dandruff, saliva of various animals (cats, dogs, guinea pigs, hamsters and other rodents). Found in saliva, fur or dander, the cat allergen is the most potent of all allergens and is exceptionally stable and can penetrate deep into the lungs. It persists in the environment for a long time, even after the cat is removed from the house. Dog allergens (from wool, saliva and dander) can keep high level for several months, even after the removal of the dog from the house. Horse dander, dry food for aquarium fish, and insects, especially cockroaches, are also common causes of asthma attacks.

A serious reason for the development of bronchial asthma can be mold spores contained in the air, air conditioners, as well as in damp dark rooms (basements, garages, bathrooms, showers). In winter, when the ground freezes or becomes covered with snow, mold on the street is no longer a problem for asthmatic children. Molds begin to multiply rapidly in the air from the beginning of May, reaching a peak in July or August and can cause symptoms of the disease until the first frost. Molds are present in many food products(aged cheeses, beer, pickled vegetables, kefir, champagne, dried fruits, yeast dough, kvass, stale bread).

Pollen from flowering plants in 30-40% of children with asthma can cause asthma attacks. The peak incidence, as a rule, occurs in April-May and is associated with the pollen of trees - birch, alder, hazel, maple, ash, chestnut, willow, poplar, etc. If the symptoms of bronchial asthma occur in June-August, then they are caused by pollen cereal grasses - timothy, fescue, ryegrass, hedgehogs, bluegrass. weeds(quinoa, ragweed, wormwood, dandelion, nettle) cause asthma symptoms in the summer-autumn period of the year. The spectrum of pollen allergens and the timing of flowering vary depending on the climatic and geographical zone. In many plants, the pollen is so light that it is carried through the air and easily enters the respiratory tract. Heavier pollen (for example, from roses and pines) is carried by low-flying insects, i.e. it is less allergenic than airborne pollen.

In some children, asthma attacks can induce medications such as antibiotics, especially penicillins and macrolides, sulfonamides, vitamins, aspirin. At the same time, contact with medicinal substances is possible not only when they are taken, but also when children stay near pharmaceutical industries.

The increase in the incidence of bronchial asthma noted in recent years is associated to a large extent with environmental pollution, and above all, atmospheric air. chemical compounds, usually due to industrial (a complex of particles of sulfur dioxide) and photochemical smog (ozone, nitrogen oxides).

An adverse effect on children with bronchial asthma is caused by air pollution of living quarters with chemical compounds. New building technologies (more lighting, less natural ventilation, the use of modern finishing materials, heating and humidification technology) have significantly changed indoor air quality and increased its negative impact on the respiratory system.

In addition to the above factors, exacerbation of bronchial asthma in children can cause physical exercise, emotional stress, crying, laughter, changing weather conditions, strong smells of paints, deodorants, perfumes, and tobacco smoke. Asthmatic children whose parents smoke often have frequent exacerbations that require anti-asthma medications. It has been established that the severity of a child's disease is directly dependent on the number of cigarettes smoked by parents daily. Attacks of difficulty breathing can develop in a child as early as one month old if parents or other relatives smoke in the family.

Viral infections are among the most common causes of asthma attacks. Respiratory viruses damage the ciliated epithelium of the mucous membrane of the respiratory tract and increase its permeability to allergens, toxic substances, increasing bronchial hyperreactivity. Many asthmatics are prone to frequent acute respiratory diseases. The presence of foci of chronic infection, mainly in the nasopharynx, increases the degree of sensitization of the body.

Thus, bronchial asthma is a multifactorial disease, the development of which is closely related to the influence of genetic and environmental factors. Finding out the causes of bronchial asthma significantly increases the effectiveness of therapeutic measures.

Literature

1. National program "Bronchial asthma in children. Treatment strategy and prevention". M., 1997.

Bronchial asthma is an immune disease of the respiratory tract. It is based on increased reactivity of the bronchi, which is manifested by periods of shortness of breath. It has chronic course. The nature of the disease is not fully understood. Attacks of bronchial asthma are most often provoked by causative allergens: household mites, dust, pet dander, pollen, etc. The disease is often inherited.

In contact with

The first signs of bronchial asthma in children

Cough, difficulty breathing for pungent odors;
in young years - atopic dermatitis(rashes on the skin);
frequent bronchitis with the development of bronchial obstruction;
frequent colds without fever, followed by the development of bronchitis;
persistent .

The main signs of asthma

The most common symptoms of asthma are in contact with allergens : animals, house dust, pollen, etc. They can also appear with a cold, with the appearance of pungent odors in the air (deodorants, tobacco, other pungent odors). Provoke an attack and physical activity, laughter, crying, abrupt change ambient temperature. Family predisposition matters.

So to symptoms of asthma include:

Periods of difficulty breathing, shortness of breath;
wheezing wheezing;
a cold is constantly accompanied by a cough, wheezing, shortness of breath;
other signs of allergy - itching, sneezing, "stuffing" of the nose.
wheezing wheezing;
cough that gets worse at night and early in the morning.

Signs of asthma in infancy

Define developing signs asthma at an early age for a person without special training very difficult, however, parents should alert the following points:

Cough leading to the urge to vomit;
feeding is difficult - the child breathes heavily, groans, weakly sucks;
wheezing wheezing;
an increase in the frequency of inhalation and exhalation.

Normally, breathing at the age of two months should be within 60 respiratory movements per minute. From two months to a year, the norm is no more than 50 per minute.

Features of development in children

The development of the disease begins to be traced in infancy, when, due to the early introduction of complementary foods, artificial feeding there is an increase in the body's sensitivity to allergens. The first signs of asthma appear in the form of rashes on the skin, periodic nasal congestion. begin to be accompanied, there are elements of obstruction, difficulty breathing. Then cough, wheezing, asthma attacks appear and after contact with a provocateur (allergen).

Due to frequent episodes of lack of oxygen in the blood, immaturity of organs and systems, children often have common signs of bronchial asthma: fatigue, poor grades at school, and lag in physical development.

First aid for an asthma attack in a child

First aid should include the following steps:

Remove the factor that triggers the development of an attack, if possible - pollen, a pet, tobacco smoke, etc .;
provide a free flow of air to the child - remove tight clothing;
help the child to take a body position in which breathing is most effective - a sitting position with the body tilted forward with support on the hands;
give a warm drink;
effectively the same exercise with holding the breath on exhalation;
the use of an aerosol through a spacer from a metered dose inhaler (ventolin, salbutamol) or through a nebulizer (ventolin, salgim). If necessary, 3-4 inhalations every 20 minutes. If there is no effect within an hour, the child should be hospitalized;
during an attack moderate, in the absence of the effect of 2-3 inhalations of the above drugs, Pulmicort or dexamethasone is recommended. In the absence of effect within an hour - hospitalization.

Are you worried about what baby inflammatory processes in the lungs will lead to more complex diseases? Professional information about possible complications after pneumonia in children is given.

What to do if there is no inhaler?

Provide air to the child, remove tight clothing;
enter intramuscularly, in the form of an injection of eufillin (5 mg / kg), dexamethasone (0.6 mg / kg);
in the absence of effect and the development of signs of asthma, hospitalization is recommended.

Treatment in children

Treatment is prescribed only by a doctor. In addition to excluding the patient's contact with the allergen, it is also recommended:

Helper Methods– physiotherapy, salt caves, methods of controlled breathing, acupuncture, psychotherapy, ASIT therapy (injection);
basic therapy– inhaled glucocorticosteroids. Taken daily and for a long time. These are Flixotide, Pulmicort, Klenil. From combined drugs this is Seretide and Symbicort. In addition, the use of montelukast, zafirlukast is recommended;
in older children as well as component of basic therapy Omalizumab may be used, which refers to drugs that bind the trigger component in the blood allergic reactions(IgE);
if standard doses of inhaled glucocorticosteroids do not allow controlling bronchial asthma, they are combined with Formoterol, Salmeterol;
funds emergency care if necessary - salbutamol (Ventolin). Fenoterol, eufillin, dexamethasone, prednisolone are also used.

Forecast

To date, bronchial asthma is not amenable to complete cure. However, a wide range of drugs can minimize its symptoms and significantly improve the patient's quality of life. In some children, the symptoms of asthma disappear on their own with age.

Used Books:
1. Allergology and immunology / ed. A.A. Baranova and R.M. Khaitova: The Union of Pediatricians of Russia. - 3rd ed., Rev. And extra. - M .: Union of Pediatricians of Russia, 2011. - 256 p. - ( Clinical guidelines for pediatricians).
2. Handbook of a pediatrician / Ed. IN. Bykova, A.S. Kalmykova. – Ed. 3rd, revised. and additional - Rostov n / D: Phoenix, 2007. - 573 p. - (The medicine).
3. Reference pediatrician. 2nd ed. / Ed. N.P. Shabalova. - St. Petersburg: Peter, 2009. - 720 p. - (Series "Doctor's Companion").

Bronchial asthma is a disease characterized by chronic inflammation respiratory tract. This pathology increasingly seen in children. This is due to the deterioration of the environmental situation, which significantly affects children's immunity. Therefore, absolutely every parent needs to know the signs and symptoms of asthma in order to have time to help their baby.

About the disease

Chronic inflammation of the airways is characterized by narrowing of the bronchial lumen. Because of this, bronchospasms occur, which provoke the formation increased amount mucus. This prevents the normal flow of air masses, breath holding occurs. Such a violation in the body is called bronchospasm.

Classification of asthma:

Atopic or allergenic: caused by allergens entering the body. The most popular ones are: dust, food, pollen, animal hair, cosmetic fragrances, etc.
Non-atopic or non-allergenic: begins development under the action of infectious agents. A rare asthmatic form.

The severity of the pathology:

light;
average;
heavy.

The severity of the disease is determined by the number of attacks, their duration and the strength of the impact on the body. Based on these data, a specific treatment is selected. It should be aimed at stopping the pathology. You should also choose, together with the pediatrician, preventive measures to reduce the number of seizures.

It is noteworthy that children who suffer from asthma already from birth contain the asthmatic gene. Often there is a hereditary transmission of this disease. has a strong influence on the course of the disease environment in which the baby grows.

A common cause of childhood asthma is hypersensitivity to irritants. This is due to the hyperreactivity of the bronchi in babies.

Congenital factors:

Overweight: Asthma in obesity is common. This is due to a change in the position of the diaphragm against the background. heavy weight. In this case, the diaphragm rises up, which prevents the normal respiratory process.
Heredity: increased risk the occurrence of asthma in children whose relatives are susceptible to the same disease.
Gender of the child: according to the average data, males are more likely to suffer from asthma. This is due to the specific structure of the airways. In boys, the lumens of the bronchial tree are much narrower than in girls.

Environmental factors affecting the manifestation of asthma:

animal hair;
pollen, often seasonal;
dampness in the room, mold;
food products, for example, citrus fruits, milk, honey, etc.;
dust of various etymologies;
medications.

Allocate the following reasons occurrence of bronchial spasms:

dry air;
viral diseases;
perfumed cosmetics;
traffic fumes;
household means;
cold air;
shortness of breath caused by excessive exercise.

Bronchial asthma in children important symptoms

It is very easy to confuse childhood asthma with colds. Some parents perceive the first signs of asthma as symptoms of SARS or flu. At the same time, they do not even realize that their baby has a rather serious pathology.

A distinctive feature of asthma is the absence of an increase in body temperature against the background of a prolonged dry cough.

Before an immediate attack, you can identify indicators of precursors in a baby.

How Asthma Begins: Pre-Initial Signs:

Irritability and fear in a child.
Bad dream.
Mucus from the nose, after a night's sleep. Accompanied by itching of the nose, frequent sneezing.
A few hours after waking up, a dry cough occurs.
After daytime sleep cough becomes wet.
The appearance of precise asthmatic symptom in few days.

After these manifestations can be seen in the little one obvious symptoms asthma:

Additional symptoms in children older than 1 year:

when inhaled by mouth, increased dry cough;
tightness in the chest;
the impossibility of performing a full breath;
prolonged dry cough without signs of mucus discharge;
dermatological rashes, as an atypical symptom of asthma;
onset of symptoms observed under similar conditions.

In the presence of bronchial asthma in children, the symptoms should not be ignored, treatment should be carried out immediately. Strict monitoring of the health of the baby is necessary.

An asthma attack is a very serious phenomenon. Therefore, every parent needs to know what an attack looks like, as well as effective ways from his deliverance.

An asthmatic attack can start at any time, so correct algorithm action will help you respond quickly.

Look at the behavior of the baby, listen to him:

Respond absolutely to any signs of deterioration in breathing in a toddler. Older children can tell you what exactly hurts them, tell you about breathing problems.
Pain in chest can also symbolize asthma. This factor should not be ignored. Such pain present with poor airflow through the respiratory tract.
Often children do not admit their problems. If you notice that the baby is scared, closed, then try to calm him down and find out what's wrong.

Take a look at the appearance of the child:

Soreness appearance may indicate an asthma attack. Children with colds have a similar appearance.
See if there excessive sweating at the baby. severe pallor skin may also indicate an impending attack. This is due to a lack of oxygen in the blood.
A severe case of asthma is accompanied by blueness of the mouth and nose area. This sign indicates a severe oxygen deficiency. In this case, emergency medical attention is needed.

Baby breath test:

Pay attention to whether the child has to make any effort to inhale. Raising the shoulders is an important sign of difficulty breathing.
Unusual posture may indicate an attack. With difficulty in the flow of air, the child can stoop, rest against the table, adhere to the wall, which at least slightly alleviates his condition.
The respiratory rate is the most striking indicator. A calm intake of air occurs in about 20 breaths per 1 minute. With rapid breathing, you should ask general well-being child.
With increased inhalation of air during an attack, the baby has significant expansion nostril.
A strong dry cough creates pressure in the bronchi, which allows you to breathe a little easier. Therefore, pay attention to this indicator of asthma.
Look at the area below the ribs. Contractions in this area during breathing symbolize the lack of oxygen volume.
During an asthma attack, wheezing is often observed when inhaling or exhaling. Hissing and whistling sounds are also possible.

A mild first attack is a serious factor for contacting your doctor. It is the pediatrician, together with other narrow specialists, who will help to draw up a competent treatment.
A severe prolonged attack must be urgently stopped. Therefore, you should immediately call an emergency medical care.
With recurring attacks, you need to keep inhalers at the ready, which relieve bronchospasm. Young children need help using the inhaler. For older asthmatics, training in the independent use of an inhaler is provided.

Unfortunately, to date, there are no drugs that can cure asthma. The list of prescribed medications is aimed at stopping asthmatic attacks. The number of drugs taken depends on the form of the course of the disease. Gradually the dosage increases.

Only a doctor has the right to prescribe treatment. It is the pediatrician who will be able to establish the correct required dosage of the active ingredients of the drugs.

There are two groups of drugs for the treatment of asthma:

basic;
symptomatic.

Basic drugs are prescribed to relieve inflammation, as well as remove allergic substances from the body. These include cromones, antileukotriene and anticholinergic drugs, glucocorticoid hormones. It is necessary to treat a child with these means constantly, as well as for preventive purposes.

It should be remembered that they are not able to quickly stop the attack, do not relieve bronchospasm.

Such drugs should be taken for a long time. The result is not immediately visible, it will be noticeable only after a couple of weeks of systematic treatment.

Parents need to know that glucocorticoid hormones have several important side effects. These include:

decreased immunity;
problems with the gastrointestinal tract;
hormonal disbalance;
increase in body weight.

Symptomatic drugs can quickly relieve bronchial spasm. This improves the passage of air through the respiratory tract. Such drugs are the basis for emergency care for an attack. Such drugs are not used as a preventive treatment.

Medicines are the basis for maintaining a child's body with asthma. These include inhalers, tablets and syrups.

There are also a number of other methods to improve the condition of the body with asthma:

acupuncture;
reflexology;
physical training;
breathing exercises;
salt caves.

Prevention

Preventive measures help reduce asthma attacks. To do this, it is necessary to increase the immunity of the child, to help improve the general condition.

Helpful tips for preventing asthma attacks:

Breastfeeding plays an important role in prevention. It should continue for at least 1 year.
When feeding with a mixture, you should discuss the composition of the milk with the pediatrician.
Avoid foods in the children's menu that have a hanged allergy.
Avoid pets if your baby is prone to allergies.
accustom children's body to hardening. This method perfectly enhances natural immunity.
Monitor the condition of the living space, remove dust in time.
Use anti-allergic cleaning products.
Children's care cosmetics should be made from eco-friendly components of a hypoallergenic nature.
Ventilate the child's room.

Bronchial asthma in children is quite common. Therefore, every parent needs to know the signs of asthma in children. This will help you quickly respond to an attack. This ailment needs constant parental supervision. Precisely due drug prophylaxis, as well as other medicinal measures can reduce the number of dangerous attacks.

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Sholokhova Olga Nikolaevna

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Symptoms, causes and methods of treatment of bronchial asthma in children

It is especially dangerous in children, as it can cause bronchial obstruction due to sharp increase mucus in bronchial tree. Asthma can develop in a child at any age, even in infancy.

Why does a child develop asthma?

A chronic disease characterized by inflammation of the bronchi and mucus secretion occurs for several reasons. Children are most susceptible to manifestations of the disease, as their respiratory system still weak, perceives all stimuli sharply and reacts intensively to them. The causes of the disease are:

Important: In the first month after childbirth Great chance the fact that the disease develops due to the mother's smoking during the period of bearing the baby. Also the reason is her eating foods, causing allergies, infectious diseases during pregnancy.

Pathologies of the gastrointestinal tract only aggravate the course of bronchial asthma. Symptoms and treatment in this case will differ from mild degree diseases. When the intestines are damaged by toxins, the bacteria are absorbed into the blood, this worsens the condition of the already weak bronchi.

Asthma periods

The disease in children, depending on age, causes and severity, proceeds differently: the symptoms of bronchial asthma change, the rate of relief of an attack and further treatment. The manifestations of the disease are divided into three periods.

Remission time

The state in which little patient almost nothing worries: there is no obvious cough, wheezing, suffocation. The remission stage is a break between attacks. When the disease manifests itself at an early age, it is severe, the brain does not receive necessary nutrition. As a result, the child's brain also does not perform all the functions. The baby begins to cry over trifles, mood swings are observed, some mental processes are a little behind in development. Remission manifests itself in different ways: some children lead a familiar lifestyle, others find it difficult to play outdoor games, others cannot perform their usual activities without medication.

Aggravation

Develops in short time, this is the time at which bronchospasms occur. According to the nature of the course of the disease during the period of exacerbation, the attending physician makes a conclusion about the severity of the disease.

Characteristics of an attack

This is a condition in which the main symptoms of the disease appear. It is very important for parents to recognize the onset of an attack in time and stop it as quickly as possible. To do this, you need to be sensitive to the child's complaints about breathing problems, listen to his speech and breathing during sleep. After all, attacks of bronchial asthma in a child often occur suddenly at night. Therefore, before sleep, you need to analyze his breathing:

Symptoms of asthma in children

It is important for parents to know how bronchial asthma manifests itself in order to help the child in time and prevent his condition from worsening. Signs of bronchial asthma in children are:

wheezing;
dry frequent cough, especially at night;
feeling of heaviness in the chest, aggravated after physical exertion;
coughing, wheezing when breathing after communicating with animals that have hair;
dry cough, difficulty inhaling and exhaling after taking medication;
feeling of congestion in the chest, something interferes;
the child is short of breath when inhaling;
feeling that the little patient cannot exhale air in any way, the exhalation is delayed and is accompanied by whistling and wheezing;
the child is looking for the optimal position for comfortable inhalation and exhalation.

Important: With a rapid deterioration in the child's well-being, parents should immediately call an ambulance. This can also occur with improper use of bronchodilator drugs. Frequent and incorrect use of inhalers leads to an increase in the intensity of asthma symptoms in children.

Forms of the disease

How to treat bronchial asthma in children depends on the form of the disease. In total, 3 forms of the disease are known to medicine:

Treatment of asthma in children

To stop the attack and prevent its recurrence, it is necessary to use all effective methods. These include not only drugs, but also diet, provision necessary conditions a small patient and a change in lifestyle.

Medical treatment

When bronchial asthma begins to manifest, it always causes panic in parents, since the symptoms are especially pronounced in young children. Therefore, every parent of a child at risk should know which medications can immediately relieve an attack, and which ones should be stocked up on long period treatment of a child with bronchial asthma. Treatment should only take place under the supervision of a doctor, as young children are difficult to tolerate the disease, and often they require immediate hormone therapy. Hormonal drugs used randomly and without a strict dosage can adversely affect the further growth and development of the baby.

There is a symptomatic and basic drug treatment, bronchial asthma is difficult to select necessary drugs and long-term therapy with periods of exacerbation and remission.

Symptomatic therapy

These are drugs aimed at helping with an asthma attack, which quickly expand the bronchi, allowing the child to breathe. These are drugs such as Ventolin, Salbutamol, Berotek. If a the immune system the baby is too weak, and the disease is severe, corticosteroid drugs (based on hormones) are used.

Aerosol medications are often used. But you also need to be careful with them: small children cannot inhale the drug in time, they can cough even more from them, active substance in this case, it reaches the bronchi not in full, but about 20%. Are used symptomatic drugs also with a nebulizer. They belong to inhalation agents and help to quickly relieve spasm.

The optimal methods of introducing medicinal substances into the child's body are the spacer, cyclohaler, turbuhaler, "easy breathing" system. These are special chambers into which the medicine enters, and then it enters the human respiratory tract. With the help of these devices, the active substance of the preparations (aerosols, powders) is better absorbed and enters the bronchi in a larger volume. There is no danger that the child will cough from a sudden intake of medicine, since these chambers allow the medicine to be injected at a slower rate.

Symptomatic drugs are not able to cure children, they only help to short span time, and after the end of their action in a small patient, an asthmatic attack may again occur.

Basic therapy

Such treatment of bronchial asthma in children involves the use of several types of substances, depending on the severity of the disease and individual features baby. The following drugs are used:

Basic therapy has been used for a long time. Only a doctor can reduce or increase the dose, and this is done strictly under his control so as not to worsen the patient's condition. If there were no attacks within six months, a slight decrease in the dosage of the base drug is possible. Two years after the last attack, the doctor has the right to stop taking the drug until new manifestations of the disease occur.

Often, in addition to these drugs, immunomodulatory agents are prescribed to increase the body's resistance.

Non-drug treatments

These include:

physiotherapy;
diet;
physiotherapy;
phytotherapy;
visiting medical sanatoriums, resorts.

There are several methods therapeutic gymnastics with bronchial asthma. They are combined with diet, physiotherapy. In sanatoriums, the diet, procedures and regimen for children are correctly selected.

You should carefully monitor the child's diet to prevent allergens from entering the body. To do this, you need to refrain from fruits and vegetables of red color (tomatoes, strawberries, etc.), fish, fatty species meat, cottage cheese, yogurt and other dairy products with the addition of preservatives, chocolate, honey.

Particular attention should be paid to the prevention of the disease and early complaints of children, so as not to start the disease. It is also important to strengthen the immune system.