Symptoms of bronchial asthma in a 2-year-old child. The first signs and symptoms of bronchial asthma in children, treatment and prevention of the disease. How bronchial asthma manifests itself, symptoms in children

unfavorable environmental conditions and bad habits parents (in particular, smoking) both during the period of gestation and after the birth of a baby, directly contribute to an increase in the number of asthma patients.

In fact real reasons occurrence of bronchial asthma in children is not fully understood. Medicine identifies several factors that increase the risk of developing the disease:

genetic predisposition. At risk are children whose parents or relatives are asthmatics;
gender identity. The lumen of the bronchial canals in boys is narrower, so most cases of the disease have been registered in them;
excess weight, due to which the diaphragm has a higher position in thoracic region and prevents free full breathing;
atopic dermatitis or others allergic diseases a newborn can provoke the development of asthma;
frequent respiratory diseases flowing with a complication in the bronchi (this dependence was found in 25% of children);
parents smoking;
unsatisfactory environmental situation.

Non-allergic and allergic bronchial asthma

Depending on the factor causing spasm bronchi, asthma is divided into atopic and non-allergic.

The vast majority of children (up to 90%) diagnosed with bronchial asthma have exactly the atopic form. Allergic asthma involves the presence of a certain substance (allergen) that provokes an attack. These are the various particles that enter by inhalation:

plant pollen and dust;
hair of cats (less often - dogs);
perfumery, household chemicals and its fragrances;
waste products of insects;
various types of fungus and mold.

Asthma attacks can be triggered by certain foods, such as protein, chocolate, citrus fruits. But in this case, cross-allergic reactions take place. All allergens have a similar structural structure, so a person with an allergy to birch pollen may develop bronchial spasm after eating apples.

Non-allergic bronchial asthma in children under 3 years of age and older is very rare. In most cases, it develops against the background of concomitant respiratory diseases and without the participation of any "irritants" of an allergic nature.

The reasons for its appearance include:

chronic infectious diseases upper respiratory tract (sinusitis, sinusitis and others);
change hormonal balance in women (premenstrual period, menopause);
loads of a physical and neuropsychic nature;
taking medications;
congenital pathologies (altered bronchial reactivity).

Bronchial asthma in children

Diagnosis of bronchial asthma in children is somewhat difficult (especially under the age of 3 years), since its symptoms are similar to those of colds or viral diseases(swelling of the mucous membrane, in some cases there is copious sputum). This is due to the peculiarities of the structure of the bronchi at an early age. In addition, small children still cannot clearly explain their condition.

However, there are some features asthma in a child

it does not involve an increase in temperature, even in the case of a very frequent cough;
before the onset characteristic symptoms there are so-called precursors.

These two differences will help attentive parents think about the possibility of a more serious illness than a cold.

AT medical practice there is a certain set of methods of analysis and techniques to determine the presence of the disease. Diagnosis of bronchial asthma in children includes the following set of measures:

collection of information for anamnesis (all the details of the child's life, the identification of respiratory diseases in parents and relatives, how an asthmatic attack occurs);
conducting a blood test for an allergen and identifying a compound or group of substances that provoke bronchial spasm. A less preferred analysis is a skin test: solutions of the proposed allergens are applied to the forearm. If there is a reaction to the "irritant", then the skin at the point of contact turns red. This method is not used on the day of an asthmatic attack, as it can provoke a worsening of the condition;
measurement of lung volume or spirometry. According to the obtained values assess the severity of asthma.

Symptoms of bronchial asthma in children and its precursors

Childhood asthma is characterized by mild early symptoms or precursors. As a rule, they appear a day or two before the symptoms of the disease themselves. Forerunners include:

discharge of watery mucus from the nasal passages after a night's sleep, the child often sneezes and rubs his nose;
the occurrence of a weak dry cough after a few hours;
increased cough after a nap or in the afternoon with sputum production, and in some cases a very large amount.

(up to 3 years of age or more) are more pronounced than the precursors:

paroxysmal cough (occurring before or after sleep), the intensity of which may decrease in an upright position;
the appearance of intermittent wheezing, shortness of breath, frequent and short breaths;
dry cough that does not go away for a long time;
inability to fully breathe;
before an attack, the baby begins to act up because of the stuffy nose.
paroxysmal cough begins under the same conditions (the presence of an animal nearby, a visit to the library, from a bouquet of flowers);
very rarely skin rash, lacrimation, itching.

Treatment of bronchial asthma in children

Currently, childhood asthma, like asthma in adults, is not amenable to complete cure although there are many effective drugs. With their help, they prevent (stop) the development of bronchial spasm, remove the allergen from the body and relieve inflammation.

Bronchial asthma a child is not a sentence. Properly selected treatment, modern medicines and new therapeutic methods allow the baby to grow and develop normally. In addition, as the child grows older, bronchial spasms are relieved, and in some cases stop completely.

The first step in the treatment of this disease is to remove the allergen from the environment of the patient. Sometimes this is quite enough.

The complex of such measures includes more frequent wet cleaning of the premises, the use of humidifiers and air purifiers. It is advisable to remove carpets, pillows and mattresses made of feathers and down or use special tight covers for bedding with minimal permeability. As an alternative to down filler, synthetic materials are used.

If a positive effect is not achieved, then experts prescribe medication.

Medicines for the treatment of childhood asthma are divided into two groups: basic and symptomatic. The latter are used to relieve spasms of the bronchi and increase the lumen of the channels of the bronchial tree in order to improve air circulation. They are not prophylactic and are used exclusively in emergency situations. Available in aerosol form.

Basic therapy drugs, on the contrary, are intended to maintain therapeutic effect, removing allergens from the body, do not have an instant effect and are applied constantly. They remove and suppress inflammatory processes, reduce the frequency (or completely stop) and the intensity of attacks.

Basic drugs for the treatment of bronchial asthma in children take enough long time Therefore, the result is manifested at least in two to three weeks.

Glucocorticoids in inhaled form can be attributed to new generation drugs. They have a minimal list of side effects on the body, good tolerance and increased efficiency.

Asthma treatment is not limited to medication. Other treatments include:

physical training according to specially designed programs;
various types of breathing exercises with the use of equipment;
easy hardening program (especially relevant for children 3 years old);
reflexology (acupuncture, massage);
specially designed rooms with any natural substances that have positive effect(salt mines, gala chambers).

AT recent times Allergen-specific immunotherapy is gaining popularity. The essence of this method is the introduction of small doses of the allergen to the patient and the control of emerging bronchospasm. As the body "gets used" the concentration of the "irritant" is increased, thus, the reaction to the allergen becomes less acute.

Studies have shown that 75% of patients who have undergone this kind of therapy do not show signs of the disease for 20 years. In spite of nice results developments in this direction are ongoing.

Treatment of bronchial asthma in children with folk remedies

Treatment of bronchial asthma folk remedies involves supporting the body between attacks, enriching it with natural micro- and macroelements, reducing the frequency of exacerbations or investing in the course of an attack.

There are a great many recipes of traditional medicine, not only for adults, but also for children:

Infusion based on coltsfoot. It is used for bronchitis and laryngitis in a chronic form, bronchial asthma. Pre-crushed and dried leaves of the coltsfoot (4 teaspoons) are poured with one glass of boiling water, let it brew for one hour. Filter the leaves, drink the liquid residue 50 ml no more than three times a day.

A mixture of lemon juice and horseradish. The use is advisable for diseases of the respiratory tract and sputum thinning. Horseradish is grated, squeezed out the juice (150 g), which is poured into a bottle. Lemon juice is also added there, the mixture is infused for a day. The infusion is stored in the refrigerator for up to 2-3 days and take half a teaspoon before meals for breakfast and dinner.

Hypericum infusion. A tablespoon of dried or chopped St. John's wort is poured with a glass of boiling water (300 ml), insisted for one hour. Take up to 4 times a day before meals. Used as antihistamine up to 40 drops 3-4 times a day.

Children's bronchial asthma and sports

Previously, bronchial asthma was a contraindication to sports. However, properly selected treatment and new generation drugs in no way interfere with physical education.

In particular, exercises aimed at training the respiratory muscles contribute to an easier and shorter course of attacks, prepare the body for hypoxia and develop endurance.

Disability and childhood bronchial asthma

According to domestic regulatory documentation, a child with a diagnosis of bronchial asthma is assigned a disability only in the case of a severe course of the disease.

If there is a favorable prognosis for a partial restoration of health or a reverse course of the disease, then disability is assigned for 2 years, followed by re-examination.

If there is no positive prognosis, asthma is hormone-dependent and involves constant drug therapy, then disability is established when the child reaches the age of 16 years.

The main task of the rehabilitation system is not only to solve problems with medical supervision, but also the socio-psychological adaptation of the patient in terms of solving social problems of a different nature.

Dr. Komarovsky about bronchial asthma in children

The famous pediatrician, whose books have been recognized by millions of parents, talks in an accessible video about how asthma manifests itself in children under 3 years of age and older, about new approaches to understanding it, early symptoms and treatment, how mothers and fathers of a baby with this diagnosis should behave.

Ogulov about the problem of the lungs

Pollution environment and constant growth respiratory infections render pernicious influence on children's immunity. As a result, children suffer various allergies and bronchial asthma.

Asthma is a disease caused by inflammation of the airways, resulting in spasms with copious mucus secretion. This disease is chronic, and the mucus itself prevents the normal passage of air into the lungs. Bronchial asthma is of 2 types: allergenic and non-allergenic.

Modern medicines for asthma

Symptomatic - help relieve spasm and facilitate the passage of air to the lungs. They are taken during seizures as instant help, for the prevention of their use is prohibited.
Basic - relieve inflammation and remove allergens. Used for permanent treatment and prevention, but instant action are not characterized. They are prescribed to reduce and eliminate inflammatory processes in the bronchi, as well as to completely eliminate attacks.

Almost five centuries ago, on December 8, 1542, Mary Stuart, queen of two states - France and Scotland, was born. Her amazing life, more like an adventurous romance, was filled with love adventures, palace intrigues, betrayals and passions…..

Mary Stuart. Flerova Elena Nikolaevna

664

Ilga

More than a year My husband's mother died back. There was a stepfather (according to the documents, the husband was not adopted) and a brother by mother. His parents saved up for a cottage, but did not have time to buy it, all the property passed first to his father, who asked to write a waiver of inheritance in order to take over a car and so on. The youngest son lives with his father with a girlfriend, I don’t know if he wrote a renunciation of the inheritance. The bottom line is that the father and the younger divided the money accumulated for the cottage (not a small amount) into their accounts, but they didn’t tell us anything, they accidentally found out from their brother (he said that they were saving money further for themselves), it turns out that the husband does not receive anything from the mother inheritance in general. Everything will be assigned to the brother. The husband claims that he will earn for everything (this is unrealistic). His father lied to him that all the money "burned out." In general, it was always the case that for all the years my father never called himself, never once asked how he was doing, and so on. Brother is like that too. But the husband consistently calls them himself, worries about their health, and so on. I tell my husband - I wonder if you yourself had not called them, would they have remembered about you, called? He says - the father is definitely not, he was brought up like that (or not brought up sooner)! I feel sorry for my husband, that he is abandoned by them and does not understand this, that his father does not act honestly, and did not receive any inheritance from his mother at all, nothing.

450

Alena Viktorovna

Hi all. I quarreled with my mother, I managed to do this - hang a lump of guilt on me. She lives in the country, she has about 30 cats and several dogs. Favorite dog shepherd) is aggressive, that I don’t even go into the yard of this dacha, I can’t tie it, I don’t like it. The cats are neutered, but they don't get smaller: kind people constantly throw someone up or she picks them up ... it is very expensive to maintain this zoo. the mother is retired (she never actually worked), the father works and receives a pension, but they barely make ends meet. and then someone advised her to go online. It's so simple - you create a page and that's it, they started sending you money! she does not understand anything about this, there is no computer, a push-button telephone. can open google and make a request. all. what social networks appears vaguely. Came to me today. Make, he says, a page and lead it. I am in the city, I have two children, two jobs, the youngest just went to the garden, she is constantly sick. She does not sit with children - she does not want to, she has no time. What is it like to create a page / channel and promote it, how long it takes - she has no idea. I can't stand social media! these groups... I'm not even on Instagram. In general, I freaked out, my mother sobbed that no one wanted to help her, she was asking for such a little! I’m trying to explain to her - I need photos, videos, stories about animals ... but I can’t even go there. Like this is not a problem - my father takes pictures, I write.
now I’m sitting, crushed by a feeling of my own insignificance (((buy her a good phone? a tablet? will she figure out how to make and develop her blog or page? I definitely don’t want to do this myself. This is an encroachment on the last piece of my personal time ((( I don’t have it anyway ... children, work, home, and also - I teach at a university, I have to write scientific articles (now I have a manual “hanging”, it’s about to be handed over, and I’ve been toiling with the youngest child for two weeks - she has the flu (((no one ever told me: "Alena, let's sit with the girls, and you go to the bathhouse!" No. My father still sees with my children if I need to work urgently, my mother - never. I still have duties, yes ((((in general, I’m sitting, I feel like a piece of ... organic origin ((((

302

Squirrel

In general, do men feel sorry for women? Why is it in their minds that a woman is a horse, and must plow at work and at home. And don't whine or complain. In short, plow and laugh at the same time with happiness.
I don't know about others. But I’ll say it myself, it’s hard to work full time, and weekends don’t look like holidays. How are you?

199

Olga Veselova

I have a girlfriend. She has been involved in charity work for several years. She has no financial means to participate. But she has a talent to unite, inspire, infect people with an idea. They are also involved in helping families in difficult situation, and shelters, but the main activity is fundraising for medical treatment. There have been many stories over the years. And with children, and a pregnant woman, and even for a man who has an accident. She rarely gives details. But then I decided to ask myself. How then communication develops with the people she helps. After all, in order for the story to shoot, you need to get sick of it. They print flyers, stick them around the city, raise all the media, hold charity fairs and concerts. It turned out that after the end of the gathering, people never make contact again. They do not take part in the training camp (to help with putting up leaflets, for example), they do not congratulate you on your newborn. Some who meet in the city turn away and pretend that they do not know each other. Let me tell you right now, she has no worries about it. She has long passed the stage when she was fascinated by people. Trying not to get too close. Helped to the side. Usually newbies who get on the team. disappointed at first. So all the same, you need to remember the good? Do not carry the burden and duty on your shoulders, do not go half-bent to the one who once helped. And for example, do not forget to congratulate him on social networks, or support him when he finds himself in a difficult situation. Most often, when a friend is asked for help, the first words - we have no one else to turn to.

177

And the reason is personal, for example, my thirty-something nephews. Such a grasshopper, skips, chirps to itself. No, not a bum. And the work is not bad, not dusty, and the career is little by little visible, not so “ah!”, But there is where. And so they offered him a place - super, the salary cannot be compared with the current one, and then - grow, try. No, he says, I don't want to. I'm still young - I'm looking for my own and haven't lived enough yet. I am silent, but I do not consider him right. Or right?

158

Bronchial asthma is a chronic disease characterized by allergic inflammation and increased sensitivity of the bronchi to substances that enter the body from outside.

In most cases, the disease manifests itself in childhood. This is due to the fact that the structure of the bronchial tree in children has its own characteristics. In almost 50% of cases, the disease is diagnosed by the age of two. In 80% of children, signs of bronchial asthma are detected at school age. In boys, the disease is observed twice as often as in girls.

Under the influence of an irritant, the airways narrow, which causes the production of a large amount of mucus. This, in turn, leads to disturbances in the normal flow of air during breathing.

Types of bronchial asthma in children

Classify bronchial asthma in children according to several criteria.

Depending on the causes of the disease:

Endogenous - associated with psycho-emotional or physical stress, infection.
Exogenous - associated with the ingestion of allergens.
Atopic - associated with a hereditary predisposition to allergies.
Mixed genesis - any of the above factors can provoke an attack.

Depending on the severity of the disease:

Light form. Short asthma attacks occur less than once a week, while at night they are absent or occur very rarely (no more than twice a month).
Medium form. Symptoms of the disease occur more often than once a week, but less than once a day. Night attacks occur at least twice a month. With exacerbations of the disease in a child, sleep is disturbed and oppressed. physical activity.
Severe form. Attacks occur almost once a day, while night attacks are repeated no more than once a week. The child's physical activity and sleep are disturbed.
Severe persistent form. Asthma attacks occur daily during the day and at night. At the same time, physical activity is limited.

Attacks of bronchial asthma in a child can occur under the influence of the following factors:

Inhalation of allergens (particles of fur, plant pollen, mold), cold or polluted air, including strong odors.
Emotional overstrain.
Some food products and medicines.

Factors that influence the development of the disease:

hereditary predisposition. The presence of bronchial asthma in close relatives increases the risk of the disease in a child by 20%.
Increased sensitivity. It is caused by genes located on the fifth chromosome. At the same time, the bronchi have hypersensitivity to antigens from the environment.
environmental factors. The highest incidence of bronchial asthma is observed in areas with high air pollution.
Acute respiratory diseases in early childhood.
Maternal smoking during pregnancy or while breastfeeding.
Premature birth, when the child's respiratory system is not sufficiently developed.
Poor diet and weight loss.

Symptoms of bronchial asthma in children

To obligatory clinical manifestations bronchial asthma include characteristic attacks of suffocation. There are three periods of the disease. During remission, the child does not show any symptoms. In some cases, he behaves less actively than his peers. If the disease manifested itself at an early age, then constant hypoxia can lead to a lag in neuropsychic development.

Prevention of bronchial asthma in children is to eliminate all potential allergens and strengthen the immune system.

Before the onset of an attack (a few days, hours or minutes), the following symptoms of bronchial asthma in children can be observed:

Increased irritability.
Lack of appetite.
Insomnia or drowsiness.
The appearance of copious mucous discharge from the nose.
Headache.
Dry cough that worsens over time and becomes wetter.

Signs of asthma in a child:

Shortness of breath and a feeling of constriction in the chest which prevents him from breathing. It can develop suddenly and reach great strength in a few minutes.
Wheezing and feeling short of breath. Inhalation becomes short, but deep and strong, and exhalation becomes convulsive slow (3-4 times longer than inhalation).
Paroxysmal cough, during which very viscous transparent sputum begins to depart. Sometimes she stands out in enough in large numbers which makes breathing easier.
Bloating of the chest. The number of breaths per minute is more than 50, in children over 5 years old - more than 40.
Lack of nasal breathing, the child gasps for air with his mouth, trying to help himself with his shoulders, torso and neck.
Forced position in an attempt to ease breathing. The child refuses to lie down. He prefers to sit with his elbows on his knees or hard surface, sometimes gets on the elbows and knees with an emphasis on the upper limbs.
An increase in body temperature up to 37 ° C.

During an attack, the face becomes pale, puffy, with a bluish tinge. The child experiences a feeling of fear, is covered with a cold sweat, cannot talk. Muscles involved in breathing abdominal wall, shoulder girdle and back. Life-threatening signs include blue skin, mute lung, respiratory failure.

The attack can last up to 40 minutes or several hours (in this case, it is diagnosed asthmatic status). After its completion, the child's breathing gradually normalizes, while weakness remains. With a quick and deep exhalation, wheezing may persist.

Along with the exacerbation of bronchial asthma, other chronic diseases are activated, such as urticaria, rhinitis, obstructive bronchitis.

In children infancy the disease is difficult to recognize. AT prodromal period discharge from nose in infant liquid slime, sneezing and dry cough occur. The tonsils become edematous and there are single dry rales over the lungs.

The child does not sleep well, becomes nervous and irritable. There may be problems with the stool, constipation or diarrhea. During an asthma attack, breaths are short and frequent, and exhalations are accompanied by noise and whistling, as a result of which breathing begins to resemble a sob. In this case, during inhalation, the wings of the nose swell.

In some cases, simultaneously with attacks of bronchial asthma, a child may experience episodes of coughing that appear at night or in the early hours and disappear after taking bronchodilators. In children early age Moist rales may be noted during an asthma attack.

Symptoms of bronchial asthma in children aged 1–6 years:

Sleep disturbances and irritability.
Intermittent coughing during sleep.
Violent dry cough when breathing through the mouth.
Strengthening or appearance of cough during physical exertion.

Bronchial asthma is often associated with allergic rhinitis, which can be observed year-round or seasonally, and atopic dermatitis.

Signs of bronchial asthma in a child older than 6 years:

Cough during sleep.
Cough after exercise.
Decrease in physical activity.

Diagnostics

At the first signs of the disease, it is necessary to seek advice from a pediatrician, therapist, pulmonologist or allergist.

One of severe complications bronchial asthma in children is status asthmaticus. This is a life-threatening condition that occurs as a result of a prolonged attack, which is almost impossible to stop.

The instrumental methods for diagnosing bronchial asthma in children include peak flowmetry. A portable device resembling a tube is used. The child needs to exhale as much air as possible in order to assess the patency of the bronchi. The measurement is carried out in children older than 5 years. Perform the procedure twice a day, while fixing the use of drugs and daily routine. This makes it possible to evaluate the effectiveness of therapy and determine the cause of seizures.

Radiography or CT scan rule out other lung diseases.

Laboratory research methods:

General and biochemical analysis of blood.
General analysis urine.
General analysis of sputum.
Bacteriological examination of sputum.
Determination of protein fractions.
Allergen analysis.

Differential diagnosis makes it possible to distinguish bronchial asthma from pathologies such as:

hyperventilation syndrome.
Croup.
Diphtheria.
foreign body in respiratory tract.
Neoplasms in the respiratory tract.

In order to reduce the number of asthma attacks in children, it is necessary to exclude the contact of the child with the allergen or to conduct specific immunotherapy.

Contraindications for specific immunotherapy:

Age up to 5 years.
Lack of clear evidence of the allergen.
Exacerbation of bronchial asthma or other chronic diseases.
The presence of neoplasms, as well as autoimmune, endocrine and infectious diseases.

For the treatment of bronchial asthma in children, drugs of the following groups are used:

Beta2-agonists.
Methylxanthines short action.
Systemic glucocorticosteroids.
Anticholinergics.

These drugs allow you to relax the smooth muscles of the bronchi, and they also reduce swelling of the mucous membrane and vascular permeability, increase the number of contractions of the diaphragm and block the development of bronchospasm.

The drugs can be used in the form of metered inhalations or enterally. In order to prevent bronchospasm, use the following means:

Mast cell membrane stabilizers.
Glucocorticosteroids.
Cromoglycic acid preparations.
Leukotriene receptor antagonists.

During an attack, you must:

Give the child a seated position.
Give him fresh air.
Release from squeezing clothing.
Try to calm down.
Carry out inhalation with a drug that expands the bronchi.

A child over 5 years of age should be taught to stop asthma attacks on their own using an inhaler.

In severe attacks, emergency medical attention should be called.

Complications

One of the severe complications of bronchial asthma in children is status asthmaticus. This is a life-threatening condition that occurs as a result of a prolonged attack, which is almost impossible to stop. Its consequence is swelling of the bronchioles and the accumulation of thick mucus in them, which leads to an increase in suffocation. In 5% of cases, the attack ends lethal outcome. With the development of status asthmaticus, emergency hospitalization is indicated. Treatment is carried out in the intensive care unit.

In most cases, by puberty, the attacks practically stop, but bronchial hyperreactivity and some impairment of lung function remain.

Also, bronchial asthma in children can cause the following types of complications:

Respiratory - in the form of pneumonia, spontaneous pneumothorax, acute respiratory failure, atelectasis.
Chronic respiratory - in the form of emphysema, pneumosclerosis, chronic obstructive bronchitis.
Cardiac - in the form of myocardial dystrophy, heart failure, arrhythmia, hypotension.
Gastrointestinal.
Brain - in the form of respiratory encephalopathy, fainting, neuropsychiatric disorders.
metabolic.

by the most frequent complication bronchial asthma in children is atelectasis. This is a blockage of the walls of the bronchi, resulting from edema. In the absence of timely treatment, a suppurative process may occur in the damaged bronchi.

Forecast

The prognosis of the disease depends on the age at which its first signs appeared. Most children diagnosed with allergic asthma have a mild illness, but serious complications are also possible.

The long-term prognosis of bronchial asthma, the first signs of which appeared in childhood, is favorable. In most cases, by puberty, the attacks practically stop, but bronchial hyperreactivity and some impairment of lung function remain.

If the illness starts at adolescence, the prognosis is not so favorable. In general, the disease is slowly progressive and chronic. Proper and timely treatment of bronchial asthma in children can eliminate or reduce the number of attacks, but does not affect the cause of the disease. The remission period can last several years.

Prevention of bronchial asthma in children

Prevention of bronchial asthma in children is to eliminate all potential allergens and strengthen immunity:

Timely treatment of all diseases respiratory system caused by pathogenic microorganisms.
Smoking cessation during pregnancy and breastfeeding, as well as in the future in the presence of the child and in the room where he can be.
Carrying out regular wet cleaning and ventilation of the room where the child lives. Clothes and books should be kept in closed cabinets. It is recommended to get rid of soft toys.
Breathing exercises, sports.
Exclusion from the child's diet of foods containing harmful additives and potential allergens.
Exclusion of hypothermia.
Creating a comfortable environment for the child and minimizing emotional stress.
The use of special hypoallergenic powders for washing children's clothes.

Video from YouTube on the topic of the article:

Respiratory disorders, in which bronchial conduction is disturbed, leads to the development of broncho-obstructive syndrome. With a long course, this condition turns into asthma.

What it is?

Several factors lead to the development of respiratory disorders at once. various reasons. With bronchial asthma, there is an increased reactivity of the bronchi to certain substances, which leads to the development of bronchial obstruction (blockage). Air with oxygen dissolved in it does not pass well through the narrowed bronchi. As a result, this leads to violations of air exchange between blood, lung tissue and the environment.

After exposure to various provoking factors, a violation of bronchial conduction occurs. This condition is called broncho-obstructive syndrome. If this process lasts for a long time, then the course of the disease passes into chronic form. In this case broncho-obstructive syndrome becomes bronchial asthma.

According to statistics, this disease occurs in 10% of children. Boys get sick more often than girls. The peak incidence occurs at the age of 4-10 years.

Bronchial asthma occurs not only in pediatrics. Adults can also get sick. The first signs of the disease can occur at any age.

The course of bronchial asthma is undulating. Periods of exacerbations are replaced by remissions. The duration of the quiet period can be different. It mainly depends on the state immune system and the presence of concomitant chronic diseases in the child. Weakened babies have many more exacerbations than children who undergo regular rehabilitation.

Risk factors

Various provocateurs can lead to the development of bronchial asthma. In some situations, the action of several provoking factors at once has a more pronounced effect, leading to a persistent broncho-obstructive syndrome.

Among the most significant risk factors:

genetic predisposition. If one of the parents has bronchial asthma, then the risk of having a sick baby is 25%. In cases where father and mother are both sick, the risk of a child with respiratory failure is already 75%. Not in all cases, a genetic predisposition leads to the development of the disease. If the child is not affected by other adverse factors, then he may not develop the disease throughout his life.
Contaminated air. Children who live near industrial plants and factories, as well as near major highways, have a higher risk of developing bronchial asthma. The smallest particles of toxic products can remain in the air for quite a long time. Upon contact with the mucous membranes of the upper respiratory tract, they easily cause inflammation, leading to bronchial obstruction.

Dust and house mites that live in pillows and blankets. These seemingly harmless factors often lead to the development of persistent symptoms of bronchial obstruction. The smallest mites are constantly in contact with the skin, causing severe allergization. Ultimately this leads to pronounced violation breathing.
Animals. The most dangerous are pets that live at home. Wool, fluff, and animal dander often become a source of severe allergic reactions. It is manifested not only by the appearance of specific rashes on the skin, but is also characterized by the presence of impaired breathing.

Food products. Especially food prepared in an industrial way. There are a lot of synthetic additives, dyes and aromatic components in such products. Once in the gastrointestinal tract, they cause severe allergic reactions. This contributes to the development of systemic adverse symptoms: cough with sputum and wheezing when breathing.

Household chemicals. Many synthetic products contain a fair amount of various perfume additives and fragrances. They substances have a pronounced irritant on the respiratory tract. With prolonged contact with such products, the risk of developing bronchial obstruction in a child greatly increases.
Individual sensitivity to flowering herbs. Typically, asthma attacks in this condition have a clear seasonality. The well-being of the baby worsens in spring and autumn. It is at this time that weeds bloom and meadow grasses and various trees and shrubs.
Strong humidity and dampness in the room. This condition provokes the development of mold fungi. In wet and damp conditions, they grow and multiply rapidly. Large colonies of mold fungi can cause severe breathing problems in the baby.
Infection with viruses and bacteria. Currently, more and more doctors began to register a virus-induced form of bronchial asthma. In a frequently ill child with reduced immunity viral infection often becomes the development of broncho-obstructive syndrome. Also, in some cases, bacterial infections lead to asthmatic breathing problems.

Ingestion of tobacco smoke. Scientifically proven effect passive smoking for the development of bronchial asthma. If one of the parents constantly smokes in the apartment or room where the child is, then the risk of developing bronchial asthma increases significantly.
Strong physical exertion leading to exhaustion. Excessive workouts, chosen incorrectly, can lead to disturbances in the immune system. After prolonged stress the child has respiratory problems, and shortness of breath occurs.

Causes

Bronchial asthma most often develops when a child has a genetic predisposition that is initially present. With additional exposure to adverse environmental factors, the course of the disease worsens and becomes chronic.

The development of asthmatic respiratory failure leads to:

Eating hyper allergenic products. Most often it is: citrus fruits, chocolate, sweets, seafood, fish, honey and others. The ingestion of allergenic products into the body leads to the development of an allergic reaction. It may appear in particular severe syndrome bronchial obstruction.
Inhalation of polluted air. Toxic industrial products and traffic fumes have a toxic effect on the epithelial cells of the upper respiratory tract. These substances cause severe spasm of the bronchi, which leads to a narrowing of their lumen and respiratory failure.
Allergic diseases. Often these pathologies are secondary and develop as a background with concomitant chronic diseases. To the development of bronchial asthma lead: persistent dysbacteriosis, pathology gastrointestinal tract, dyskinesia of the gallbladder and chronic hepatitis.
The use of medicines without the prior recommendation of a doctor or chosen incorrectly. All medicines can have side effects. Many of them are capable of causing persistent bronchial obstruction. If a child has a genetic predisposition to bronchial asthma, this can lead to the development of the disease.
Severe traumatic situation or stress. There have been cases of the development of the disease after moving to a new place of residence, divorce of parents, as well as death of close relatives in early childhood. Severe stress contributes to the production of an increased amount of hormones. They cause constriction of the bronchi, which leads to respiratory failure.
Improper therapy of chronic respiratory diseases. Frequent bronchitis, especially flowing with a pronounced broncho-obstructive component, ultimately lead to the development of bronchial asthma. If a child often has a cough and has a cold up to 4-5 times a year, then parents should think about the presence of bronchial asthma in the baby.

Classification

All forms allergic asthma can be divided into several groups. This classification is based on the causes that cause the disease. This division is very important in pediatric pulmonology. This classification helps doctors prescribe the right treatment.

Taking into account the leading cause, bronchial asthma can be:

Allergic. The development of this form of the disease leads to the ingestion of allergens that provoke the development of adverse systemic manifestations. In the presence of individual hypersensitivity to foreign substances, the level of immunoglobulins E increases in the baby. These components lead to severe bronchospasm, which is manifested by the appearance of a cough.
Non-atopic. With this form of the disease, a spasm in the bronchi occurs due to any exposure, but not an allergen. This variant of asthma develops later severe stress, hypothermia, or as a result of excessive and improperly selected physical activity.
Mixed. May occur as a result of exposure to both allergic and non-atopic causes. It is characterized by the appearance of numerous symptoms. The course of the disease is usually the most calm. Remission periods can be quite long.
Asthmatic status. This extremely dangerous emergency condition stands out as a separate form of bronchial asthma. A child may have several of these attacks throughout his life. This condition is extremely severe, in which the symptoms of respiratory failure increase sharply. In this case, it is required to emergency treatment.

The course of asthma can be different. This is influenced by several factors:

the age at which the baby showed the first signs of the disease;
state of immunity;
the presence of concomitant chronic diseases;
region of residence;
appropriateness of the chosen treatment.

All forms of the disease can be divided into several groups, taking into account the particular severity:

With a slight episodic course. With this form of functions external respiration not noted. Attacks of impaired breathing occur less frequently than once a week. The seizure-free period can be quite long.
With a slight persistent course. It is characterized by the appearance of attacks of impaired breathing several times during the week. There is no daily deterioration in well-being. When an attack occurs, breathing is disturbed, a hacking cough appears, shortness of breath increases. Spirometry shows no abnormalities.
With a moderate course. Deterioration of well-being occurs almost every day. During such attacks, the child's sleep is disturbed, and severe respiratory disorders are observed, leading to severe shortness of breath. In the treatment of the condition, daily use of bronchodilators is required. Spirometry shows deviations from the norm by 20-40%.
With a severe course. Dangerous by the development of several attacks in one day. Also, such deterioration can occur at night. Therapy with short-acting bronchodilators does not bring a pronounced effect. To control the course of the disease requires the appointment of hormones. Spirometry shows a deviation from normal breathing rates by more than 40%.

What is bronchial asthma in children, Dr. Komarovsky will tell in detail in the next video.

Symptoms

Recognize bronchial asthma initial stage hard enough. Quite often, parents believe that the child just has an allergy or broncho-obstructive bronchitis. AT interictal period sometimes even experienced doctor often fails to identify asthma in a child. Further development The disease is manifested by the development of characteristic adverse symptoms that should alert parents.

For bronchial asthma in the period of exacerbation is characteristic:

The appearance of shortness of breath. It is expiratory in nature. In this case, exhalation is noticeably difficult. You can check for shortness of breath at home yourself. This is evidenced by the increase in the number respiratory movements in one minute more than 10% of the age norm.
Cough with difficult expectoration. Mostly this symptom worries the child during the day. At night, the cough is somewhat lessened. Sputum in bronchial asthma is quite viscous, "glassy". When trying to cough it up, the child may even experience soreness in chest.
Increased heart rate. Even in the absence of physical activity, the child develops tachycardia. This symptom is usually associated with shortness of breath. The more pronounced it is, the more the number of heart contractions increases in one minute.
The appearance of dry wheezing during breathing. At severe course such breath sounds become audible from the outside, without the use of a phonendoscope. The rales are predominantly dry and wheezing. It is believed that with bronchial asthma "an accordion plays in the chest."
The appearance of a box sound during percussion. This method is carried out to clarify the diagnosis. When tapping fingers on the chest, a characteristic sound is heard, reminiscent of blows on an empty box. The appearance of this symptom manifests itself already in the remote stages of the disease and indicates an increased filling of the lungs with air.
Lack of effect from conventional drugs, used to relieve cough. Visible therapeutic effect have only bronchodilators and hormonal agents. At allergic form bronchial asthma antihistamines bring a pronounced effect.

Seizure symptoms

The well-being of the child during the worsening of the disease is greatly disturbed. The kid becomes more capricious, frightened. Some babies, especially in the first months after birth, begin to cry, ask for more in their arms. Babies almost completely lose their appetite, they refuse to eat.
During an attack, the child develops expiratory dyspnea. To facilitate given state, often the baby takes forced posture. He leans forward a lot. The head may be slightly thrown back.
Often asthmatic children during an attack they try to lean their hands on a chair or even a bed railing. Such forced position somewhat facilitates the discharge of sputum and improves breathing.
With a severe attack the baby shows symptoms of respiratory failure. Lips become pale, and in some cases even bluish. Hands and feet are cold to the touch. The child has a paradoxical pulse. With this rhythm disturbance, the number of heart contractions during inhalation and exhalation changes.
Some babies try to take a sitting position. This helps them breathe better. Even from the side you can see the participation of the auxiliary respiratory muscles during breathing. The child breathes deeply and often. The condition is aggravated by a strong hacking cough. In some cases, it even leads to the fact that the child begins to cry.
After the attack, the baby feels overwhelmed. Some kids can't calm down for a long time. Their sleep is disturbed. The duration of an attack may vary. With the late use of inhalers, a dangerous and life-threatening condition can develop - status asthmaticus. In this situation, it is impossible to cope with the elimination of adverse symptoms at home - a medical ambulance is required.

How is it manifested in the chest?

The course of bronchial asthma in an infant can also occur in different ways: from mild degree severity to the heaviest. Infants often have asthma attacks on sour-milk products and molds. The second most common is food allergy.

Usually, the first symptoms of bronchial asthma in an infant appear by the age of 5-6 months. At this time, the baby begins to receive new foods as complementary foods. If a child has an individual intolerance or hypersensitivity to a substance, he may develop symptoms of bronchial obstruction.

A striking symptom of bronchial asthma in an infant is the occurrence of coughing. The baby begins to cough both day and night. In some cases shortness of breath joins. Even while in bed, without physical activity, the number of breaths and heartbeats in one minute increases in the child.

Babies begin to suck badly, efficiency decreases breastfeeding. Such children lose weight and are somewhat behind their peers in terms of physical development. Silent crying is also one of the symptoms of bronchial asthma in a baby of the first year of life. The child becomes lethargic, badly asks for hands. Some babies do not sleep well and often wake up during the night.

Diagnostics

In order to put correct diagnosis just taking an anamnesis and examining the child by a doctor will not be enough. To detect persistent bronchial obstruction, it is required to perform additional tests and surveys. Only conducting various diagnostic tests will help establish the correct diagnosis.

To diagnose bronchial asthma, you will need:

General blood analysis. An increase in white blood cells and moderate eosinophilia (an increase in the number of eosinophils in leukocyte formula) indicate increased allergization. Such changes are characteristic mainly for the allergic form of bronchial asthma.

Sputum examination. Detection of specific Charcot-Leiden crystals, Kurshman spirals, an increase in the number of desquamated epithelial cells, as well as elevated level eosinophils indicate the presence of persistent bronchial obstruction.
Conducting a study on the ratio of blood gases. With a long course of bronchial asthma, there is a decrease in the content of dissolved oxygen and a slight increase carbon dioxide. Such changes indicate the presence in the body of severe hypoxia or oxygen starvation cells.
Spirometry. Reflects indicators of external respiration. Evaluation of forced expiration and general vital capacity indicators help to identify persistent bronchial obstruction in the body, leading to a change in the parameters of the respiratory function of the lungs. The decrease in these parameters is estimated as a percentage of the age norm.
Carrying out scarification tests. They help to identify all possible allergens that cause the development of bronchial obstruction in a child. The study is carried out only by an allergist. The test can only be performed on children older than five years.

X-ray of the chest organs. Helps to install secondary signs bronchial obstruction: increased airiness of the lungs and a change in the diameter of large bronchi.
Bronchoscopy. It is used in limited cases, mainly for differential diagnosis in order to exclude similar diseases flowing, as well as bronchial asthma with symptoms of bronchial obstruction.

Complications

The development of adverse effects of bronchial asthma depends on many factors. The most important of them is timely diagnosis and correctly prescribed treatment. With an inadequately selected therapy regimen, a child may experience numerous adverse effects illness.

Among the most frequently reported complications in bronchial asthma:

Development status asthmaticus.
Sudden onset of symptoms acute respiratory failure.
Spontaneous pneumothorax. In this condition, the capsule that covers the outside of the lungs ruptures. This condition usually occurs during a severe attack.
Rise of shock. The development of acute respiratory failure leads to a sharp drop in blood pressure. This condition is extremely unfavorable and requires emergency treatment and hospitalization in a hospital.
Pneumonia. Appears when joining inflammatory process bacterial flora. It is characterized by a rather severe course. Antibiotics are required to relieve symptoms.
Emphysema. It develops in asthmatics with experience. It is characterized by increased air filling of the lung tissue. In this case, the respiratory function of the lungs is significantly reduced, which leads to the appearance of symptoms of respiratory failure.
Formation cardiovascular insufficiency . It is an extremely unfortunate complication. This condition requires the appointment of several types of drugs at once, including cardiac glycosides.

Treatment

Selection essential medicines carried out only after a comprehensive examination of the child. Before choosing the necessary inhalers or tablets, it is necessary to accurately identify the form of bronchial asthma and determine the severity of the disease.

A child with bronchial asthma is treated by a pulmonologist. With an allergic form of a child, it is imperative to show an allergist. This doctor will help to make a more individual treatment, taking into account the characteristics of the immune system.

Treatment in the pulmonology clinic is carried out only in complex cases of the disease. At easy course regular visits to the clinic and outpatient consultations with doctors are quite enough.

The treatment of bronchial asthma includes several basic principles:

The appointment of symptomatic drugs. In this case, drugs are used only during an attack in order to eliminate acute adverse symptoms illness. Usually, various inhalers are used for these purposes.

Selection of basic therapy. These funds have already been earmarked for permanent reception. They help prevent new attacks and improve the course of the disease. Monitoring the effectiveness of drugs is carried out using spirometry. At home, a special portable device, a peak flow meter, is perfect for this purpose.
Exception from Everyday life all types of allergens. Compliance hypoallergenic diet, the use of special bed linen, as well as restrictions on games with soft toys help prevent new attacks and the development of asthmatic status.
Use of special humidifiers. These devices help to create an optimal microclimate in the room. Too dry air irritates the respiratory tract, causing breathing problems and new asthma attacks.

The use of antitussive and expectorant drugs. These remedies help to eliminate a pronounced hacking cough. Also suitable if the child does not have allergies healing herbs: coltsfoot, thyme, calendula and others. Phytotherapy should be used only after consulting a doctor.
Limit play with animals. For a toddler with asthma, it's best not to have furry pet friends. Animal hair and fluff can adversely affect the child's health and cause him to have new seizures.

Regular disinfection. The visitation where the child is located should be cleaned daily. Use caustic and too aggressive chemicals for this it should not. It is better to choose detergents that do not contain pronounced aromatic additives. The best option - products household chemicals, having a special marking on the safety of use even in children's rooms.

Strengthening immunity. For this, active walks on fresh air, exercise therapy complexes, breathing exercises, as well as various hardening. Correctly harden the child should be already from the very early years his life. Hardening should be regular. A set of these measures will help strengthen the weakened immunity of the baby, which will help reduce asthma attacks in the future.

Medical therapy

Various groups of drugs are used as basic treatment. Among them:

Mast cell membrane stabilizers. Help reduce pro-inflammatory biologically active substances that appear during allergic inflammation. The effect does not come immediately. Usually, it takes from 14 days to several months to achieve the effect. These drugs include: Ketotifen, Kromogen, Cromohexane, Nedocromil, Intal and others.
Antihistamines. Help to eliminate swelling from the smooth muscle cells of the bronchi. This helps to improve sputum discharge and reduce inflammation. Appointed by an allergist. To control bronchial asthma, Suprastin, Loratadin, Zirtek, Claritin and others are suitable.
Hormonal. They are prescribed for severe asthma, as well as in cases where the previous therapy regimen was ineffective. They have a pronounced anti-inflammatory effect. At long-term use may cause side effects. They can be prescribed in the form of inhalers or tablets (in severe cases).

For symptomatic treatment and elimination of unfavorable, acute symptoms of bronchial obstruction, drugs with a bronchial effect are used. They help to quickly eliminate bronchial spasm and improve breathing.

These funds are prescribed as aerosols, which are available in the form of various inhalers, spacers and nebulizers. They help distribute active substance as quickly and efficiently as possible. The smallest particles of the drug reach the bronchi in shortest time. Usually the effect is achieved within the first 5 minutes from the moment of use.

The following groups of drugs have a bronchodilator effect:

Adrenomimetics. They block adrenoreceptors, which are located on the surface of bronchial cells. They can be short and long acting. Preparations based on salbutamol eliminate bronchial spasm in 5-10 minutes. Foradil, Serevent and Valmaks help eliminate obstruction in the airways for 10-12 hours.

Anticholinergics. They have a pronounced effect. May cause systemic side effects. Often greatly reduce blood pressure. These include: Atropine, Atrovent, Platifillin and others.
Xanthines. They are not drugs of choice. They are prescribed only with the ineffectiveness of previously selected therapy. Often used in combined regimens for the treatment of bronchial asthma. These include: theophyllines, Eufillin and others.
Combined. The combination of an anticholinergic and adrenomimetic allows you to achieve a quick effect and keep it for a long time. These include: Berodual, Ditek, Intal plus, Symbicort, Seretide and others. Assigned to 1-2 inhalations per day. With prolonged use, dose adjustment or replacement with other drugs may be required.

In babies with lactase intolerance, an asthma attack may occur after drinking fermented milk products and cow's milk. In such cases, it is better to switch to using goat cheese and cheese. These products will be safer for an asthmatic baby.

The optimal menu for a child with asthma should contain hypoallergenic protein products, porridge and enough fiber. Suitable proteins are: chicken breast, rabbit, turkey (in the absence of allergies to chicken eggs). For a side dish, you can cook porridge or mashed potatoes made from potatoes or cauliflower.

All grains can be included in the children's diet. Restrictions can only be barley and oatmeal in case of gluten intolerance. As fiber, any vegetables and root crops of white and green colors are suitable. Dessert can be apples and pears. Try to choose green varieties grown in the region where you live.

Harbingers of an imminent attack

Before a strong sudden deterioration in well-being begins, the child develops some borderline symptoms. They are also called "aura". Before the development of an asthmatic attack, the child may experience severe sneezing, sore throat, runny nose.

The baby is getting anxious. In some cases, even panic. The child's behavior may change. He becomes more silent, refuses to make contact. Many children try to be in own room as it brings them more peace of mind.

The appearance of a dry cough indicates the transition of a borderline state into a real attack. In the next few hours, all symptoms worsen. Cough begins to increase and numerous dry wheezing rales appear, as well as shortness of breath.

Do not leave your child alone when he first shows signs of deterioration in well-being. An older baby should be asked about what worries him and where it hurts.
Pay attention to whether the child has shortness of breath. To do this, count the number of breaths in one minute. Evaluating this is very simple: watch the movement of the ribs during breathing. If the number of breaths is more than 20 per minute, then this indicates that the baby has shortness of breath.
Help your baby get into a comfortable position. Do not lay the child on his back if he is still unable to breathe. This situation can only aggravate the development of an attack.
Ensure air flow. If the room is too stuffy, then open the window or window. Try not to let your child catch a cold during this time.
Use the inhaler recommended by your doctor to relieve symptoms. Usually, medications are used to eliminate seizures, which have quick effect. Salbutamol-based inhalers are often used for this.
If your baby continues to be short of breath despite taking medication, there was a pronounced cyanosis of the nasolabial triangle and a marked decrease in blood pressure, then this is a reason to call an ambulance.
Do not use 3-4 or more inhalations at a time in an attempt to achieve an effect. Such irrational use can only lead to the development dangerous state requiring hospitalization of the baby in the hospital. Large doses adrenomimetics block receptors, which further prevents the bronchi from working fully. To eliminate this effect may require the introduction of hormones by intravenous route.

Rehabilitation

Carrying out rehabilitation measures in the interictal period will improve the course of the disease, and will also significantly affect the prognosis. If bronchial asthma was registered in a baby for the first time and for a long time proceeded only in a mild course, then competent rehabilitation will help to practically lead to recovery, and in some cases even remove the diagnosis.

Rehabilitation activities include:

breathing exercises;
massotherapy;
physiotherapy methods (ultrasound treatment, speleochambers, ultraphonophoresis, hydrotherapy, magnetotherapy, electrophoresis with medicinal bronchodilators and others);
Spa treatment;
complex of therapeutic physical exercises.

All these methods together help to achieve a pronounced therapeutic effect. To achieve a stable remission of bronchial asthma, rehabilitation should be carried out regularly, throughout the entire period without exacerbations. For each child, an individual scheme of rehabilitation measures is drawn up. Efficiency control is assessed using spirometry and other examinations.

Pulmonary sanatoriums

Immunity strengthening and bronchial rehabilitation are important components of the basic treatment and rehabilitation of bronchial asthma. Holidays with a child in a pulmonological sanatorium will be an excellent option for improving health. You can go on vacation at any time of the year. The choice of sanatorium should be based on the profile of the services provided.

Young patients with a disability due to bronchial asthma with severe bronchial obstruction can receive free accommodation and treatment in such health centers. Tickets are usually issued every year. During treatment in a sanatorium, the child's external respiration improves, and immunity is restored.

Prevention

In order for the child not to have new attacks of the disease, several simple recommendations:

Regular use of properly selected inhalers to relieve seizures.
Compliance with a hypoallergenic diet.
Carrying out daily wet cleaning of the children's room.
Careful selection of bed linen, mattress, pillows and blankets. They should not be made of materials that can cause allergic reactions in the baby.
Implementation of rehabilitation measures in the interictal period.
Exclusion from everyday life of all possible allergens.
Regular visits to a pulmonologist and an allergist.