Bronchial asthma in a 4-year-old child. Bronchial asthma in children: symptoms and treatment. House and book dust

Bronchial asthma – inflammatory disease lower respiratory tract. Of particular concern is the fact that in recent years there has been a tendency to increase the number of people suffering from this disease. According to statistics, about 10% of children suffer from bronchial asthma. There are many specific terms in the description of this disease, I will try to explain them more in plain language. Therefore, let's take a closer look at what kind of disease such bronchial asthma in children is, the symptoms and factors that provoke its development.

What is bronchial asthma and its mechanism of development?

it chronic illness lower respiratory tract with an inflammatory component. This process involves a large number of cellular elements. The main link in the formation of the disease is the narrowing of the lumen of the bronchi (obstruction). The mechanism of development of the disease is complex. Briefly, it is as follows: specific immunological reactions of an immediate type occur in the child's body (increased sensitivity of body tissues to certain allergens), in other words, an allergy. If you want to know how asthma is transmitted, then this process is genetically determined. As a result, all changes lead to the occurrence of recurring attacks of suffocation. The child has episodes of shortness of breath, wheezing, a feeling of pressure behind the sternum. With appropriate treatment, paroxysm stops. Most formidable complication an asthma attack is asthmatic status.

Risk factors provoking the development of bronchial asthma in children

Untreated foci of chronic infection in the body of the baby.
Frequent colds and acute infectious diseases of the upper and lower respiratory tract (rhinitis, sinusitis, acute tonsillitis bronchitis pneumonia).
Bad adverse conditions environment.
Smoking is active or passive.
Taking certain medications: cytostatics, antibiotics.
Long-term residence in a house or apartment where mold lives on the walls.
The presence of other allergic diseases in the child: atopic dermatitis, allergic rhinitis, frequent obstructive bronchitis.
Allergic reaction to medicines, food, household chemicals, insect bites.

But the history of the pediatric disease "bronchial asthma" will be entered by a pediatrician only if all these factors work, i.e. only in the case when there is a genetic "breakdown" in the immune system and it failed. Just like that, without obvious grounds, such a diagnosis is not made.

How does bronchial asthma manifest itself, symptoms in children?

The disease has a paroxysmal course. During the paroxysm itself, the condition of children is severe. There is wheezing, paroxysmal coughing, the chest is swollen, there is a feeling of lack of air. Children are restless, rush about, do not want to lie in bed, take a half-sitting position - it is easier to breathe. Sometimes, on the contrary, they can be lethargic, it is difficult for them to speak, sit in bed. They have shortness of breath on exhalation (it is difficult to exhale air) due to blockage of the lumen of the bronchus and narrowing of its lumen. The wings of the nose swell, the veins of the neck swell, the intercostal spaces retract. The pulse is fast. The skin is pale, and bluishness may appear around the mouth (perioral cyanosis) and fingers (acrocyanosis).

Bronchial asthma in children is characterized by the fact that attacks often occur at night and in the early morning hours. This is the hallmark of the disease. The cough has its own specifics, it is dry during the paroxysm, but thick sputum is discharged at the end of the attack. Outside the attack, the child feels well.

Description of bronchial asthma in children by severity

Light. Attacks in children occur no more than 1 time per month, rarely occur at night.
Medium severity. Attacks are repeated 3-4 times a month, no more than 2-3 times at night.
Heavy. Attacks are repeated 3-4 times a week, only at night.

You may suspect bronchial asthma in your child if in the past 12 months he has had the following symptoms:

Repetitive, sudden attacks of coughing, with the appearance of whistling rales audible at a distance (remote rales).

Frequent colds associated with airway obstruction.

Appearance of cough, wheezing distant wheezing, shortness of breath in certain time of the year.

Contact with animals, odorous substances, dust, nicotine causes a cough.

The above symptoms disappear or become less pronounced with the use of medications with a bronchodilator effect.

The appearance of coughing, wheezing, shortness of breath at night, closer to the morning.

Symptoms are aggravated after slight physical exertion, inhalation of cold air.

Bronchial asthma is a serious disease, it requires a special approach. Need for early diagnosis complex treatment. Children should be under medical supervision. With the manifestation of the first symptoms of an attack, it is necessary to contact medical institution or call ambulance on house. Paroxysm must be stopped on time, otherwise it can turn into asthmatic status, which is difficult to treat. And then it will take several years to remove the diagnosis of bronchial asthma.

Bronchial asthma in children is the most common chronic respiratory disease. Boys are more often diagnosed before the age of five in children. It is difficult for parents to recognize the first anxiety symptoms, the appeal to the doctor is late for several years. Often, disability is immediately issued.

The etiology of the disease is extensive. Possible reasons:

• dust mites;
• animal hair;
• mold fungi;
• plant pollen;
• tobacco smoke;
• antibiotics (penicillin).

Maternal smoking during pregnancy increases the risk of developing asthma in the child.

Among the reasons, psychosomatics plays a special role: children who are emotionally attached to their mother are more likely to get sick. A healthy lifestyle during pregnancy is the prevention of this disease for the baby. Otherwise, the child may require a disability.

Taking aspirin can trigger an attack of aspirin asthma, which is a allergic form.

Pathogenesis

Pathogenesis consists of stages that proceed sequentially:

1. Sensitization is the first encounter with an allergen. Cells of the immune system produce immunoglobulin E in response to the penetration of the allergen. It settles on mast cells that are in the bronchi. The immune cells of the respiratory system remember the allergen and are ready to fight it.
2. pathochemical. It develops upon repeated contact with the allergen. It binds to immunoglobulin on the surface mast cells. The latter, in response to exposure, secrete inflammatory mediators that interact with the cells of the bronchial wall.
3. Pathophysiological. Inflammatory mediators trigger a cellular response. Develops, swelling of the bronchial wall and production of viscous sputum. The lumen of the bronchus is greatly reduced and the air passes through it with difficulty. An attack develops. The clinic is based on changes in the bronchi.

Forms

Exacerbation of the disease, in most cases, in children is replaced by remission. The etiology of the disease makes it possible to distinguish between atopic (allergic) and non-allergic forms. Their pathogenesis differs, but the clinic is the same.

Disability is issued in any of the forms and allows you to receive benefits.

atopic

The atopic form is established if an allergic etiology of the disease is identified. These include:

• a history of allergies in a child;
• an attack upon contact with an allergen;
• increased immunoglobulin E in the blood test;
• allergic diseases siblings, parents and other close relatives.

Non-allergic

It proceeds in the same way as an allergic one, but with a thorough examination it is impossible to detect the causes. Factors provoking an attack can be physical activity, inhalation of cold air, pungent odors. The level of immunoglobulin E remains normal. The pathogenesis has not been studied.

Symptoms

The main symptoms are suffocation and feeling short of breath. In children, sometimes the only symptoms are frequent colds of the respiratory system and coughing for a long time, especially at night. Frequent SARS that occur without temperature should alert parents. Atopic asthma develops upon contact with a trigger.

Other characteristic symptoms:

• difficulty breathing, especially exhalation;
• dry wheezing , audible at a distance;
• the child is late in growth or development from peers;
• blueness of the skin.

How to remove an attack

The attack develops most often at night or in the early morning hours. Psychosomatics plays an important role: an attack develops under stress. The pathogenesis (if asthma is atopic) is based on the fact that dust mites live in the mattress and close contact with the allergen occurs at night.

The following symptoms develop:

• suffocation;
• the child is frightened, excited;
• exhales with difficulty;
• wheezing wheezing is heard;
• his skin turns blue.

The attack is removed with the help of an inhaler prescribed by a doctor. If the attack is not stopped, complications will develop.

Diagnostics

The diagnosis of bronchial asthma up to five years in children is made, taking into account the symptoms and tests for immunoglobulin E, sensitivity to allergens. Diagnosis is made in children older than five years using instrumental research. Diagnosis is carried out in a hospital.

The simplest and most common method is peak flowmetry.

A small device measures the child's exhalation rate. Signs of the disease - a decrease in this indicator by 20% or more. The attack causes the most pronounced decrease in the strength and speed of breathing.

Severity

Bronchial asthma in children occurs with different severity. The following are evaluated: the clinic, how often an attack occurs, the severity of exacerbations, signs of complications and the results of peak flowmetry. Classification:

• Light intermittent (non-permanent). Exacerbations are short-term. Peak flowmetry indicators are 80% of the norm and above. The prognosis is favorable. Disability is not recognized.
• Light persistent (permanent). Daytime symptoms several times a week. Exacerbations disrupt the child's activity and sleep. Expiration rate of 80% or more. The prognosis is favorable.
• Medium persistent. Day symptoms daily, night attacks several times a week. On peak flowmetry 60-80% of the norm. Disability 3 groups, in the presence of severe concomitant diseases. The forecast is doubtful.
• Severe persistent. Psychosomatics are often involved. Attacks every night, day symptoms daily. Sleep and activity of the child are significantly disturbed. Exhalation rate is less than 60% of normal. The prognosis is unfavorable. With such severity, disability of 2-3 groups is given.

Classification allows you to change the severity when the child's condition changes.

First aid

The child must first be calmed down. Psychosomatics plays important role in the development of an attack.

1. Remove tight clothing, open a window to let fresh air into the room (avoid cold).
2. Give the child an inhaler or nebulizer, you can supplement it with an aminophylline tablet.
3. It is advisable to make a warm bath for hands and feet.

If these measures do not stop the attack within half an hour, call an ambulance. Further waiting may lead to respiratory arrest!

Treatment

Treatment depends on the form, cause and extent of the disease. Hospitalization is required for severe exacerbations and if serious complications- status asthmaticus, . In other cases, the child is treated at home, under the supervision of parents.

Prevention is based on the removal of the allergen from the environment of the child. To do this, daily wet cleaning is carried out, an impenetrable cover can be put on the mattress - this alleviates the condition of the child if he has an allergic form.

Preparations

Apply inhalation forms of drugs. Most of them contain glucocorticoids in combination with a beta-agonist. This combination gives a pronounced anti-inflammatory effect and makes breathing easier. Children can use the inhaler from the age of five. Prior to this, drugs are administered through a nebulizer or spacer.

• Read also:

Inhalers are prescribed by a doctor. It is possible to use them only when an attack occurs or on an ongoing basis. To stop the signs of an attack, salbutamol is most often used.

Antiallergic drugs zafirlukast, montelukast, sodium cromoglycate are prescribed in the form of tablets. Used as prevention and treatment of exacerbations. Sometimes assigned to permanent reception if the effect of inhalation is insufficient.

There are benefits for drugs if a disability is registered.

Folk remedies

Can be used as helper method or prevention. Treatment is carried out using infusions of herbs, ginger, propolis preparations. Of the herbs, the most effective is "Breast collection", licorice root, chamomile decoction.

• Be sure to read:

Treatment folk methods contraindicated in the presence of an allergy to the components of the remedy - this can cause a very severe asthma attack, a serious exacerbation and subsequent disability.

Aggravation

Cases of exacerbation often occur in children during acute respiratory infections. Pathogenesis - increased inflammation in respiratory tract. If the etiology is plant pollen, then atopic asthma is exacerbated during their flowering. The classification of exacerbations takes into account many factors. Exacerbation symptoms:

• feeding problems due to shortness of breath;
• the child is less active, prefers to sit or lie down;
• in severe exacerbation, he speaks only in separate words;
• the baby is excited;
• wheezing becomes louder, breathing is frequent and shallow.

• Read also:

The pathogenesis of periods of exacerbation requires an increase in the dose of drugs. Prevention of exacerbations includes vaccination against influenza, pneumococcus and Haemophilus influenzae. Severe exacerbations- a reason to apply for disability and benefits.

Rehabilitation

Rehabilitation of children with bronchial asthma includes physiotherapy exercises, hardening, drainage massage. It is carried out when there is no clinic. Significantly improves the prognosis, prevents complications.

Sanatoriums

Fresh air, mineral water, wellness procedures, climate - effective prevention of exacerbations in the diagnosis of bronchial asthma in children. Benefits for obtaining a ticket are possible if a disability is issued. Be sure to heal before traveling. acute diseases and chronic complications.

Bronchial asthma in children is manifested by an inflammatory process, leading to spasm of the bronchial muscles and a sharp increase in the formation of mucus. As a result of these processes, the child begins an asthma attack due to the inability to take a normal breath.

It is not always obvious that a child, especially infancy disease develops. How do you know when to seek medical attention urgently? There are symptoms that help to understand whether a child has asthma or not.

In any case, do not be afraid of this disease. The best thing parents can do is to concentrate on the exact implementation of all the doctor's recommendations. Moreover, the prognosis for asthma in most cases is favorable. And in a teenager with asthma, hormonal changes in the body can lead to recovery.

Bronchial asthma in children develops due to an increased reaction of the smooth muscles of the respiratory organs to various stimuli. The leading role in the mechanism of the development of the disease belongs to allergens.

1. Internal factors.

Most often it means genetic predisposition to illness. If close relatives of the child had bronchial asthma, then the risk is very high that the baby will also get this disease.

But you should also know that boys get sick much more often than girls. This is due to the fact that in male children the bronchial lumen is narrower.

Being overweight can also cause disease. With excessive fullness, the high location of the diaphragm limits the ventilation of the lungs, which leads to various respiratory disorders.

Asthma in adolescents may be due to hormonal adjustment.

1. external reasons.

This group includes exposure to various allergens, causing development asthma in a child. So, the disease can develop against the background of a hypersensitive reaction to drugs, house or book dust, household chemicals, animal hair, food. Also, risk factors include poor living conditions: dampness in the premises, mold on the walls.

1. Other reasons.

Significant physical exertion, increased air pollution, inhalation of tobacco smoke by the baby, and various infections can also cause bronchospasm. viral etiology, psycho-emotional stress. It should be borne in mind that the strong smell of perfume is also difficult for children to tolerate. Also, the development of the disease can be provoked by a child's prolonged stay in conditions that are too dry or humid, as well as a cold climate.

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• You lead the right lifestyle, and asthma does not threaten you

  Are you an active person who cares and thinks about his respiratory system and health in general, continue to play sports, lead a healthy lifestyle, and your body will delight you throughout your life, and no bronchitis will bother you. But do not forget to undergo examinations on time, maintain your immunity, this is very important, do not overcool, avoid severe physical and severe emotional overload.

• It's time to start thinking about what you're doing wrong...

  You are at risk, you should think about your lifestyle and start taking care of yourself. Physical education is obligatory, and even better start playing sports, choose the sport that you like best and turn it into a hobby (dancing, cycling, gym or just try to walk more). Do not forget to treat colds and flu in time, they can lead to complications in the lungs. Be sure to work with your immunity, temper yourself, be in nature as often as possible and fresh air. Do not forget to undergo scheduled annual examinations, treat lung diseases on initial stages much easier than in the running form. Avoid emotional and physical overload, smoking or contact with smokers, if possible, exclude or minimize.

• It's time to sound the alarm! In your case, the likelihood of developing asthma is huge!

  You are completely irresponsible about your health, thereby destroying the work of your lungs and bronchi, pity them! If you want to live long, you need to radically change your whole attitude towards the body. First of all, go through an examination with specialists such as a therapist and a pulmonologist, you need to take drastic measures, otherwise everything may end badly for you. Follow all the recommendations of doctors, radically change your life, it may be worth changing your job or even your place of residence, absolutely eliminate smoking and alcohol from your life, and keep contact with people who have such addictions to a minimum, harden, strengthen your immunity, as much as possible be outdoors more often. Avoid emotional and physical overload. Completely exclude all aggressive products from everyday use, replace them with natural ones, natural remedies. Do not forget to do wet cleaning and airing the room at home.

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Classification of bronchial asthma in children is carried out according to etiological signs and severity of the course of the disease.

• atopic (exogenous, i.e. caused internal reasons). In this case, attacks begin under the influence of various allergens in the air or the space surrounding the baby (mites, pollen, wool, dust, etc.);
• non-atopic (exogenous). In this case, the symptoms appear at the peak of excessive emotional experiences, increased physical exertion, during respiratory viral infections, when exposed to an unfavorable climate, etc.;
• mixed genesis. The disease can begin as a result of exposure to both exogenous and endogenous factors.

• mild degree(intermittent form). appear about once a month, mostly in daytime. The duration of asthma attacks is short, moreover, they are quickly stopped. This degree always manifests itself in early stages illness;
• mild persistent form. This condition is distinguished by the addition of respiratory failure. Attacks appear no more than once a week, can occur at night, disrupting the child's sleep. Physical activity the baby during an attack is reduced;
• medium severity. The disease manifests itself several times a week. Frequent nocturnal attacks. The physical activity of the child is markedly reduced;
• severe degree. Exacerbations of asthma occur daily and almost every night. The child does not show any physical activity.

Bronchial asthma in children, depending on the etiology and severity of the disease, has distinctive symptoms which will show up anyway.

Asthma in children has the same signs and symptoms as a respiratory infection. Therefore, it is sometimes quite difficult to make a diagnosis at the beginning of the disease. It should be remembered that the symptoms of bronchial asthma always occur against a background of normal temperature, and suffocating frequent cough not accompanied by sputum.

How does asthma start? Usually, a few days before the onset of an exacerbation, so-called precursors appear. It is very difficult to identify asthma in a baby, so these precursors should be paid attention to. The first signs of bronchial asthma in children usually appear copious excretion watery mucus from the nose in the morning after waking up. It irritates the mucous membrane, so the baby often rubs his nose, sneezes. Then a dry cough joins, turning into a dry cough with a small amount wheezing. If preventive measures are not taken at this time, such a condition will lead to the development of the disease in a day or two.

How does bronchial asthma manifest in newborns? The difficulty is that at this age children cannot yet complain about the manifestations of the disease.

• the child has a stuffy nose. Because of this, he becomes restless and capricious;
• after waking up, a paroxysmal dry cough appears, subsiding when the child is moved to a vertical position and resuming if he is laid down again;
• the baby begins to breathe often intermittently, while wheezing and whistling will be clearly audible. After a day or two, suffocation begins to develop.

At two years old, the child is already trying to breathe through the mouth in this case, which leads to new bouts of coughing. Symptoms in children from 3 years old can already be voiced by the baby. At the same time, he may complain of chest pressure, as well as symptoms that are not typical for asthma, such as itchy skin or a rash.

In a teenager, the symptoms of the disease do not differ from the course of asthma in an adult. However, in children school age seizures can often occur for no apparent reason.

The signs of bronchial asthma in children, especially in small children, are not always clearly expressed, so it is necessary to speak to the pediatrician about the slightest changes in their health. How to recognize asthma in the future and take action in time, the attending doctor will tell.

How to diagnose asthma in children? During the examination, the doctor pays attention both to the typical signs of asthma in children, and to typical manifestations illness. Typical attacks include difficulty breathing, especially at night, the appearance of a dry cough, wheezing against the background of normal temperature. Also, when examining a baby, the doctor notes such symptoms of asthma as protrusion of the intercostal muscles or pathological expansion of the chest, dark circles under the eyes.

Bronchial asthma in children is also diagnosed using physical examination methods. Characteristic changes during percussion, auscultation will also give rise to suspect the diagnosis of bronchial asthma.

The doctor can also check for atypical asthmatic symptoms related to atopic diseases.

To identify provoking factors, the doctor will conduct a survey about the child's contact with various natural and synthetic allergens.

Diagnosis of bronchial asthma in children includes hardware and laboratory examinations.

• general and biochemical research blood;
• analysis for the content of specific antibodies in the plasma;
• skin tests for the determination of the allergen;
• determination of increased reactivity of bronchial muscles;
• spirometry to determine respiratory functions;
• determination of the speed of exhaled air.

Before diagnosing asthma in a child, the doctor will also differential diagnosis with other respiratory diseases.

Do not attempt to diagnose your child on your own. For any manifestations of a cough in a baby, you should contact your doctor.

The specialist will be able to diagnose early stage disease development.

Children's bronchial asthma can develop at any age, so it is necessary that the parents of children at risk understand when the baby needs first aid.

1. If the child is talking, he may complain about discomfort in the chest, may try to describe in words accessible to him the feeling of pressure and difficulty in breathing. You have to be careful and try to understand what the baby wants to tell you. You also need to be wary if the child is closed in on himself. It happens that children are embarrassed to complain or do not know how to convey their feelings to adults.
2. Listen to the child breathe. Normal frequency respiratory movements should be no more than 20 per minute. If breathing is more frequent, the baby should be asked how to breathe, easily or something interferes. Also a bad sign is the appearance of wheezing during the act of breathing and participation in the act of breathing of the muscles of the abdomen and chest.
3. In babies under one year old, with an asthmatic attack, the nostrils begin to expand.
4. Outwardly, the manifestation of the attack is also manifested by pale skin, a blue nasolabial triangle, and sticky sweat.

Treatment of an attack in bronchial asthma in children should be prescribed by the attending physician. In such cases, inhalations are used with a remedy selected by the doctor to stop the attack. For small children, this procedure is carried out by adults.

Treatment of moderate and severe asthma is best done in a hospital.

In the event of an attack for the first time, you should urgently call an ambulance.

Parents often ask the doctor if asthma can be cured? More likely to translate the disease into more light form and lifelong control, preventing the occurrence of seizures.

Can bronchial asthma be permanently cured? It is impossible to completely get rid of the disease. Therefore, the answer to the question of whether bronchial asthma is treated will be the answer "no". But if desensitizing treatment courses are carried out in a timely manner, the disease is easily manageable.

How to cure asthma so that it bothers a sick child as little as possible? First of all, you need to understand that symptoms and treatment are closely related. The more severe the symptoms, the more strong medicines used in therapy. Also, with varieties of etiology, it will be used specific treatment.

1. Symptomatic therapy. It is aimed at providing emergency care for an asthmatic attack that has begun. In this case, drugs for bronchial asthma from the group of bronchodilators are used. They relax the tense spasm muscles of the bronchi and restore normal breathing. Such substances have instant effect, but it is impossible to cure bronchial asthma with long-term therapy.
2. Basic therapy of bronchial asthma. Medicines are used on a long-term (lasting for years) or permanent basis. Therapy is aimed at curing or attenuating the allergic reactions of the body as much as possible. For this purpose, anti-inflammatory, desensitizing drugs are used, as well as hormonal agents.

Also, basic treatment is supplemented by various physiotherapy procedures and physiotherapy exercises.

Do not try to self-prescribe medications. How to treat bronchial asthma, you can only find out from your doctor.

Do not try to cure bronchial asthma with various folk methods! Many herbs are strong allergens. Therefore, their use may exacerbate the disease.

Timely symptomatic and basic therapy is needed in order not to develop complications of bronchial asthma in children.

1. Work disruptions of cardio-vascular system, including various violations rhythm, as well as dangerous manifestation like cardiac arrest.
2. Pathology from the side gastrointestinal tract occurs with improper therapy medications and can be manifested by ulceration of the mucous membranes of the gastrointestinal tract up to bleeding.
3. If the child has asthma long time is treated with glucocorticosteroids, then various metabolic disorders are possible, leading to the development of pathological processes in the organs and systems of the whole organism.
4. The most tangible complications of bronchial asthma are in the central nervous system, causing changes in the psyche and other brain functions.
5. Respiratory disorders.

• , in which a long, unyielding symptomatic therapy life-threatening asthma attack;
• acute respiratory failure, requiring urgent artificial respiration;
• lung rupture;
• collapse;
• pneumonia.

If you correctly and on an ongoing basis treat bronchial asthma in a child, you can avoid the development of complications that cause serious harm his health.

Rehabilitation of children with bronchial asthma consists of following methods:

1. Physiotherapy.

The exercise therapy doctor makes up an individual set of exercises aimed at forming a strong muscular corset, increasing the functioning of the brain due to increased blood supply, and restoring the activity of the central nervous system. It also aims to improve lymph flow throughout the body and increase immune forces to prevent the development of various complications.

1. Hydrotherapy.

Strengthens immunity. But important condition is a comfortable water temperature during procedures. too hot or too cold water can lead to exacerbation and development of an attack.

1. Massage.

Properly selected technique will strengthen the intercostal muscles, relieve spasm of the bronchial muscles and strengthen the entire body.

1. Breathing exercises.

It will help to normalize the tone of the muscles of the bronchi and cleanse the bronchial tree from sputum.

1. Basic medical treatment.

Reduces the overall sensitization of the body, minimizes the possibility of repeated asthmatic attacks.

1. climate therapy.

Indicated for children with bronchial asthma wellness vacation on the sea coast in a mild, not hot climate, for which, for example, the beaches of the Baltic states are suitable.

Carrying out rehabilitation measures will restore the health of the child and minimize the risk of further development of the disease and the appearance of various complications.

The prognosis for bronchial asthma in children depends mainly on the age of the child at the time of the onset of the disease. Asthma that first appears before the age of three is curable by adolescence. The child may have only minor changes in the immune system and various specific respiratory disorders. Also, increased reactivity of the bronchopulmonary muscles to external stimuli may persist. But cured asthma will no longer manifest itself as severe attacks.

If the child first fell ill in adolescence, then the disease will remain forever. However, the severity of the course of the disease does not increase, and may even become less over time. And even after reaching adulthood, it is possible to reduce the severity of symptoms even in the absence of regular therapy.

Only bad habits(smoking) and working in an environmentally unfavorable workplace.

Unfavorable prognosis possible only in case of inadequate basic therapy or if the babies were not systematically treated.

Prevention of bronchial asthma in children can be primary, secondary and tertiary:

1. If it is likely that bronchial asthma in children will develop due to hereditary factors, then primary prevention is carried out.

All measures in this case are aimed at preventing the occurrence of allergic reactions in the child. To do this, you should feed him as long as possible. breast milk. It is also necessary to eliminate such risk factors as smoking in the immediate vicinity, exposure to adverse household and environmental allergens.

The diet of such a child should be fully coordinated with the attending physician. Exclude from the use of products that increase the sensitization of the body.

To prevent the disease, you should also keep the house completely clean, exclude any appearance of various animals in the house.

Living quarters should be cleaned and ventilated frequently. Long walks in the fresh air will also help protect against illness. Also, due attention should be paid to hardening procedures.

1. Secondary prevention is carried out already in the presence of a child with increased spastic readiness of the bronchial muscles.

The main preventive measures in this case are specific drug therapy to reduce obstructive processes in the bronchi. Properly selected immunotherapy also gives a good result.

1. Tertiary prevention is carried out already with an existing disease and is aimed at taking asthmatic processes under full control.

To this end, for a child with asthma, the most gentle microclimate in the home is created, hardening procedures and specific drug therapy.

Treatment and prevention of the development of bronchial asthma in children should be carried out only under the supervision of the attending physician. He will also explain how to prevent the development of the disease at various stages.

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By this is meant the increased reactivity of the bronchi to environmental factors. At the same time, their spasm, obstruction occurs, mucus secretion increases, swelling of the bronchi develops. The disease usually occurs in chronic form, and is accompanied by coughing, wheezing and choking. - the disease is by no means rare, 10% of children suffer from it. Most often, the disease manifests itself at an early age from 2 to 5 years, but later clinical signs are not excluded.

If bronchial asthma began in childhood, it most often accompanies a person all his life. However, there are times when, during puberty, the clinical picture of the disease weakens and disappears. But at the same time, we must not forget that the increased reactivity of the bronchi continues to persist, therefore, it is impossible to assume that the disease has receded. As soon as provoking factors arise, the symptoms of the disease will appear again.

Despite the fact that it is impossible, it is possible to treat and prevent the disease in a child. In addition, it is important to learn how to stop an exacerbation of asthma in time, and in this case, a person may well live full life- study, work, play sports.

There are the following forms of the disease:

• allergic or atopic form - develops under the influence of allergens;
• non-atopic form - provoke stress, exercise or cold air;
• mixed - in this case, the two previous forms are combined;
• status asthmaticus is a condition that can be life-threatening, as it is accompanied by obstructive phenomena in the small bronchi.

IMPORTANT! In childhood, asthmatic attacks are especially dangerous and severe, since life threatening the condition can develop in a very short time.

This is due to the fact that in early childhood the diameter of the bronchi is significantly smaller than in adults, so the edema causes their persistent narrowing. In addition, in adults, obstructive processes in the bronchi are mainly associated not with swelling, but with bronchospasm, which greatly facilitates the situation.

Reasons for the appearance of a child

Speaking about the causes of bronchial asthma in a child, the following should be noted:

First signs and symptoms

Specialists allocate during this disease the following periods:

Remission. During this period, the child does not complain about anything, feels great, he does not have a cough syndrome, no wheezing and there is nothing that may indicate the presence of bronchial asthma.

This period, in turn, is divided into complete, incomplete and pharmacological remission.

In the case of complete remission, the patient looks absolutely healthy, with incomplete remission, it is not so easy for him to perform physical actions, for example, to play outdoor games. As for pharmacological remission, in this case, normal health can be achieved only with the use of medications.

Aggravation. These are the time periods when asthma attacks. By how long they last and how severe they are, the severity of the disease is diagnosed.

Attack. This is the condition of the child when the main asthmatic syndrome is observed - whistling when exhaling and difficulty breathing. Most often, this condition begins in the evening or at night, but even during the day you can observe signs of an impending attack.

Clinical signs, according to which it is possible to assume bronchial asthma in children - these are attacks. The pre-seizure syndrome can be clearly noticeable from several minutes to a day, this next state:

• irritability and tearfulness;
• bad sleep;
• loss of appetite;
• the appearance of mucous discharge from the nose, dry cough, which is constantly increasing, and after a while becomes wet. May be bothered by a headache.

The attack itself is accompanied by the following:

• strong dry cough that becomes less intense in vertical position;
• wheezing when breathing and difficulty breathing;
• strong fear;
• normal or slightly elevated temperature;
• if the attack begins in a dream, the child rushes about in bed;
• skin turn pale, and blue appears around the mouth;
• heartbeat quickens.

IMPORTANT! dangerous signal attack is a blue nasolabial triangle.

As they begin, the first symptoms of an asthma attack can go away on their own, this may take from several minutes to several days. But waiting for the situation to improve on its own is dangerous, since oxygen starvation of the brain can lead to dangerous and irreversible consequences.

Therefore, when an attack occurs, it is necessary urgent inhalation Berodual or another bronchodilator prescribed by a doctor.

When the attack ends, the cough is moistened, and mucus begins to be expectorated from the bronchi. In children 5 years of age and older, sputum looks viscous and glassy.

At asthmatic bronchitis the attack develops very quickly, and passes immediately as soon as an inhaled bronchodilator is used.

With an allergic form in a child, the symptoms of an attack develop for a longer time, and the help of medications does not lead to an immediate effect. In different age groups, the ailment under discussion may have slightly different clinical picture.

It is rather difficult to diagnose asthma symptoms in an infant up to a year, because the clinic at this age has some differences:

• without fail, there is a so-called prodromal syndrome, which is accompanied by a dry cough, sneezing, and a flow of liquid mucus from the nasal cavity,
• edematous tonsils, single dry wheezes are heard above the lungs - only a doctor can diagnose these symptoms,
• often cries, sleeps badly,
• there are problems from the gastrointestinal tract - constipation or diarrhea,
• breaths are frequent and short, exhalations with noise or whistle.

In older children - up to 6 years, bronchial asthma is accompanied by:

• restless sleep;
• irregular night cough;
• dry cough;
• at outdoor games may complain of a feeling of pressure in the chest;
• when breathing through the mouth, cough syndrome immediately manifests itself.

At junior schoolchildren:

• night cough;
• intuitively tries to run and jump less;
• when coughing, he immediately tries to sit up, bend over and lean forward.

In adolescence, as a rule, the diagnosis is already established. The child has an idea of ​​what exactly can provoke an asthmatic attack, and how to stop it with an inhaler. As already mentioned above, at this age the disease can fade, but not go away completely, but “wait in the wings”. Often in such cases, asthma returns in old age.

Treatment

In bronchial asthma of an allergic type, it is necessary first of all identify the allergen, which provokes seizures, and minimize (and preferably completely eliminate) the child's contact with him.

For this you need:

1. Often carry out wet cleaning indoors, and when using a vacuum cleaner, use models with a water filter.
2. Install air filters in the room.
3. The pillow and duvet should only be used with synthetic hypoallergenic fillers.
4. Eliminate Stuffed Toys.
5. Store books on glass shelves.
6. Covers on upholstered furniture should be lint-free.
7. During the flowering of plants, limit exposure to the air, walks are allowed only in evening time when dew falls or after rain. It is better to install a special mesh on the windows at this time.

In asthma that develops with physical activity, running, jumping and significant stress on the body should be excluded. If the child has "aspirin asthma", it is necessary to avoid taking drugs based on this substance. Concerning drug treatment disease, it is divided into basic therapy and symptomatic treatment of an asthma attack.

IMPORTANT! Treatment of bronchial asthma is a complex and lengthy process, self-medication in this case is unacceptable, since an incorrectly selected drug can provoke an asthma attack and respiratory failure.

For the relief of seizures in a child, the following are most often prescribed:

• Ventolin;
• Berotek;
• Salbutamol or other bronchodilators.

If seizures in a child are accompanied by severe symptoms, then the treatment is recommended hormonal preparations. It is important not only to choose the right remedy, but to get ahead of its adequate introduction.

Most often, drugs are administered by inhalation - in the form of an aerosol. However, small children cannot use an inhaler, because for the correct administration of the drug, the medicine must be inhaled during injection. In addition, such use of the drug implies that about 20% of the drug does not reach the bronchi, but settles on the back of the throat.

Now you can purchase some devices that provide maximum transportation of the medication to its destination - in the bronchi. Such devices are optimal for children who cannot yet use inhalers on their own.

An example of such a device is spacer, at the same time you can use the system " easy breath". There are devices with the help of which a powdered medicine can be introduced into the body - this is a turbuhaler, cyclohaler or diskhaler.

A modern inhaler - nebulizer - is a device that with which any medicine turn into an aerosol. Nebulizers can be ultrasonic or compressor. Such a device allows for a long time to carry out inhalation procedures.

It must be understood that all drugs of systematic action can only have a temporary effect.

IMPORTANT! Uncontrolled use of inhalers with bronchodilators can cause the bronchi to stop responding to the medication, and, consequently, status asthmaticus will develop.

That is why it is so important to control the dose of medication used by children who have already reached the age of using inhalers. Very often, fearing an attack, children can overdose the drug.

Speaking about basic therapy, it must be said that several groups of drugs are used in it:

• antihistamines- Suprastin, Loratadin, Tavegil and others;
• means that have a stabilizing effect on the membrane - Intal, Ketotifen;
• antibiotics - if available chronic lesions infections.

Hormonal agents may also be prescribed, which are designed to relieve inflammatory processes in the bronchi and to prevent exacerbation of the disease.

After being prescribed by a doctor necessary drugs, parents should constantly support basic therapy. In no case should you cancel the drugs on your own, or change the dosage, especially if the child is taking hormonal drugs. The dose can be reduced only if not a single attack has been observed within six months. When remission is observed within 2 years, the drug can be completely canceled. If seizures recur, therapy begins again.

It is very important to treat infectious foci in a timely manner - caries, tonsillitis, etc., and also to prevent malfunction of the gastrointestinal tract.

REFERENCE! All drugs of basic therapy are selected by the doctor, taking into account the severity of the disease and individual characteristics child.

Concerning non-drug treatment, it can be physiotherapy, massage, physiotherapy exercises, breathing exercises, hardening, acupuncture and so on. The mountain microclimate and the conditions of the salt caves are highly recommended.

In the remission stage, sanitary-resort treatment in the Crimea, the Elbrus region or other areas recommended by the doctor is desirable.

ASIT is an immunotherapy that is prescribed to children after 5 years of age. The method consists in introducing a minimum dose of the allergen into the body. Thus, the body, as it were, gets used to it.

Phytotherapy for bronchial asthma should be used very carefully, since many medicinal herbs may provoke allergic attack asthma.

Aromatic oils have a beneficial effect - thyme, tea tree, lavender. However, they are recommended to be used from minimum doses, as they can also cause allergies.

For a child with asthma, the doctor will definitely prescribe special diet, which should exclude allergenic products.

REFERENCE! If asthma is suspected, parents should show the child to the district pediatrician, who, after primary diagnosis, if necessary, will help determine which doctor is treating and who to contact next. And he will refer the patient to a specialist of a narrow focus.

Useful video

Familiarize yourself visually with bronchial asthma in children in the video below:

conclusions

It is very important to start asthma treatment as early as possible. Besides that severe course advanced forms of the disease can lead to to lifelong dependence of the child on hormones, asthma can be a real threat to a child's life.

In the absence of adequate and timely therapy, the following complications may develop:

• asthmatic status;
• respiratory or heart failure acute form;
• pneumothorax;
• lung atelectasis;
• emphysema;
• disturbances as a result of hypoxia;
• chest deformity.

Preventive measures for bronchial asthma include the elimination or complete elimination of provoking allergens, immunoprophylaxis, treatment chronic ailments respiratory system.

“Asthma is when you walk at a quarter of a step, think at a quarter of a thought, work at a quarter of your ability and only suffocate at full power” (K. Paustovsky)

According to official data, the prevalence of bronchial asthma in children is 5-12%. However, the disease is much more common. Unfortunately, the diagnosis is made in a timely manner in only one case out of four or five. But bronchial asthma is a very formidable disease, because at any moment its course can be complicated by an attack.

So how do you recognize an insidious disease? How to help a child during an asthma attack?

Bronchial asthma: features of an attack depending on the age of the child

Dear mothers, of course, you are not doctors and you cannot know everything, and you are not obliged to. However, it will be better if you “arm yourself” with some knowledge about the symptoms of an asthma attack, depending on the age of the child. This is necessary so that you can provide timely help to your baby.

Bronchial asthma sometimes debuts even in the first months of life. However, unfortunately, the diagnosis is often made later. Since doctors take shortness of breath in a baby and a wet cough as a manifestation of an acute viral infection or acute obstructive bronchitis.

The reason is the atypical course of the disease in children in the first few years of life. This is due to some structural features. lung tissue(small volume) and bronchial tree(narrow lumen of the bronchi, easily damaged mucous membrane, good blood supply).

All these moments lead to the development of pronounced edema and narrowing of the bronchi (spasm), as well as the release of a large amount of mucus into their lumen. As a result, bronchial patency is impaired. Therefore, in the lungs of a baby, a large number of moist rales are heard.

However, asthma should be considered if:

The baby has repeated episodes of a strong, painful cough, and the interval between them is less than eight days

For three days, the child has nocturnal bouts of severe, painful coughing.

Asthma attack: symptoms

In children under three years of age

Before the development of a typical (usual) attack of bronchial asthma, the so-called precursors begin., which can last from several hours to two or three days. During this period, the baby is excited, irritable, sleeps poorly or drowsy, sometimes frightened, speaks in a whisper.

Myself the attack most often develops at night or in the morning. This is due to the fact that at night the level of biologically active substances that cause bronchial constriction increases. At the same time, the level of hormones that dilate the bronchi, on the contrary, decreases. In addition, at night, the activity of the muscles involved in breathing is significantly reduced.

As a rule, a typical asthma attack begins and proceeds as follows:

* In the morning, a liquid discharge appears from the crumbs of the nose, he begins to sneeze and scratch his nose, and a cough joins after a few hours.

* In the afternoon or in the late afternoon, the cough intensifies, as a rule, it already becomes wet. Whereas in older children it usually becomes wet towards the end of the attack.

* The attack begins at night or closer to the morning (four to six o'clock in the morning): the cough becomes paroxysmal, painful, stubborn. When it reaches a maximum, vomiting may occur, in which there is a viscous mucous sputum.

During an attack, the baby breathes heavily and often (shortness of breath), his exhalation is difficult and lengthened. At the same time, the baby’s breathing becomes noisy, whistling and audible at a distance of several meters.

Besides, accessory muscles often take part in breathing. You can see this by the retracting intercostal spaces, the areas of the neck above the sternum and collarbones, and the swollen wings of the nose.

At the time of the attack, the child behaves restless and refuses to lie down. He seeks to take the forced, but comfortable position: half-sitting or sitting, but resting his hands on his knees. Because it makes breathing easier.

Often the skin changes its color: around the mouth nasolabial triangle) and at the fingertips, it may acquire a bluish tint.

* Often, during an attack, the child's body temperature rises, which becomes the basis for establishing an incorrect diagnosis: SARS, Pneumonia, Obstructive bronchitis.

* The attack ends on its own or with the help of drugs with sputum discharge.

* After an attack, the baby is usually drowsy and inhibited.

However, due to the structural features of the lungs and bronchi, a typical attack in children under three years of age rarely develops. Much more often it occurs in the form of a persistent, painful cough at night.

In children over three years of age

The attack is associated more with spasm of the bronchi, while the swelling of the mucous membrane and the release of mucus into their lumen is slightly expressed. Therefore, it is accompanied by dry wheezing and dry cough, and the child complains of a feeling of tightness in the chest. All other symptoms of an asthma attack are the same as in children under three years of age.

In addition, if a child of any age has severe bronchial asthma, an attack can develop in the daytime.

Note to mom

* In order to notice rapid breathing in crumbs in time, you need to learn how to correctly determine its frequency.

To do this, outside the attack, put your palm on the chest or back of the baby and count how many times it rises in 15 seconds. Then multiply the resulting figure by 4, which will be the number of respiratory movements per minute. Or count for 30 seconds and multiply by 2.

During an attack, just count the frequency of respiratory movements. This will help you understand if the child's condition is improving or not.

Normally, the frequency of respiratory movements per minute in a child is:

In a newborn - 40-60

From a month to two - 35-48

From six to twelve months - 35-40

From one to three years - 28-35

From four to six years - 24-26

From seven to nine years - 21-23

From ten to twelve years - 18-20

From thirteen years old and older - 16-18

* There is a device that allows you to find out about the approach of an asthma attack in a child a few hours or even days before it - a peak flow meter. This is a portable device that is equipped with a scale and a movable arrow.

A peak flowmeter measures peak expiratory flow (PEF), which decreases as the bronchial lumen narrows. The device is good, but has a drawback: after a little training, only children over five years old can use it.

Asthma attack: what should mom do?

First of all, remember that at home, you can stop only mild and moderate attacks. During them, the child develops shortness of breath (breathing becomes more frequent and exhalation is difficult) only when moving or showing emotions - for example, if the baby plays, walks, laughs, cries, eats. That is, there is no shortness of breath in the crumbs at rest. In addition, skin color does not change during an attack.

So what to do?

If the attack developed for the first time, immediately call an ambulance, and before it arrives, help the baby:

* If possible, stop contact with the allergen if it is known.

* Provide air access to the room.

* Remove, if any, tight clothing.

* Help the baby to take a half-sitting position. This will make it easier for him to breathe.

* Keep calm and inspire the baby that there is no danger and the attack will soon pass. This is how you calm him down.

* Give your baby clean or mineral still water to drink often and in small portions. This is very important, because with rapid breathing, he loses a lot of fluid, which leads to dehydration, increases the narrowing of the bronchi and worsens the general condition of the child.

If the diagnosis has already been made, and the attack has not developed for the first time, you already should have a first aid kit with the necessary medicines fast action that dilate the bronchi (bronchodilators).

As a rule, this is a canister of a metered-dose aerosol inhaler: berodual, salbutamol, berotek or others. That's why take the medicine recommended by your doctor (one inhalation dose), give free access to air, be sure to calm the child and give him water.

Then, every 20 minutes, evaluate the general condition of the crumbs and, if necessary, repeat the inhalation. For example, if the child feels better, but cough and shortness of breath persists.

However, remember that for cupping one attack of bronchial asthma, you can apply only five to six inhalations with a twenty-minute interval. Since an overdose is possible medicinal product or development undesirable consequences (side effects). Usually, 1 to 3 inhalations with a twenty-minute interval are enough to relieve a mild and moderate severe attack of bronchial asthma.

When breathing becomes less frequent, and coughing decreases, we can assume that the child's condition has improved.

Unfortunately, children cannot always take a full breath, so therefore for inhalation, use a special auxiliary device - a spacer.

It is a hollow cylinder (but may have a different shape), which is equipped with a mask or mouthpiece. It is not difficult to use the spacer: a balloon with a medicinal substance is inserted into a special hole, which is injected into the cavity of the device, and it is inhaled through a mask (in children under four years old) or a mouthpiece (in children older than four).

Besides, for children of the first years of life, it is preferable to use nebulizers to deliver the drug directly to the lungs (inhalers). For them, use pharmacy solutions of drugs, the dosage of which should correspond to the age of the child. Best to apply compressor inhaler or mesh nebulizer, because they medicinal substances are not destroyed.

Note to mom

During an attack, do not put mustard plasters on your child, do not take foot baths with warm water, do not rub his skin with smelling substances, do not give decoctions of herbs and honey. These actions can only increase the attack!

Important! Remember that in children the general condition can quickly and dramatically worsen, so do not hesitate to call an ambulance in the following situations:

* If after one or two hours from the start of assistance, the attack did not stop.

* With the appearance of rapid breathing and difficult exhalation in a child at rest.

* When the child has difficulty talking and walking, he sits in a forced position.

* If the baby's skin has turned pale or its cyanosis has appeared on the fingertips, around the lips and wings of the nose.

* When the baby is overly excited ("respiratory panic") or his weakness grows.

* If you live far from a medical facility.

* You are unable to provide full assistance at home.

* If your baby is under one year old.

What to do after an attack?

It all depends on the general well-being of the child:

- If your baby is active and doing well the next day , continue the main (basic) treatment prescribed by the doctor.

- If the child has a cough that worsens after physical or emotional load, try to protect him from active games and running.

For treatment, continue to inject the bronchial dilator for another 1-2 days, one inhalation every 4 hours of wakefulness.

And necessarily consult with your doctor. Since it may be necessary to increase the dose of the already prescribed drug for the main (basic) treatment by 7-10 days or prescribe another drug.

Important! Drugs that dilate the bronchi are used only to stop an attack of bronchial asthma. Because they do not work on allergic inflammation and have no medicinal properties . Therefore, never increase their dose or duration of use, it is better to consult a doctor.

Dear mothers, an attack is a formidable complication of bronchial asthma, so it is better to prevent its development. To do this, try to protect the baby from possible provoking factors (house dust, honey, animal hair, and others), and also follow all medical recommendations. And then you can control it insidious disease and your baby will enjoy free breathing.

pediatric resident doctor