Asthma attack symptoms in children. Bronchial asthma: signs in a child. Emergency care for an asthma attack in a child

is a chronic allergic disease of the respiratory tract, accompanied by inflammation and changes in the reactivity of the bronchi, as well as bronchial obstruction that occurs against this background. Bronchial asthma in children occurs with symptoms of expiratory dyspnea, wheezing, paroxysmal cough, episodes of suffocation. The diagnosis of bronchial asthma in children is established taking into account the allergic history; spirometry, peak flowmetry, chest radiography, skin allergy tests; determination of IgE, blood gas composition, sputum examination. Treatment of bronchial asthma in children involves the elimination of allergens, the use of aerosol bronchodilators and anti-inflammatory drugs, antihistamines, and specific immunotherapy.

ICD-10

J45 Asthma

General information

Bronchial asthma in children is a chronic allergic (infectious-allergic) inflammatory process in the bronchi, leading to a reversible violation of bronchial patency. Bronchial asthma occurs in children of different geographic regions in 5-10% of cases. Bronchial asthma in children often develops at preschool age (80%); often the first attacks occur already in the first year of life. The study of the features of the occurrence, course, diagnosis and treatment of bronchial asthma in children requires interdisciplinary interaction between pediatrics, pediatric pulmonology and allergology-immunology.

The reasons

Bronchial asthma in a child occurs with the participation of a genetic predisposition and environmental factors. Most children with bronchial asthma have a burdened heredity for allergic diseases - hay fever, atopic dermatitis, food allergies, etc.

Sensitizing environmental factors can be inhalation and food allergens, bacterial and viral infections, chemical and medicinal substances. Inhalation allergens that provoke bronchial asthma in children are more often house and book dust, animal hair, waste products of domestic mites, mold fungi, dry food for animals or fish, pollen from flowering trees and grasses.

The triggers of bronchial asthma in children can be viruses - the causative agents of parainfluenza, influenza, SARS, as well as a bacterial infection (streptococcus, staphylococcus, pneumococcus, Klebsiella, Neisseria), chlamydia, mycoplasmas and other microorganisms that colonize the bronchial mucosa. In some children with bronchial asthma, sensitization can be caused by industrial allergens, taking medications (antibiotics, sulfonamides, vitamins, etc.).

Factors of exacerbation of bronchial asthma in children, provoking the development of bronchospasm, can be infections, cold air, weather sensitivity, tobacco smoke, exercise, emotional stress.

Pathogenesis

In the pathogenesis of bronchial asthma in children, there are: immunological, immunochemical, pathophysiological and conditioned reflex phases. In the immunological stage, under the influence of the allergen, antibodies of the IgE class are produced, which are fixed on target cells (mainly mast cells of the bronchial mucosa). In the immunochemical stage, repeated contact with the allergen is accompanied by its binding to IgE on the surface of target cells. This process proceeds with degranulation of mast cells, activation of eosinophils and the release of mediators that have a vasoactive and bronchospastic effect. In the pathophysiological stage of bronchial asthma in children, under the influence of mediators, swelling of the bronchial mucosa, bronchospasm, inflammation and mucus hypersecretion occur. In the future, attacks of bronchial asthma in children occur according to a conditioned reflex mechanism.

Symptoms

The course of bronchial asthma in children is cyclical, in which there are periods of precursors, asthma attacks, post-attack and interictal periods. During the warning period, children with asthma may experience anxiety, sleep disturbance, headache, itchy skin and eyes, nasal congestion, and dry cough. The duration of the precursor period is from several minutes to several days.

Actually, an attack of suffocation is accompanied by a feeling of pressure in the chest and lack of air, shortness of breath of the expiratory type. Breath becomes wheezing, with the participation of auxiliary muscles; wheezing can be heard in the distance. During an attack of bronchial asthma, the child is frightened, takes the position of orthopnea, cannot talk, catches air with his mouth. The skin of the face becomes pale with pronounced cyanosis of the nasolabial triangle and auricles, covered with cold sweat. During an attack of bronchial asthma in children, there is an unproductive cough with thick, viscous sputum that is difficult to separate.

Auscultation determines hard or weakened breathing with a large number of dry wheezing wheezes; percussion - box sound. On the part of the cardiovascular system, tachycardia, increased blood pressure, muffled heart tones are detected. With a duration of an asthma attack of 6 hours or more, they talk about the development of status asthmaticus in children.

An attack of bronchial asthma in children ends with the discharge of thick sputum, which leads to easier breathing. Immediately after the attack, the child feels drowsiness, general weakness; he is slow and lethargic. Tachycardia is replaced by bradycardia, increased blood pressure - arterial hypotension.

During interictal periods, children with asthma may feel almost normal. According to the severity of the clinical course, 3 degrees of bronchial asthma in children are distinguished (based on the frequency of attacks and respiratory function indicators). With a mild degree of bronchial asthma in children, asthma attacks are rare (less than 1 time per month) and are quickly stopped. In the interictal periods, the general state of health is not disturbed, the spirometry indicators correspond to the age norm.

Moderate degree of bronchial asthma in children occurs with a frequency of exacerbations 3-4 times a month; speed indicators of spirometry are 80-60% of the norm. With a severe degree of bronchial asthma, asthma attacks in children occur 3-4 times a month; FVD indicators are less than 60% of the age norm.

Diagnostics

When diagnosing bronchial asthma in children, data from a family and allergic history, physical, instrumental and laboratory examinations are taken into account. Diagnosis of bronchial asthma in children requires the participation of various specialists: a pediatrician, a pediatric pulmonologist, a pediatric allergist-immunologist.

The complex of instrumental examination includes spirometry (for children over 5 years old), tests with bronchodilators and physical activity (veloergometry), peak flowmetry, X-ray of the lungs and chest organs.

Laboratory studies for suspected bronchial asthma in children include a clinical blood and urine test, general sputum analysis, determination of general and specific IgE, and blood gas analysis. An important link in the diagnosis of bronchial asthma in children is the production of allergic skin tests.

In the process of diagnosis, the exclusion of other diseases in children with bronchial obstruction is required: foreign bodies of the bronchi, tracheo- and bronchomalacia, cystic fibrosis, bronchiolitis obliterans, obstructive bronchitis, bronchogenic cysts, etc.

Treatment of bronchial asthma in children

The main areas of treatment of bronchial asthma in children include: the identification and elimination of allergens, rational drug therapy aimed at reducing the number of exacerbations and relief of asthma attacks, non-drug rehabilitation therapy.

When detecting bronchial asthma in children, first of all, it is necessary to exclude contact with factors that provoke an exacerbation of the disease. For this purpose, a hypoallergenic diet, the organization of a hypoallergenic life, the abolition of drugs, separation from pets, a change of residence, etc. can be recommended. Long-term prophylactic use of antihistamines is indicated. If it is impossible to get rid of potential allergens, specific immunotherapy is carried out, which involves desensitization of the body by introducing (sublingual, oral or parenteral) gradually increasing doses of a causally significant allergen.

The basis of drug therapy for bronchial asthma in children is inhalation of mast cell membrane stabilizers (nedocromil, cromoglycic acid), glucocorticoids (beclomethasone, fluticasone, flunisolide, budesonide, etc.), bronchodilators (salbutamol, fenoterol), combined drugs. The selection of the treatment regimen, combination of drugs and dosage is carried out by the doctor. An indicator of the effectiveness of the treatment of bronchial asthma in children is a long-term remission and the absence of progression of the disease.

Forecast and prevention

Manifestations of bronchial asthma in children may decrease, disappear or intensify after puberty. In 60-80% of children, bronchial asthma remains for life. The severe course of bronchial asthma in children leads to hormonal dependence and disability. The course and prognosis of bronchial asthma is influenced by the timing of onset and the systematic nature of treatment.

Prevention of bronchial asthma in children includes timely detection and exclusion of causally significant allergens, specific and non-specific immunoprophylaxis, and treatment of allergies. It is necessary to train parents and children in methods of regular monitoring of the state of bronchial patency using peak flowmetry.

In most cases, asthma is caused by allergies. It manifests itself in the form of inflammation of the airways, in which acute bronchospasm is accompanied by an increase in mucus secretion.

Symptoms of the disease

Every parent should know how asthma can manifest itself. Signs in a child are usually pronounced. The baby begins bronchospasm, which doctors call bronchial obstruction. This is expressed as follows. The child begins paroxysmal dry cough. Over time, viscous sputum begins to stand out.

You can understand that obstruction has begun by breathing. If in a healthy child the duration of inhalation and exhalation is approximately the same, then with the development of an asthmatic attack, shortness of breath appears. It is characterized by a short inhale and a long exhale. In this case, the patient has wheezing, which is heard from afar.

There are also so-called first signs of asthma in children, which are observed even before the onset of an attack. So, the baby starts coughing, nasal congestion and itchy skin are observed.

During an attack, older children may complain of a feeling of lack of air, squeezing in the chest area. Sleep is disturbed in babies, they become whiny, irritable, lethargic.

Provoking factors

To prevent the development of the disease, you need to know what exactly can lead to problems. Experts include air pollution, changes in atmospheric pressure, flowering of allergenic plants, and even an unfavorable psychological atmosphere in the house as provoking factors.

If you have people in your family with hereditary allergic diseases, then you first need to find out how asthma can manifest itself in a child. The symptoms must be known in order not to miss the onset of problems. Also at risk are children with exudative-catarrhal diathesis.

An allergen that leads to bronchospasm can be plant pollen, certain foods, tobacco smoke, drugs, and household dust. The reaction can start from inhaling cold air or from physical exertion.

At the first contact, the body, as it were, gets acquainted with a foreign substance, but at subsequent “meetings” it already begins to react violently. The immune system produces antibodies, and they, in turn, release biologically active substances, which cause asthma in children to develop. Signs and symptoms in the form of shortness of breath, a compulsive cough, and difficulty breathing are hard to miss.

Characteristic features of the disease in infants

In all babies, before an asthma attack, the so-called At this time, deviations from the respiratory organs can be noticed. Liquid mucus begins to stand out from the nose, itching appears and the constant sneezing associated with it, dry cough. The doctor can listen to single dry rales, see swollen tonsils. These are the first signs of asthma in a child under one year old.

The disease also affects the nervous system. The baby becomes restless, irritable, his sleep deteriorates. Violations are also observed from the digestive system - constipation may begin or loose stools may appear.

Asthma develops in babies, as a rule, against the background of respiratory diseases. Only in exceptional cases, its appearance can be due to stress. In this case, the symptoms of asthma appear gradually. This is due to the fact that swelling of the bronchial mucosa and hyperemia increase at a slow pace.

The attack itself can last from several minutes to several days. It will be accompanied by wheezing, which is heard even at a considerable distance, expiratory shortness of breath.

It is worth noting that sometimes the first signs of asthma in children under one year old go unnoticed. They can appear sporadically without any regularity, at different times. At the same time, they can pass on their own, without any therapy. And in the period between attacks, parents do not notice any deviations.

Preschool children

It is also not always possible to suspect the development of the disease in older children. Signs of asthma in a child at 2 years old can be blurred. For example, they may experience rapid and irregular breathing during sleep. It also happens during physical activity.

The characteristic manifestations of the disease also include frequent sneezing, periodic coughing, restless sleep. Often children do not even notice that they are coughing in their sleep. This happens reflexively. If the child sleeps separately, then the parents may not even hear the cough. Therefore, it is necessary to observe the child, if the teacher from the kindergarten speaks, then the baby coughs during sleep.

Preschoolers cannot always describe their feelings, so parents should monitor their condition. For example, signs of asthma in a 5-year-old child may appear during active games. It is necessary to consult a doctor if, after a short run, the baby begins to cough. Active movement can cause pain in the chest, a feeling of squeezing.

Symptoms of asthma in schoolchildren

The older the child, the more and more accurately he can describe his condition. Therefore, it is already a little easier to determine the disease in schoolchildren. But this can only be done if you know what signs of asthma in children may be.

As in preschool children, in school-age children, the disease is indicated by coughing during sleep and after physical exertion. Patients can talk about the pressing feeling that has appeared in the chest area. In addition, having caught the connection between physical activity and emerging discomfort, children try to run as little as possible, avoiding any active games. Even in the absence of complaints, it is necessary to monitor students who refuse to attend physical education classes, try not to run, and sit quietly during breaks.

If a child has a coughing fit, it is difficult for him to sit upright. He tries to alleviate his condition, bends, humpbacks, leans forward. You may also notice excessive pallor. Preschoolers and children of primary school age may become frightened and even burst into tears during an attack.

Adolescence

As a rule, by the age of 12-14 the diagnosis is already established. At this age, it is important to teach your child to recognize when asthma starts. Signs in a child, as a rule, are always similar. He should always have with him a special inhaler prescribed by a doctor. Parents are obliged to ensure that the medicine does not run out in it, and change the used container in time.

Symptoms of the disease in children of middle and senior school age are not particularly different from those found in babies. But adolescents are already able to control the disease, which means they can prevent an exacerbation.

It is worth noting that despite the fact that many people have attacks during sports, teenagers with asthma need physical activity. Just before the loads, you need to take the medicine prescribed by the doctor and monitor your breathing. It should be even and rhythmic.

Attacks can cause allergens. But teenagers should already know which substances provoke the disease. If possible, they should avoid them. If seasonal plants provoke allergic attacks, then it is necessary to take medications on a regular basis that block their development.

Often at this age, the process of remission begins. All signs of asthma disappear, and parents decide that their child has simply "outgrown" the disease. But in fact, bronchial hyperreactivity persists. If a teenager encounters several provoking factors, then the disease may return. Sometimes it happens in adulthood. Quite often there are situations in which asthma disappears in adolescence and reappears in the elderly.

Diagnostics

To accurately determine whether a child has asthma, it is not enough to know the first signs and main symptoms of this disease. Shortness of breath, rapid and difficult breathing, obsessive cough can also appear with obstructive bronchitis. Therefore, without consulting doctors can not do. First of all, you need to visit a pediatrician. He will already give a direction for all the necessary tests and refer you to an allergist. If necessary, you may also need to consult a pulmonologist.

In addition to general blood and urine tests, it can also be taken for asthma. In asthma, an increased content of eosinophils, Kurschmann spirals (mucus from the respiratory tract), Charcot-Leiden crystals (lysophospholipase released from eosinophils), Creole bodies (accumulation of epithelial cells) are found in it.

To establish a diagnosis, the doctor must deal with the details of the baby's life. He needs to know how and when the seizures start. Even according to such a description, sometimes it becomes clear to a specialist what exactly is an allergen for a baby. It is also important for the doctor to know how the child reacts to bronchodilators. Asthma will be indicated by a temporary improvement in the background of their use.

Diagnosis consists in conducting special tests. One of the most common are skin allergy tests. For these purposes, potential allergens are applied to slightly scratched areas of the forearm. After 20 minutes, the doctor evaluates the results. Look at which particular areas of the skin turned red the most.

This allows you to identify the allergen, but does not make it possible to understand whether the respiratory system is disrupted. Parents themselves can determine this, knowing the signs of bronchial asthma. The cough form in children requires a more thorough diagnosis. To determine the working volume of the lungs, a special examination is carried out - spirometry. With its help, the degree of impaired functioning of the respiratory system is assessed.

To do this, measure the volume of exhalation-inhalation made with an effort and the total capacity of the lungs. For the first time, these measurements are taken without any drugs. Then the examination is repeated after taking bronchodilator medications. If the lung volume increases by more than 12%, then the sample is considered positive.

Bronchial hyperreactivity after exercise is also assessed. If the forced expiratory volume decreases by 20%, this indicates that the small patient has asthma. Signs in a child, however, can be so pronounced that such a detailed examination is not always prescribed.

Clinical manifestations

It should be understood that in children it is often impossible to make a diagnosis due to the fact that an obstructive syndrome occurs with bronchitis. In a few days, they develop a cough, symptoms appear that indicate respiratory disorders, and wheezing wheezes are heard. As a rule, treatment consists not only in taking brocholytics, but also antibiotics, antihistamines. With subsequent SARS, symptoms of pulmonary obstruction may appear.

The signs of asthma in infants are quite vague, so special attention is paid to the history, asking parents about the onset of the disease, and physical examination.

The course of the disease itself can be divided into 3 conditional stages:

1. Attack immediately. Acute suffocation develops due to difficult entry. It is preceded by a pre-attack stage, which can last from several minutes to 3 days.
2. Exacerbation period. It is characterized by shortness of breath, the appearance of periodic whistles, an obsessive cough and difficulty in expectorating sputum. At this time, acute attacks may periodically recur.
3. Remission. The period is different in that the child can lead a normal life, he does not have any complaints. Remission can be complete, incomplete (determined by indicators of external respiration) or pharmacological (preserved when taking certain medications).

It is important to be able to recognize the first signs of asthma in children in order to prevent the development of an acute attack. If it was not possible to prevent it, then the parents and the immediate environment of the child should know what needs to be done. It is also important to understand that attacks are distinguished by the severity of bronchospasm.

The safest is the mild degree. With such an attack, a spasmodic cough begins, breathing is slightly difficult. At the same time, the general well-being of the child remains good, speech is not disturbed.

With a moderate attack, the symptoms are more pronounced. The child's health worsens, he becomes capricious and restless. The cough is paroxysmal in nature, thick viscous sputum is difficult to pass. Breathing is noisy and wheezing, shortness of breath is present. The skin at the same time turns pale, the lips become bluish. Children can only speak in single words or short phrases.

A severe attack is characterized by the appearance of shortness of breath, which is heard at a distance. The heartbeat in babies quickens, cold sweat appears on the forehead, general cyanosis of the skin is observed, the lips are blue. Symptoms of asthma in children 6 years of age and older are characterized by the fact that the patient cannot speak, he is able to pronounce only a few short words. Babies, as a rule, cannot explain their condition, they only cry and express anxiety in all available ways.

The most severe cases are called status asthmaticus. This is a condition in which a severe attack of the disease cannot be stopped for 6 or more hours. The child develops resistance to prescribed medications.

Features of the course of the disease

It is important to know how asthma can manifest itself before an attack begins. Signs in a child can be as follows: capriciousness, irritability, tearfulness, headache, obsessive dry cough.

In most cases, attacks begin in the evening or at night. Initially, there is a cough, noisy breathing, shortness of breath. Children are often frightened, start crying, tossing about in bed. The initial manifestations of asthma in children are often expressed in the form of broncho-obstructive syndrome in acute respiratory infections. Also, against the background of colds, an attack of asthmatic bronchitis can begin. It is characterized by shortness of breath, in which breathing is difficult, and a wet cough.

Atopic bronchial asthma is characterized by the rapid development of an attack. Timely use of bronchospasmolytics allows it to stop. But with an infectious-allergic form, attacks develop slowly, symptoms increase gradually. It is far from immediately possible to stop an attack by taking bronchospasmolytics.

After normalization of the condition, sputum begins to be coughed up, shortness of breath disappears. In some cases, the condition improves only after vomiting.

Actions of parents

Regardless of the age of a child who has been diagnosed with asthma, his relatives should be careful to prevent the development of attacks and reduce their frequency. To do this, you must strictly follow all the recommendations of doctors, drink prescribed drugs and avoid potential allergens.

In kindergarten, all educators, a nurse, a music worker should be aware of the situation. It is also important to give them a list of allergens that are the reason that asthma begins in a child. It is also advisable to report the symptoms of the onset of an attack to them. In this case, they will be able to send the child to a health worker in a timely manner or call the parents.

If caregivers know what the child is allergic to, they can help avoid contact with these substances. For example, you can replace flowers in a preschool if some of them provoke the onset of an attack. Also, educators are able to monitor the nutrition of the baby. Of course, even two-year-old crumbs need to be explained that they should not eat. But not always children can control it themselves.

At school, teachers should also be aware of the child's problems. First of all, it is necessary to tell the class teacher that the child has asthma. In children, signs and symptoms may appear gradually. For example, if there was contact with an allergen at school, then the child may sleep restlessly at night, cough during rest, his breathing may become confused. In this case, it is necessary to ask the baby in detail about what he did during the day, what he ate and in what rooms he was.

Physical education teachers should also be warned. But if the doctor sees the need, he will send the child to the commission, where he can be given partial or complete exemption from physical activity at school.

But keep in mind: the child must be gradually accustomed to an active lifestyle. Asthma is not a hindrance to most sports. Even some Olympic champions suffered from this disease in childhood. It is important to simply teach your child to monitor their condition and be able to recognize the first signs of bronchial asthma. Children should have a good defense mechanism. You just need to explain to the child that it is important, even with a slight discomfort, to stop and restore breathing.

Treatment tactics

It is impossible to figure out on your own what to do if the first signs of asthma appear. Treatment should be prescribed by an allergist, sometimes complex work and the involvement of a pulmonologist are required. Equally important is the correct behavior of parents. There is no need to panic, but there is no need to be inactive either. It is necessary to have a conversation with the baby, discuss the possible causes of the development of the disease, tell what can and cannot be done.

How to deal with a condition such as bronchial (Komarovsky, by the way, claims that it is simply necessary) is to use medication to prevent the development of an attack and put the patient into a state of remission.

You can stop the condition with the help of glucocorticosteroids. First, you need to use fast-acting inhalers. Therapy should be supportive. If it is not possible to achieve the desired effect with the help of Nedocromil or cromoglycic acid, then inhalations are made with glucocorticosteroids.

Therapy should be aimed at:

Elimination of clinical manifestations;

Improving the function of breathing;

Reduced need for bronchodilators;

Prevention of the development of life-threatening conditions.

How Asthma Develops

Asthma is defined by doctors as a disease characterized by episodes of bronchial obstruction (bronchial obstruction), fully or partially reversible. It is based on inflammation of the bronchial mucosa and bronchial hyperreactivity.

During an attack of bronchial obstruction, a narrowing of the lumen of both small and larger bronchi occurs.

In all patients with asthma, when there is no attack, nevertheless, signs of an inflammatory process in the bronchial mucosa are found. This fact raises the question of the treatment of the inflammatory process - and not only during an asthma attack. There are such drugs, so persistent long-term treatment should be the basis of the fight against asthma.

No less important is the second provision - about the presence of bronchial hyperreactivity in patients with asthma, that is, increased irritability of the bronchi, which respond with a spasm even to insignificant amounts of irritating substances in the inhaled air. This makes it necessary to create a healthy air environment for these patients.

"Not all asthma that whistles"

Bronchial obstruction is observed not only in asthma, but also in a number of other diseases. In most of them, especially in adults, the disease does not have a remission (light intervals), which distinguishes them from asthma.

But in childhood, there is a group of diseases very similar to asthma associated with a viral infection. They have nothing to do with asthma. Both an asthmatic infant and a peer without signs of allergy can give an episode of obstruction against the background of SARS. The only difference is that asthma attacks will recur, and not only with ARVI, but also in response to one or another non-infectious allergen, while a child without allergies will get obstructive bronchitis and, most likely, will “outgrow”, so bronchial obstruction after 1-2 such episodes will stop. It is this fact that creates difficulties in the above "relationships" with the diagnosis of "asthma" in many parents, as well as the incomplete acceptance of the definition of asthma by pediatricians.

What is the difference between obstructive bronchitis against the background of SARS and asthma? In some viral infections in infants, inflammation of the bronchial mucosa is observed, which thickens and increases mucus production. This leads to constriction of the very narrow childhood bronchi, which is accompanied, as in asthma, by difficulty in exiting. This picture can be repeated 1-2 times, but with the growth of the child and the increase in the diameter of his bronchi, a new infection, although it causes bronchitis, does not cause a significant violation of bronchial patency.

The same thing happens in an allergic child, but over time, due to the preservation of bronchial hyperreactivity, almost every new infection will be accompanied by bronchospasm. Moreover, such a child can give attacks of obstruction in response to the inhalation of aeroallergens - and this is bronchial asthma.

Among children of the first three years who have obstructive diseases, the risk group for bronchial asthma are:

Children with an allergic predisposition (allergies from parents who have allergic skin manifestations, positive skin allergy tests, or high levels of immunoglobulin E);

Children whose obstructive disease develops without fever (which indicates the role of a non-infectious allergen);

Children with more than 3 obstructive episodes.

After the age of 3 years, it is appropriate to diagnose bronchial asthma in almost all children with obstructive manifestations, however, in many of them, the disease stops after 1-3 years.

Forms of bronchial asthma

Above we mentioned two forms of asthma - allergic and non-allergic. This division of asthma into forms is not limited.

Many children have asthma without pronounced attacks, during an exacerbation they develop bronchitis with obvious signs of obstruction, which we usually call asthmatic bronchitis, which should not reassure parents: asthmatic bronchitis is a form of bronchial asthma.

In some children, an asthma attack occurs as a persistent nocturnal cough without severe shortness of breath - this is also a form of asthma, which can eventually turn into a typical form.

A number of children experience shortness of breath and difficulty breathing in response to physical exertion - this is asthma of physical exertion, and an attack develops as a result of bronchial hyperreactivity, stimulated by muscle efforts.

Many parents notice that an asthma attack occurs when the child is very excited, sometimes they even talk about "mental asthma." There is hardly any reason to talk about the mental mechanism of asthma, but there is no doubt that in any form of this illness, excitement, especially those associated with the child’s inability to cope with a particular problem, can cause an attack. Therefore, in a family where there is a child with asthma, a healthy psychological climate is very important.

How does asthma progress?

The "usual" attack develops suddenly, breathing quickens, exhalation is difficult, the child takes a sitting position and breathes shallowly. Often wheezing can be heard from a distance, sometimes it is felt only when bringing the ear to the child's mouth. Difficulty exhaling leads to air retention in the chest, it usually swells, if you put your hands on it, then you feel a trembling at the exit.

The attack can last from several minutes to many hours, often it ends spontaneously. However, waiting for it to pass, or using dubious means (a lot of them have been invented) is unacceptable: suffocation is a very painful phenomenon, so every minute of delay with effective treatment increases the child's suffering, frightens him, which in itself can increase bronchospasm. In more severe cases, intensive care is required.

Patients also differ in the nature of the interictal period. In some patients, no changes can be detected, while in others there are significant restrictions on the respiratory function in the interictal period.

Asthma treatment

When I see a child with asthma, the first thing I tell his parents is that asthma is not cured by any known remedy. It may be cruel, but why am I saying this? Because many parents, in search of a miracle cure, try a variety of methods, most of which not only do not benefit, but also harm the patient.

If you do not count on a cure, then what is the point of treatment? Its meaning is to reduce the severity of asthma, to learn how to prevent attacks, at least make them rarer, to quickly relieve an attack if it occurs. In short, to make the child's life full - like a healthy child.

And with regard to the possibility of a cure, I always "lighten the soul" of parents - in a very large percentage of cases, asthma in a child goes away on its own.

So, what is the right way to treat asthma? It is necessary to clearly distinguish between therapeutic measures to help get rid of an attack that has already occurred, and means to mitigate the course of the disease.

How to prevent an attack? Seizure prevention is the main goal of basic treatment. But to this should be added measures to possibly prevent contact with allergens, primarily with house dust. It is better to remove carpets and upholstered furniture, at least in the room where the child sleeps. I often joke - the ideal bedroom for a child is a prison cell, where, apart from a bed, a table and a stool, there is nothing. It is important to close books in glass shelves, use a vacuum cleaner more often for cleaning, and moisturizing is better. To reduce the contact of the patient with the dermatophagoides mite, cover the child's mattress with plastic wrap and put 2 pillowcases on the pillows. Taking into account the allergenic properties of bird feathers, feather pillows should be replaced with cotton or foam rubber ones.

It is very difficult to part with pets, but it is necessary if the child's sensitivity to their hair is revealed. The room should not have fresh flowers - not only their smells and pollen can be dangerous for the patient, but also the aspergilus fungus, which often starts in flower pots. In small patients with asthma, it is not uncommon for an attack to be associated with food allergens.

It is hardly necessary to talk about the dangers of smoking in an apartment where there is a patient with asthma. For him, first of all, it is necessary to create conditions that ensure maximum stay in the fresh air. Yes, and all other allergy prevention measures must be fully observed.

It is very important to temper the child - this will reduce the purity of respiratory infections, which are often the cause of an attack and contribute to increased bronchial hyperreactivity.

Many children with asthma do not tolerate physical activity well - after 5-7 minutes from the start of running or outdoor games, they experience bronchospasm, causing shortness of breath, or even an asthma attack. To prevent this, you should do 1-2 inhalations of a beta-mietic or take aminophylline powder, after which bronchospasm will not develop, and after 20-30 minutes, under the influence of physical activity, the bronchi, on the contrary, will expand, which is very useful for the patient.

That is why physical culture, increasing physical endurance is included in the arsenal of therapeutic agents for asthma. Moreover, physical training increases the self-esteem of the patient, contributes to the development of his self-confidence and reduces dependence on adults. Respiratory gymnastics is very useful, asthma patients learn proper breathing in the process of exercising.

Many parents ask if a child with asthma can travel south to the sea. Experience shows that such a change in climate usually provokes an asthma attack, so you need to be prepared for this. But then children usually feel good and get a lot of benefits from being at sea - after all, the sea air is very clean, breathing with them reduces bronchial hyperreactivity. Upon returning home, many patients again have asthma attacks, and one must also be prepared for this. In general, the benefits of such a trip will be tangible if you stay in the south for a month and a half or two, no less.

Another frequently asked question is about climate change. In most cases, it is not possible to "pick up" the climate, so I usually do not advise parents to embark on this very difficult undertaking. If asthma is clearly associated with the flowering of a particular plant, for this period it is sometimes possible to take the child to another region, but most often it is not possible to completely get rid of asthma in this way. The same applies to trips to the mountains, where there are very few allergens at an altitude of 1500-2000 meters: this is useful (including from the point of view of physical training), but it is still not possible to completely get rid of asthma.

Well, what about the treatment of asthma in salt mines? There are no allergens in the air, and this helps to reduce bronchial hyperreactivity. But you can’t spend your whole life in a mine, so you can’t count on a cure. But staying in a halochamber (a room whose walls are covered with salt) seems to me at least doubtful.

Alternative Treatments

Many have heard or read about miraculous remedies - acupuncture, special breathing techniques, miracle drugs, psychics, supposedly curing asthma. Yes, indeed, a mild attack can be removed by holding the breath or acupuncture, but I have never been able to understand how acupuncture is better than inhalation. Moreover, even with moderate asthma, holding your breath can be very dangerous.

I don't know of any solid research that has proven that asthma can be cured using these methods, and reports like "we were treated by a psychic - and the asthma went away" are completely unconvincing: after all, most children have asthma sooner or later!

And the harm from all these methods is the same - resorting to them, parents are distracted from those measures that really help with asthma, in particular - they do not carry out basic treatment. And the use of other drugs during an attack (you have to hear from parents that they were recommended broncholithin, no-shpu, papaverine, solutan and even antibiotics) is unacceptable, since they, as a rule, do not alleviate the suffering of the child.

What is the future of asthma patients? With proper treatment, as a rule, it is possible to stabilize the child's condition, and if the attacks do not stop completely, then their frequency and severity decrease.

And do not forget that very often asthma goes away.

Bronchial asthma is a chronic disease that develops on the basis of an allergic inflammatory process in the airways of a child. There is an acute bronchospasm and increased mucus secretion. The accumulation of mucus in the bronchi against the background of their spasm leads to bronchial obstruction (bronchial obstruction).

Bronchial asthma is a rather dangerous disease; it can develop at any, even infancy, age.

There are atopic (allergic) and non-atopic (non-allergic) forms of asthma. The atopic form predominates, it is noted in 90% of children with this disease. The disease has a chronic course with alternating exacerbations and interictal periods.

Causes of bronchial asthma

• Hereditary predisposition to the atopic form of the disease: if one of the parents suffers from bronchial asthma, the probability of developing asthma in a child is 25-30%, if both parents - up to 75-80%.
• The presence of an allergic disease in a child or members of his family (atopic dermatitis, hay fever, food or drug allergy) is a signal: bronchial asthma may develop. In 60% of children with bronchial asthma, relatives suffer from allergic diseases.

In the first year of life, allergens more often enter the body through the gastrointestinal tract (food allergy), and pollinosis predominates in older children. Often the cause of this disease is a pathological reaction to house dust, plant pollen, drugs and foods. Allergens from pollen of grasses and trees can have a seasonal allergenic effect (from May to September).

The most pronounced ability to provoke bronchospasms is possessed by microscopic mites that live in house dust, carpets, soft toys and bedding. A high sensitizing role is also played by down and feathers of birds in blankets and pillows, mold on the walls of damp rooms. Wool and saliva of pets (dogs, cats, guinea pigs, hamsters), dry food for aquarium fish, fluff and feathers of poultry also often contribute to the allergization of the child. Even after removing the animal from the premises, the concentration of allergens in the apartment decreases gradually, over several years.

• Environmental factor: inhalation of harmful substances (exhaust gases, soot, industrial emissions, household aerosols) with the air is a common cause of asthma due to immune disorders in the body.

An important risk factor for developing asthma is smoking (for young children - passive smoking, or being near a smoking person). Tobacco smoke is a strong allergen, so if at least one of the parents smokes, the risk of asthma in a child increases significantly (tens of times!)

• Viruses and bacteria that cause damage to the respiratory organs (ARI, SARS) contribute to the penetration of allergens into the walls of the bronchial tree and the development of bronchial obstruction. Frequently recurring obstructive bronchitis can be a trigger for bronchial asthma. Individual hypersensitivity only to infectious allergens causes the development of non-atopic bronchial asthma.

• Factors of physical impact on the body (overheating, hypothermia, physical exertion, a sharp change in the weather with changes in atmospheric pressure) can provoke an attack of suffocation.

• Asthma can be the result of a child's psycho-emotional stress (stress, fear, constant scandals in the family, conflicts at school, etc.).

• A separate form of the disease is "aspirin" asthma: an asthma attack occurs after the use of aspirin (acetylsalicylic acid). The drug itself is not an allergen. When it is used, active biological substances are released, they cause bronchospasm.

The occurrence of seizures can be facilitated by the use of non-steroidal anti-inflammatory drugs and a number of other drugs, drugs in colored capsules. as well as products containing food coloring.

• Diseases of the digestive tract can aggravate the severity of bronchial asthma:,. The occurrence of an asthma attack at night may be associated with the reflux of gastric contents into the esophagus (duodeno-gastric reflux).
• The cause of asthma in the first months of a baby's life can be a woman's smoking while carrying a child, her excessive consumption of allergenic foods (honey, chocolate, fish, citrus fruits, eggs, etc.), infectious diseases during pregnancy and the use of drugs.

Symptoms of bronchial asthma

The disease can begin imperceptibly, with manifestations that are difficult to treat. Bronchial asthma develops more often in children under the age of three, boys are more likely to get sick.

The following manifestations should alert parents and make them assume the development of bronchial asthma in a child:

• intermittent wheezing;
• the appearance of a cough, mainly at night;
• the appearance of coughing or wheezing after contact with the allergen;
• cough with wheezing after emotional or physical exertion;
• lack of effect from antitussive drugs and the effectiveness of anti-asthma drugs.

The main manifestation of bronchial asthma is an asthma attack. Usually such an attack appears on the background of SARS. Initially, difficulty in breathing may occur with high fever, cough (especially at night), runny nose. Then attacks of difficult wheezing become more frequent, occur without connection with colds - upon contact with an animal or during physical exertion, near plants with a pungent odor, or when the weather changes.

When an attack of bronchial asthma occurs in children, it is difficult to exhale. Normally, the duration of inhalation and exhalation is the same in time, and in asthma, the exhalation is twice as long as the inhalation. Respiration is rapid, wheezing, noisy, audible at a distance. The chest during an attack is somewhat swollen, the face acquires a purple hue.

The child takes a forced position: he sits, leaning slightly forward, leaning on his hands, his head is pulled in, his shoulders are raised (the so-called "coachman's position"). The breath is short, not providing enough oxygen. With a prolonged attack, pain may appear in the lower parts of the chest, the cause of which is an increased load on the diaphragm. An attack can last from several minutes to several hours. At the same time, the cough is initially dry, painful, and then thick, viscous sputum may be released.

Sometimes an atypical variety of bronchial asthma develops - a cough variant: a classic asthma attack does not occur, a symptom of the disease is a painful cough with thick and viscous sputum, which occurs mainly at night.

Older children complain of lack of air, and babies cry, show anxiety. The attack often develops very quickly, instantly after contact with the allergen. But in some children, it may be preceded by “harbingers”: nasal congestion, complaints of itchy throat, cough, skin rashes and itchy skin, as well as irritability, drowsiness or anxiety.

Oxygen starvation of tissues (including the brain) contributes to the lag of a child suffering from bronchial asthma in intellectual, physical and sexual development. Such children are emotionally labile, they may develop neuroses.

Classification

According to the classification of bronchial asthma in children, there are mild, moderate and severe course of the disease, depending on the frequency of occurrence of attacks, their severity and the need for anti-asthma drugs.

Light degree:

• symptoms occur sporadically;
• asthma attacks are short-lived, occur spontaneously and are stopped by taking bronchodilators;
• at night, there are no manifestations of the disease or they are rare;
• physical activity is tolerated normally or with minor disturbances;
• during the period of remission, the function of external respiration is not impaired, there are no manifestations of the disease.

Moderate degree:

• attacks occur once a week;
• attacks are moderate, the use of bronchodilators is often required;
• nocturnal symptoms are regular;
• there is a limitation of exercise tolerance;
• without basic therapy, remission is incomplete.

Severe degree:

• attacks occur several times a week (may occur daily);
• attacks are severe, protracted, daily use of bronchodilators-corticosteroids is necessary;
• night manifestations are repeated every night, even several times a night, sleep is disturbed;
• drastically reduced exercise tolerance;
• there are no periods of remission.

If the attack cannot be stopped within a few hours, this is an asthmatic status that requires immediate hospitalization of the child.

Treatment

First you need to establish an allergen (provoking factor) and completely exclude any contact of the child with it:

• regularly carry out wet cleaning of the premises (if necessary with anti-tick means); when cleaning, use a vacuum cleaner with a water filter; use air purifiers to filter the air;
• purchase pillows and blankets for the child with hypoallergenic synthetic fillers;
• exclude games with soft toys;
• place books in glass cabinets;
• remove excess upholstered furniture, and cover the necessary with a lint-free cloth;
• in case of significant air pollution, change the place of residence;
• during the flowering period of plants provoking asthmatic attacks, minimize the child's stay in the fresh air - only in the evening, after dew falls, or after rain; hang a special mesh on the windows;
• with "asthma of physical effort" significantly reduce the load, including jumping and running;
• with "aspirin" asthma, exclude the use of medications provoking an attack.

Medical treatment

Drug treatment of bronchial asthma is divided into two groups: symptomatic treatment (stopping an asthma attack) and basic therapy.

Treatment of bronchial asthma in children is a very complex process: only a doctor can choose medication. You can not self-medicate, as improper use of drugs can aggravate the course of the disease, lead to longer and more frequent asthma attacks, and the development of respiratory failure.

Symptomatic treatment includes drugs that have a bronchodilatory effect: ventolin, berotek, salbutamol. In severe cases, corticosteroids are also used. It is important not only the choice of the drug, but also the method of its administration.

The most commonly used method is inhalation (the medicine enters the lungs in the form of an aerosol). But it is difficult for small children to use an inhaler balloon: the child may not understand the instructions and inhale the drug incorrectly. In addition, with this method of administration, most of the drug remains on the back of the throat (no more than 20% of the drug reaches the bronchi).

Currently, there are a number of devices that can improve the delivery of medication to the lungs. For the treatment of children, these devices are optimal: they allow the use of the drug at a lower dose, which reduces the risk of side effects.

Spacer - a special chamber, an intermediate reservoir for an aerosol. The medicine enters the chamber from a spray can, and from it the child is already inhaled. This allows you to take several breaths, 30% of the drug in the form of an aerosol enters the lungs. The spacer is not used to administer the drug in powder form.

Together with the spacer, the “easy breathing” system is used: the inhaler turns on automatically (there is no need to press the valve on the inhaler at the moment of inhalation). At the same time, the aerosol cloud is ejected at a lower speed and the medicine does not settle in the throat, twice as much medicine penetrates into the lungs.

Cyclohaler, Diskhaler, Turbuhaler - these are the same devices as the spacer, only for the introduction of powder.

Nebulizer (inhaler) - a device that allows you to transfer the medicine into an aerosol. There are compressor (jet and pneumatic) and ultrasonic nebulizers. They allow inhalation of the medicinal solution for a long time.

Unfortunately, drugs for symptomatic treatment have a temporary effect. Frequent, uncontrolled use of bronchodilator drugs can provoke the development of asthmatic status, when the bronchi no longer respond to the drug. Therefore, in older children who can use inhalers on their own, the dose of the drug should be clearly controlled - children, due to fear of developing an attack, can overdose a bronchodilator drug.

As basic therapy several groups of drugs are used: antihistamines (tavegil, suprastin, claritin, loratadine, etc.); drugs that stabilize the cell membrane (ketotifen, tailed, intal, etc.); antibiotics (for the rehabilitation of chronic foci of infection). Hormonal preparations can also be prescribed to treat inflammation in the bronchi and prevent exacerbation of asthma. Basic therapy is also selected by the doctor individually, taking into account the characteristics of the child's body and the severity of asthma.

Leukotriene inhibitors (acolate, singular) and cromones (ketoprofen, cromoglycate, etc.) are also used. They do not affect the lumen of the bronchi and do not stop the attack. These drugs reduce the individual sensitivity of the child's body to allergens.

Parents should not cancel the prescribed maintenance therapy or basic therapy on their own. You should also not arbitrarily change the dosage of drugs, especially if prescribed. Dose reduction is carried out when there has not been a single attack for six months. If remission is observed within two years, the doctor cancels the drug completely. If an attack occurs after stopping the drug, the treatment is started again.

It is important to timely treat chronic foci of infection (, sinusitis), diseases of the digestive tract.

Non-drug treatment

Of the non-drug methods of treatment, physiotherapy, physiotherapy exercises, massage, acupuncture, various breathing techniques, hardening of the child, the use of a special microclimate of mountains and salt caves should be indicated. During the period of remission, sanatorium-and-spa treatment is used (the season and type of resort is agreed with the doctor) at the resorts of the southern coast of Crimea, in Kislovodsk, Elbrus, etc.

There is another type of fight against bronchial asthma: allergen-specific immunotherapy (ASIT). It can be received by children over the age of five. The essence of the method: a very small dose of an allergen is introduced into the body, which causes an asthma attack in a child. Gradually, the dose of the injected allergen is increased, as if “accustoming” the body to the allergen. The course of treatment lasts 3 or more months. As a result of treatment, asthma attacks stop.

Phytotherapy complements and enhances the effectiveness of traditional drug treatment, contributes to a longer period of remission. Herbal teas are used from the leaves of nettle and coltsfoot, rosemary herb, licorice roots and elecampane. Fresh decoctions should be prepared daily. Take decoctions for a long time, the use and doses will be agreed with the attending physician. Parents should not try out alternative treatments on their own!

With exacerbations and attacks of bronchial asthma, you can use decoctions and infusions from plants with an expectorant effect (plantain, horsetail, chamomile, dandelion, knotweed, calendula, nettle, yarrow, St. John's wort, licorice root, coltsfoot). During the rehabilitation period, you can take an infusion of licorice root, glycyram, pertussin for a month.

For aromatherapy, you can recommend an aroma lamp for 10 minutes a day. Essential oils (lavender, tea tree, thyme) should be used very carefully, in microdoses. You can, for example, add 5 drops of essential oil to 10 ml of massage oil and rub the child's chest.

Homeopathic treatment is also used in the treatment of bronchial asthma. A competent homeopathic doctor selects an individual treatment regimen for the child. It is impossible for parents to give drugs bought in a homeopathic pharmacy on their own!

In Russia, special asthma schools have been opened that teach both sick children and parents: they teach how to properly provide assistance during an attack, explain the essence of rehabilitation, the rules of massage and exercise therapy, and talk about non-traditional methods of treatment. Children are taught how to use the inhaler correctly. Psychologists work with children in such a school.

A child suffering from bronchial asthma must be provided with dietary nutrition:

Vegetable and cereal soups should be cooked on beef second broth;

Rabbit meat, lean beef are allowed boiled (or steamed);

Fats: sunflower, olive and butter;

Kashi: rice, buckwheat, oatmeal;

boiled potatoes;

Fresh fruits and green vegetables;

Sour-milk one-day products;

The bread is white.

You should limit the consumption of carbohydrates (confectionery, sugar, pastries, sweets). It is recommended to exclude allergen products from the diet (honey, citrus fruits, strawberries, chocolate, raspberries, chicken eggs, fish, canned food, seafood). It is also better to do without chewing gum.

Parents can keep a food diary, where all the foods eaten by the child during the day are recorded. Comparing the food received and the occurrence of seizures, it is possible to identify the food allergens of the child.

Bronchial asthma that arose in childhood, even its severe form with frequent attacks, can completely disappear in adolescence. Self-healing occurs, unfortunately, only in 30-50% of cases.

Timely diagnosed bronchial asthma in a child, the precise implementation of all therapeutic and preventive measures is the key to success.

Which doctor to contact

If your child has difficulty breathing, contact your pediatrician. He will refer the baby to an allergist or pulmonologist. Additionally, it will be useful to consult a nutritionist, a specialist in physiotherapy exercises, a physiotherapist, an immunologist, an ENT doctor, a dentist (to eliminate foci of chronic infection). With prolonged use of glucocorticosteroids, even in inhaled form, it is necessary to periodically consult an endocrinologist so as not to miss the inhibition of the function of the child's own adrenal glands. (votes - 1 , average: 5,00 out of 5)

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 a sharp increase in mucus in the 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, since their respiratory system is still weak, perceives all stimuli sharply and reacts intensively to them. The causes of the disease are:

Important: In the first month after childbirth, it is more likely that the disease develops due to the mother's smoking during the period of bearing the baby. Also, the reason is its consumption of foods that cause 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 the mild degree of the disease. 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, the rate of relief of an attack and further treatment change. The manifestations of the disease are divided into three periods.

Remission time

A condition in which the little patient is almost not bothered by anything: there is no obvious cough, wheezing, or 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 the 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 normal life, others find it difficult to play outdoor games, others cannot perform their usual activities without medication.

Aggravation

It develops in a 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, providing the necessary conditions for a small patient and changing the way of life.

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 for a long period of treatment in 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 the 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 the baby's immune system 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: young children cannot inhale the drug in time, they can cough even more from them, the active substance in this case does not reach the bronchi in full, but about 20%. Symptomatic drugs are also used with the help of 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 help only for a short period of time, and after the end of their action, the small patient may again have an asthmatic attack.

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 the individual characteristics of the 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 of therapeutic exercises for 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 red fruits and vegetables (tomatoes, strawberries, etc.), fish, fatty meats, 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.