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Features of the treatment of obstructive bronchitis in children. How obstructive bronchitis manifests itself in children A child has frequent obstructive bronchitis

An inflammatory disease of the bronchial mucosa, characterized by swelling, hypersecretion and periodic bronchospasm. Tendency to relapse. Transition to bronchial asthma is possible.

Before the child reaches the age of 3 years, this condition, which occurs against the background of ARVI, is called obstructive bronchitis. For most children, these episodes go away by age 3. If wheezing is observed in a child with severe allergies over the age of 3 years, then this is called bronchial asthma. Such a child should undergo an allergy examination. The diagnosis of bronchial asthma is also indicated by the degree of allergic sensitization (a noticeable increase in immunoglobulin E), the frequency and severity of attacks, as well as their occurrence outside of acute respiratory viral infections. However, even in this case, parents should know that these attacks may disappear with age (hormonal changes occur in the body).

If in case of bronchial asthma (in the presence of an allergy to some substance) the attack can be relatively quickly stopped (stopped), then in case of obstructive bronchitis the complete elimination of wheezing and dry wheezing in the bronchi does not occur immediately (after a few days).

Sit next to the child and count his breathing rate for 1 minute to assess the effectiveness of treatment measures (before and after treatment) and after that begin to relieve the attack.

Symptoms and signs of bronchial obstruction in children

  • dry cough;
  • coarse rales, crepitus;
  • expiratory shortness of breath, tachypnea;
  • often - vomiting and abdominal pain;
  • poor health;
  • low-grade fever, fever;
  • cyanosis.

Treatment, first aid for bronchial obstruction in children

  • Infusion treatment.
  • Possibly mucolytics (only limited effectiveness).
  • Sometimes - glucocorticoid drugs orally or intravenously.
  • In some cases - theophylline. For hypoxemia - oxygen therapy.

The first episode of bronchial obstruction, as a rule, terribly frightens parents and is the reason for hospitalization of the child, which, in general, is justified, taking into account the state of mind of the parents, their lack of experience and knowledge, as well as the lack of an inhaler (nebulizer) and bronchodilators at home first aid kit.

In the next episode, it is better to avoid hospitalization of the child, and parents should learn to act competently in such a situation. If your child has an episode of bronchial obstruction, then you should consider that it is highly likely to recur in the future. To avoid repeated hospitalizations, you need to not only learn how to deal with this condition, but also have a specially stocked home first aid kit.

During an attack, the first thing you need to do is give access to fresh air to the room where the child is.

First, inhale with a bronchodilator drug in an age-specific dose through a nebulizer. In children under 3 years of age, Berodual is used for this purpose in drops with saline; in older children, Ventolin is used (not diluted).

After 10-15 minutes, when the breathing rate decreases and the child clears his throat, it is very good to inhale with a local (topical) glucocorticoid - pulmicort (budesonide). The purpose of this drug, its dose and frequency of administration should also be discussed with your doctor. Corticosteroid hormones most effectively relieve bronchospasm, but the need to prescribe them is decided by the pediatrician. There is no need to be afraid of them. At the prehospital stage, they are prescribed, unfortunately, very rarely, although their early appointment often allows one to avoid unnecessary hospitalizations.

It must be remembered (this was mentioned earlier) that expectorant measures are based on intensive drinking. Among the expectorant drugs for bronchial obstruction, ambroxol (lasolvan) is usually prescribed, orally or by inhalation.

Periodically monitor the number of respirations; if the child feels better and shortness of breath decreases or is eliminated, continue to follow the doctor’s orders; if the child does not feel better, hospitalization is necessary.
Bronchodilators are available in aerosol packages (asthmopent, salbutamol, Berotec, Ventolin, Berodual). But it is believed that inhalation through a nebulizer is more effective. Their use in adults or older children does not cause problems. You need to exhale the air, while taking a deep breath, “puff” the aerosol a couple of times (press the valve of the aerosol can upside down, i.e., with the spray down) and hold your breath for a while. The effect comes very quickly and is manifested by easier breathing, a wetter cough and a decrease in shortness of breath (periodically you need to count the number of breaths per minute). The effect of aerosols is not very long-lasting; if necessary, the procedure should be repeated. Some of these drugs (salbutamol) are also available in tablets, but, as practice shows, the use of aerosols is more effective and has fewer side effects.

Expectorants are usually not prescribed for children under one year of age. Herbal preparations are not recommended for children with allergies.

But it is quite difficult to get young children to inhale the drug. The fact is that when children press the valve of an aerosol can, they instinctively hold their breath and swallow the medicine. The dose of the drug used in aerosols is insufficient for oral administration, and the expected effect does not occur. How can you deceive a child? For this purpose, pharmacies sell a special “spacer” tube in which aerosols accumulate. It is put on a canister and the child breathes through it.

What to do if there is no spacer? Then we do this. One of the adults sits on a chair with the child on his lap, hugs him by the shoulders with one arm so that the baby cannot move his arms, and places the other hand on his forehead to limit head movements. The second adult presses a rolled-up magazine or newspaper tightly to the child’s nose and mouth, and on the other side of the makeshift tube, an aerosol can and “squirts” it several times in a row. Next, the can is quickly removed and the hole is covered with the palm of your hand.

The child, after a reflexive breath-hold for the duration of the “puffing”, begins to actively inhale the medicinal mixture. An overdose will not occur, because part of the medicine settles on the walls of the tube and comes out when coughing and breathing. Instead of newspaper, it is better to use a plastic bottle with the bottom cut off (cut the cut to the shape of your face and cover it with adhesive tape so as not to damage the skin). An aerosol can is inserted into the neck of the bottle. Such a tube (“spacer”) should be stored in a first aid kit with a canister of the drug included in it.

There are other drugs that have a bronchodilator effect, the use of which is currently limited. This is ephedrine, to which addiction quickly develops; solutan, a complex expectorant and slightly dilating drug based on ephedrine and medicinal herbs, can also cause allergic skin rashes.

The active principle of aminophylline is theophylline (aminophylline), which is extracted from tea. It is believed that a glass of strong, freshly brewed tea contains the same amount of theophylline as there is in an aminophylline tablet (tablets of 0.15 g, which is equal to 150 mg). Recently, aminophylline has ceased to be widely used due to lack of effectiveness, however, in the absence of other bronchodilators, it can be given orally once before the doctor arrives in a single dose at the rate of 4-6 mg per kilogram of weight. For example, a one-year-old child weighing 10 kg should be given 1/4 of a 0.15 mg tablet once.

What drugs should not be given for bronchial obstruction

It should be remembered that the medicine called “broncholitin” does not dilate the bronchi! It inhibits coughing, and it is necessary for the child to cough up viscous, thick sputum.

At the first suspicion of bronchial obstruction, call a doctor immediately!

Antihistamines (diphenhydramine, suprastin, tavegil, fenkarol, diazolin, claritin, etc.) are also not prescribed for bronchial obstruction. Although bronchospasm is based on allergies, antihistamines do not affect this mechanism. These medications dry out the mucous membranes (for example, with allergic rhinitis), and the child needs expectorants. And therefore, the annotation for Suprastin, included in the box of tablets, states: “Do not prescribe for obstructive conditions!”

The information received by parents does not in any way exclude the need for the child to be examined by a pediatrician. Just remember that competent first aid will quickly ease the child’s suffering and reduce the likelihood of hospitalization.

If your child is prone to bronchial obstruction and is diagnosed with asthmatic bronchitis or bronchial asthma, there is always hope that these phenomena may disappear during adolescence. However, the likelihood of this is higher with a correct lifestyle, compliance with elimination regimens, regular observation by an allergist, as well as sanitization of the nasopharynx at the slightest suspicion of trouble with the ENT organs (such children often experience persistent difficulty in nasal breathing due to the presence of allergic rhinitis ).

Care

  • Elevated upper body position. Humidification of inhaled air. Observation of gasping, pulse.
  • Oxygen supply in accordance with medical prescription, monitoring with a pulse oximeter.
  • Physiotherapy.

Obstructive bronchitis in children is an inflammatory process in the bronchi, in which their patency is disrupted, accompanied by difficulty breathing. It is more common in young children, which is associated with an anatomically narrower lumen of the bronchi.

It is also worth pointing out that in children under one year old, the cause of this disease can be congenital anatomical malformations.

There is some seasonality of the disease. Most often, children catch infections in winter and autumn. This is due to possible hypothermia, decreased immunity, increased fatigue and contact with already sick children (attending school, kindergarten, various clubs).

Species

There are several classifications of bronchitis. Most often, doctors use a classification by degree (mild, moderate, severe) and by the course of the process (acute, chronic).

Symptoms

Early identification of symptoms of obstructive bronchitis is of great importance in subsequent treatment.

The main criteria for diagnosis are:

  • Previous acute respiratory disease. Most often, children get sick due to acute respiratory viral infections or acute respiratory infections. A complication in the form of obstructive syndrome usually occurs within 3-4 days.
  • Cough is the most characteristic symptom of bronchitis. Usually its appearance indicates the onset of the disease. The child constantly coughs annoyingly “to the point of nausea.” In this case, sputum separation does not occur, that is, the cough is “dry”. In infants, it provokes regurgitation and sometimes even vomiting. The cough begins suddenly, usually at night, and is often accompanied by a parallel rise in temperature.
  • The nature of wheezing is one of the most indicative criteria for determining whether a child has obstructive bronchitis or not. They arise due to the narrowing of the lumen of the bronchi and the accumulation of viscous mucus that is difficult to separate. With obstruction, wheezing is very pronounced on inhalation and exhalation, whistling and audible at a distance. In older children, with severe obstruction, they can be heard even in the next room.
  • Shortness of breath is the most severe sign of bronchitis. The child begins to breathe frequently and heavily, especially during physical exertion. Parents may also notice (more often in newborn babies) blue lips, the appearance of gray circles under the eyes, and refusal to eat. The frequency of respiratory movements at rest can serve as a guide (the norm for children up to one year is 35-45 times per minute, up to 3 years 30-40 per minute).

The appearance of shortness of breath in a child is an indication for immediate hospitalization!

Symptoms that are not so specific for this type of bronchitis, but are nevertheless very important, are: general weakness, lethargy, drowsiness of the child, headache, decreased appetite, increased body temperature (it is worth noting that sometimes the disease occurs without fever) .

Diagnostics

If an illness is suspected, an examination is carried out by a pediatrician or pulmonologist. Most often, these doctors involve other specialists for consultations: an allergist, an immunologist, an otolaryngologist.

To make a correct diagnosis it is necessary:

  1. Collect and analyze anamnesis (history of the present disease) from the words of the parents and the child;
  2. Auscultation - listening to respiratory sounds and wheezing using a phonendoscope;
  3. Spirometry - determining the volume of a child's lungs using a device. The study is not conducted for children under 5 years of age, as they cannot fulfill the study conditions.
  4. X-ray to clarify the diagnosis and exclude pneumonia and other complications;
  5. Sputum culture for flora and sensitivity to antibiotics;

Treatment

As we have already found out, obstructive bronchitis is a serious disease, sometimes threatening the life of a child. Therefore, only a doctor should prescribe treatment!

The first step is to relieve bronchospasm and make it easier for the child to breathe. This is achieved by eliminating swelling, reducing the viscosity of sputum and removing it from the respiratory tract. A very effective method in this case is inhalation therapy. For this purpose, as a rule, a special device is used - an inhaler. Inhalations relieve irritation of the bronchial mucosa and improve lung ventilation.

Drugs for treatment in this situation are glucocorticoid hormones and medications containing salbutamol or berodual. For older children, theophylline preparations (Teopek, Eufillin) are sometimes prescribed in parallel.

The undeniable advantage of this therapy is that the drug, along with the steam, enters directly into the lungs, and improvement occurs within a few minutes.

The next important step is eliminating the infection. In this case, antiviral drugs come to the fore. There are now a huge number of them and the doctor will be able to choose the best option for the child. For small children, syrups, candles, and drops are used. For children from three years of age, tablet forms can already be used. Antibiotics are not included in mandatory treatment. They are prescribed only when necessary.

The main indications for antibiotic administration are:

  1. high temperature for more than three days, without positive dynamics;
  2. pronounced inflammatory processes according to a general blood test (leukocytosis);
  3. yellow or dark green sputum (indicates a purulent process);
  4. with a high probability of developing pneumonia.

Of course, it is necessary to ensure that the viscous sputum is liquefied and released from the lungs. For this purpose, mucoregulatory drugs are prescribed (Ambroxol, Lazolvan, etc.). These drugs are taken for 7 days. After such treatment, the cough ceases to be painful and paroxysmal, and this indicates that it is time to prescribe expectorants. Preference is given to drugs of herbal origin (Tussin, Gedelix, Gerbion, Bronchosan, etc.)

Do not underestimate general strengthening measures. Daily ventilation is required in the room where the patient is located. It is very important to encourage your child to drink as much liquid as possible (at least 1.5 liters per day). This helps reduce the thickness and viscosity of sputum, which then drains well. A small patient can be given tea, fruit juice, mineral water, and decoctions. They also resort to time-tested mustard plasters. They are placed on the chest area and held at the back between the shoulder blades for about 10 minutes. Hot foot baths or warm baths for the whole body will help relieve the condition.

The use of mustard plasters and baths is not permissible in case of fever and obstruction!

Folk remedies

If the disease is not severe, when the child is not in the hospital, but at home, you can use folk remedies. Such treatment methods are passed down from generation to generation and have proven effectiveness. The most common and relatively safe way is to use various herbal infusions that help improve the removal of mucus from the bronchi.

These include:

  • marshmallow root,
  • licorice root,
  • thermopsis grass,
  • chest herbal collection,
  • plantain and coltsfoot juice.

One of the most common methods of traditional medicine is a decoction of primrose root. You can use black radish juice infused with sugar (or honey). It tastes good to children and has an excellent expectorant effect. Decoctions of onions, figs and garlic in milk are good for cough relief. There are a lot of such remedies, but you should always consult a doctor before using them so as not to worsen the child’s condition.

Prevention

First of all, you need to try to prevent long-term colds or infectious diseases in children. Even a prolonged runny nose or frequent runny nose can subsequently cause obstructive bronchitis in a child.

Children with allergies should be protected as much as possible from contact with allergens and irritants (tobacco smell, the smell of paint during repairs, etc.) All children need normalization of their daily routine, daily walks and hardening.

Video on the topic

Treatment of obstructive bronchitis is a troublesome process. Unfortunately, this disease is quite common in children. The peculiarity of the obstructive form is a significant deterioration in bronchial patency, which causes breathing problems. The very word “obstruction,” which frightens mothers so much, means “spasm” or “constriction.”

But acute bronchitis in a child responds quite well to therapy. Treatment of this disease requires patience and strict adherence to all doctor's recommendations. You must be prepared for the fact that you will have to fight the disease with all possible means: medications, folk remedies, physiotherapy.

How to recognize the disease?

Obstructive bronchitis in a child appears suddenly and progresses quickly. The patient's condition can rapidly deteriorate in just a few minutes.

Common symptoms of this disease include:

  • restless behavior;
  • acute bronchitis in a child is characterized by “wheezing” and “wheezing” breathing;

  • bubbling in the chest area. Unlike wet wheezing in acute pneumonia, these wheezes are not as obvious, do not have a clear localization and disappear after a coughing attack;
  • . Outwardly, it looks as if the child’s chest is constantly in a state of inhalation. To inhale, the patient needs to strain additionally. But unlike reactions with “cardiac” shortness of breath, the child does not try to stand up or sit down. On the contrary, children feel more comfortable when they sleep on their stomachs or even hang their heads below body level;
  • bouts of exhausting coughing, often even ending in vomiting;
  • increased breathing rate. There are certain norms for breathing rates in children of different ages. In children under 6 months, it should usually be no more than 60 breaths per minute, from 6 months to 1 year - 50, and from 1 to 5 years - 40.

Calculate how many breaths the patient takes per minute and if their number is 10% more than the age norm, this is already a serious cause for concern. Rapid breathing leads to a lack of oxygen in the body. Visually, this manifests itself in the bluish area of ​​the nasolabial triangle.

What drugs are used for drug treatment?

In infants and children under 2 years of age, treatment of acute obstructive bronchitis is carried out in a hospital under the supervision of doctors; older children can be treated at home.

Inpatient observation should be preferred if:

            • the child has pronounced signs of intoxication: nausea, weakness, lack of appetite, etc.;
            • respiratory failure progresses and respiratory rate increases;
            • Often the symptoms of pneumonia can be “masked” as bronchitis. Therefore, if there is the slightest suspicion of pneumonia, it is better not to refuse hospitalization.

The main groups of drugs that are prescribed for the obstructive type of disease:

            • bronchodilators. These drugs relieve bronchospasm. For young children, the following are usually prescribed in syrup form: Ascoril, Clenbuterol, etc. Possible side effects of these medications may be increased heart rate and tremor (shaking).

An equally convenient way to administer bronchodilators to young children is with a nebulizer. To prepare a solution for inhalation, the drug is diluted with saline solution. How many times a day to carry out the procedure, as well as the dosage of medications, can only be determined by the attending physician.

Tablet-based theophylline-based bronchodilators are very toxic and cannot be prescribed to small children;

            • Antispasmodics are also used to relieve bronchospasm. Drugs such as No-shpa or Papaverine can be used by inhaler, in tablet form, or intravenously. In the latter case, manipulations are carried out in a hospital;
            • mucolytics. Treatment of obstructive bronchitis is impossible without the use of drugs aimed at thinning sputum for its rapid removal from the body. These products are divided into groups depending on the main active ingredient: Ambroxol, Carbocisteine ​​or natural extracts;

            • The doctor prescribes antihistamines if the child has a tendency to allergic reactions;
            • antibiotics. Let us immediately note that acute bronchitis is treated with antiviral drugs, since in most cases its appearance is provoked by viral diseases. Treatment with antibiotics is not mandatory. It is prescribed only if the infectious origin of bronchitis is proven.

The doctor will recommend treating obstructive bronchitis with antibiotics if the child has a high body temperature (up to 39 degrees) for longer than 4 days, or it rises sharply again 4-5 days after the onset of the disease, there are clear signs of intoxication of the body (weakness, nausea, refusal to food) or severe cough.

Not just a pill!

In addition to the use of medications, obstructive bronchitis can be cured at home by following certain rules and carrying out various procedures.

To get rid of bronchitis faster:

  • Maintain the required level of humidity in the room where the patient is located. This will greatly facilitate the removal of sputum during coughing. If you don’t have a humidifier, just do wet cleaning more often or place a large container of water in the room;

  • the patient needs to follow a diet and drink plenty of fluids. This does not mean that the child needs to be “planted” only on oatmeal and water, but the diet must be balanced and fortified. Eliminate citrus fruits, brightly colored fruits, carbonated drinks, sausages, cheese curds, and anything that contains preservatives, flavor enhancers and dyes from the patient’s diet;
  • Eliminate any strong odors that the patient may inhale. Bleach, cigarette smoke, acetone and other similar “aromas” will provoke new coughing attacks;
  • massage is an indispensable assistant in the treatment of obstructive bronchitis in children. It will facilitate the removal of sputum, reduce coughing and strengthen the walls of the bronchi. Parents can do the massage themselves at home.

You should knead the collar area, chest and back muscles along the spine. Postural massage is especially effective in treating obstructive bronchitis in children. To perform it, place a pillow under the baby’s stomach (the head should hang off the bed) and tap with your palms folded in a boat along the back for 15 minutes.

Older children can be asked to take a deep breath and hold their breath, and perform the massage while exhaling. This technology will bring the greatest effect.

Physiotherapeutic procedures are contraindicated for the treatment of acute obstructive bronchitis in children. But as soon as the spasm stops and the patient begins to actively cough up sputum, UHF therapy and electrophoresis are recommended.

Acute obstructive bronchitis can be cured faster by so-called sound gymnastics. This method consists of pronouncing different sounds and their combinations in a certain way. Vibrations are transmitted from the vocal cords to the bronchi and “on the spot” relax the muscles and remove spasms.

Treatment with folk remedies: decoctions and infusions

Along with medications, even doctors recommend treating obstructive bronchitis with folk remedies. Proven unique recipes, passed down from generation to generation, will help soothe coughs, remove phlegm, eliminate pathogens and improve immunity.

But do not forget that treatment with folk remedies requires mandatory prior consultation with a doctor. Harmless at first glance, “herbs” can provoke a very severe allergy or cause significant harm to the patient’s body if these drugs are used uncontrollably.

We offer effective recipes to combat the disease:

  • Drinking plenty of infusions of raspberries, linden flowers, black elderberries and diaphoretics will help cure acute bronchitis. These infusions should be drunk very warm in quantities of at least 1.5 liters per day.

An excellent remedy that will cause moderate sweating is an infusion based on dried flowers of chamomile, linden, mint and black elderberry. All parts must be taken in equal quantities - 1 tbsp. l. Pour the mixture with a liter of boiling water and leave. The child should drink 2-3 glasses a day of this infusion;

  • A collection of licorice root, plantain leaves and coltsfoot will have a bronchodilator, antiseptic effect and increase sputum discharge. Licorice and plantain should be taken in 3 parts each, coltsfoot - 4 parts. Pour this mixture into 2 cups of boiling water and let the patient drink ¼ cup 4-5 times a day;
  • treatment of acute bronchitis with thyme herb is carried out for severe cough. Thyme has sedative, expectorant and bactericidal properties. The infusion is given to children ½ tsp. per day;

  • If the cough is unproductive (barking) or sputum is difficult to separate, traditional medicine recommends using plants that contain saponins. These substances perfectly reduce the viscosity of sputum, facilitating its easy removal from the bronchi. One of these plants is elecampane. A decoction of it is taken 4-5 tbsp. l. per day;
  • To relieve a severe cough, use a decoction of sage in milk. 3 tbsp. l. the herbs are poured into a glass of milk and the whole thing is brought to a boil in an enamel pan. Next, you need to reduce the heat, boil the broth for another 15 minutes and let it brew for an hour. The child should drink half a glass 3-4 times a day. You can sweeten the broth with honey.

Products for external use: compresses and rubbing

Treatment of acute bronchitis in a child at home involves the use of various compresses and rubs. Warming procedures will help relieve spasms and relax the muscles of the bronchi.

For obstructive bronchitis in children, any procedures using mustard plasters or dry mustard are contraindicated! Inhaling mustard vapors can cause bronchospasm and laryngeal swelling!

Compresses made from vegetable and butter oils are considered the most effective folk remedies in the treatment of obstructive bronchitis.

Refined vegetable oil is heated, a terry towel is moistened in it and wrapped around the child in the chest area. Next, the compress is covered with a layer of cellophane film, warm clothes are put on top and the whole structure is left overnight. As a rule, the disease loses ground after 3-4 wraps. Be careful and be sure to check the temperature of the oil yourself before applying the compress to your child's body.

Bronchitis is a respiratory disease that can have dangerous complications. Parents have many questions about the treatment of this disease: in what cases are antibiotics used and whether the child can be cured with inhalations and warming procedures. The baby’s condition can deteriorate sharply, it all depends on the form of the disease and age. Therefore, home treatment should always be coordinated with your doctor. To speed up recovery, you need to maintain optimal humidity and temperature in the room.

Content:

What is bronchitis? Types of disease

This is the name for inflammation of the bronchial mucosa. The disease is infectious and allergic in nature. Often the inflammatory process appears against the background of colds and flu. Most often, children fall ill with infectious bronchitis during the cold season, when the body's immune defense weakens.

The infection enters the child’s body from the outside by inhaling contaminated air. It is also possible to activate one’s own opportunistic microflora, which is facilitated by hypothermia of the body and decreased immunity.

Depending on the cause of occurrence, the following types of bronchitis are distinguished:

  1. Bacterial. Its causative agents are bacteria such as streptococci, staphylococci, pneumococci, Haemophilus influenzae and pertussis, chlamydia, mycoplasma.
  2. Viral. It occurs due to the penetration of influenza viruses and adenoviruses into the bronchi.
  3. Allergic. It occurs when the bronchi are irritated by chemicals, dust or pollen, or particles of animal hair.

Infectious species are contagious. When a patient sneezes or coughs, the infection spreads 10 meters around.

When breastfeeding, a child has passive immunity, that is, with mother's milk he receives protective antibodies to infections. Therefore, babies under the age of 1 year suffer from bronchitis only in cases where they have abnormalities in the development of the respiratory system, they were born prematurely, or the body is weakened by other diseases.

The development of infection in the bronchi occurs when the mucus formed in them as a result of irritation and inflammation of the mucous membrane dries out, blocking the respiratory passages. In this case, the ventilation of these organs is disrupted.

Causes of the disease

The causes of bronchitis in children are:

If treatment of bronchitis in children is not carried out in a timely manner or turns out to be ineffective, then the disease from an acute form becomes chronic. Moreover, it lasts for years, with periodic relapses. Most often, recurrent bronchitis occurs in children 4-7 years old. The disease recurs 3-4 times a year after a cold, for about 2 years. There are no bronchospasm attacks.

The likelihood of a complicated disease increases if the child has inflammation of the adenoids or chronic tonsillitis. Factors contributing to the occurrence of bronchitis in an infant are early weaning, unsuitable sanitary conditions, and the presence of smokers in the house.

Symptoms of various types of bronchitis

The structure of the respiratory system in children has its own characteristics. Their respiratory passages are narrower, which makes them possible to quickly close when swelling of the mucous membrane occurs. Congenital malformations of the lungs or bronchi are more pronounced in infants. After 1-1.5 years, deviations often disappear.

Children's immunity is still developing and their susceptibility to infections is increased. The respiratory muscles are weaker, causing ventilation of the respiratory organs to be worse than in adults. In addition, the lung capacity of children is smaller, which contributes to the accelerated spread of pathogens.

In children, the thermoregulation of the body is not sufficiently developed. They overheat faster and catch colds more easily.

Note: Spasm and swelling of the bronchi (obstruction) develops especially quickly in infants. The resulting lack of oxygen is life-threatening.

Types of acute bronchitis

There are the following types of acute disease:

  1. Simple bronchitis. The manifestations are the mildest. There are no symptoms of lack of air.
  2. Obstructive bronchitis. A serious and dangerous condition in which respiratory failure may occur.
  3. Bronchiolitis. Inflammation of the bronchioles (bronchial tubes with a diameter of 1 mm located in the area of ​​transition to the lungs) occurs. This leads to blockage of the pulmonary vessels and the occurrence of heart disease.

Bronchitis of any type begins with the appearance of signs of a cold, which then acquire characteristic features of the inflammatory process.

Symptoms of simple bronchitis

Against the background of a cold, the child experiences general weakness, headache, and a severe dry cough for up to 7 days. Drying of mucus leads to hissing in the bronchi. If the inflammation also affects the larynx, a barking cough appears. The temperature rises to 37°-38° (depending on the severity of the disease). Gradually, a dry cough turns into a wet one. Gurgling wheezing appears. If sputum discharge occurs normally, the child’s condition improves significantly. The disease in this form can last for 1-3 weeks. The severity of the manifestations depends on the age of the baby, his physical development, and general health.

If the disease is neglected, the child may experience complications such as bronchiolitis and pneumonia. Sometimes a disease that occurs in a viral form has an unusual course. After the virus dies (about a week), the child feels better, but then his condition worsens sharply: the temperature rises, the cough intensifies, and the headache gets worse. This indicates that a bacterial infection has joined the viral infection and urgent treatment with antibiotics is required.

The infectious process can be either unilateral or bilateral. One of the signs of the disease is redness of the eyes due to inflammation of the mucous membrane (conjunctivitis).

Symptoms of obstructive bronchitis

Signs of obstruction most often appear in children under 3-4 years of age. They usually occur with a viral or allergic form of the disease. The main signs of obstructive bronchitis are noisy, hoarse breathing with prolonged exhalation, paroxysmal cough ending in vomiting, retraction of the intercostal muscles during inspiration, and swelling of the chest.

With this form of the disease, the child’s body temperature does not increase. Obstructive bronchitis can occur suddenly after the baby plays with a pet (for example, at a party) or inhales paint during repairs.

Signs of obstruction sometimes appear around the 4th day of illness with influenza or acute respiratory infections. Characteristic attacks are dry coughs that do not bring relief. Whistling sounds are heard in the lungs.

Up to 4 years of age, relapses of the disease are possible, then attacks most often stop.

Note: Obstructive bronchitis differs from bronchial asthma in that the symptoms of respiratory failure develop slowly, while with asthma the child begins to choke suddenly.

A frequently recurring obstructive process of any origin can develop into bronchial asthma.

Video: How to treat obstructive bronchitis in children

Signs of bronchiolitis

The main sign of inflammation of the bronchioles is shortness of breath. Initially, it occurs in a child if he is actively moving, but over time it also appears at rest. During inhalation, you can hear a characteristic hissing sound. When listening, the doctor hears wheezing in the lower part of the bronchi.

As a rule, with bronchiolitis the temperature rises to 38°-39°. It is more difficult for a child to exhale than to inhale. The chest and shoulders rise. The face swells and turns blue. A persistent cough with scanty sputum does not provide relief, causing chest pain. Manifestations of this condition are also dry mouth, rare urination, and rapid heartbeat.

The course of bronchitis in children of different ages

Bronchitis after a cold in a child is a common occurrence. Sometimes it occurs easily, without fever and is manifested only by a cough. In complicated cases, the temperature is high, bronchospasms and suffocation occur.

The disease usually begins with a dry cough. Gradually, sputum accumulates in the bronchi, which becomes mucopurulent. Wheezing appears; they can be considered signs of the disease transitioning to the recovery stage. At this moment, it is important to facilitate the removal of mucus and cleanse the bronchi of infection. This is easier for older children, since they already understand that they need to cough and spit out mucus.

A small child is not always able to do this on his own. Parents can help him, for example, by turning him over to the other side. In this case, sputum moves along the walls of the bronchi, causing irritation and coughing.

In infants, due to difficulties with the removal of mucus from the bronchi and its stagnation, the main symptoms are often attacks of severe coughing with shortness of breath. At the age of 2-6 months, the disease usually occurs in the form of bronchiolitis.

Typically, recovery from uncomplicated bronchitis occurs within 7-8 days. If bronchitis is complicated by obstruction, it can manifest itself within several weeks and develop into pneumonia.

Diagnosis of bronchitis

Based on the nature of the cough and the type of sputum produced, the doctor determines what type of bronchitis occurs in the child. White sputum is characteristic of viral inflammation, and a greenish-yellow tint appears with bacterial inflammation of the bronchi. With allergic bronchitis, lumps of clear mucus are coughed up.

During examination and listening to the chest, the presence of such symptoms of bronchitis in children as hoarse breathing, difficulty in exhaling, swelling of the chest, and retraction of muscles in the intercostal area is determined.

Using a general blood test, the number of leukocytes is determined and the presence of an inflammatory process is established.

In case of dangerous complications (severe coughing attacks accompanied by high fever for more than 3 days), an x-ray of the lungs is taken. In this case, equipment with a reduced dose of radioactive radiation is used. Pneumotachometry is performed. Using a special device, the patency of the airways is examined during inhalation and exhalation.

If there are signs of an infectious disease, a sputum test is performed to determine the type of infectious agent. To diagnose bronchiolitis in infants, a histological examination of sputum is performed for the presence of characteristic viruses that can live in the bronchi and lungs, the so-called respiratory syncytial infection. An important sign of bronchial inflammation in an infant is cyanosis (blueness of the skin and mucous membranes), which appears as a result of heart and pulmonary failure.

To make a diagnosis, the presence of characteristic wheezing and shortness of breath, as well as the frequency and strength of the heartbeat, is important.

A severe cough can also occur with other diseases, such as pneumonia, laryngitis, tuberculosis. Its cause may be a congenital pathology of the functioning of the respiratory system, or the entry of a foreign body into the trachea. Diagnostics allows you to confirm the presence of bronchitis and prescribe the correct treatment.

Video: Doctor E. Komarovsky about the cause and treatment of bronchitis

Treatment of bronchitis

First of all, parents must remember that it is under no circumstances acceptable to self-medicate. As pediatrician E. Komarovsky emphasizes, a small child with bronchitis can be harmed not only by uncontrolled use of medications, but also by improper use of home procedures.

Hospitalization is carried out in cases where acute bronchitis occurs in a complicated form (in the presence of shortness of breath, high temperature, difficulty eating and drinking water). At home, when treating simple bronchitis, the child should stay in bed if he has a high temperature. As soon as it returns to normal, the child needs walks in the fresh air.

It is necessary to often drink warm tea, compote (liquid consumption should be increased by 1.5 times compared to usual). This helps to liquefy mucus and remove it from the bronchi. For drinking, you can prepare herbal teas (linden, mint). It is useful to drink alkaline mineral water, which will help reduce the viscosity of sputum. The infant is placed to the breast as often as possible and additionally given water to drink.

Thermal procedures (inhalations, mustard plasters, foot warming baths, chest rubbing) can only be carried out in the absence of elevated body temperature.

Medicines prescribed for children with bronchitis

For acute bronchitis, the doctor prescribes antiviral drugs such as arbidol, anaferon, influferon, interferon, taking into account the age and weight of the child.

Antibiotics for bronchitis they have an effective effect only when the disease is of a bacterial nature. They are prescribed when thick sputum is yellow-green in color, and there is a high temperature, difficulty breathing, and symptoms of intoxication of the body (nausea, severe headache, weakness, sleep disturbance). The presence of a bacterial process can be indicated if the symptoms of the disease do not subside within 10 days after the start of antiviral treatment. Antibiotics are necessary if a child develops bronchiolitis and there is a risk of it developing into pneumonia. Children are usually prescribed azithromycin, zinnat, suprax, sumamed.

Cough remedies. The following types of drugs are used:

  • expectorants (pertussin, licorice root extract, decoctions of some herbs);
  • sputum thinners, such as bromhexine, lazolvan, libexin.

To thin sputum during bronchitis and cough, the drug Fluifort is used, which has proven itself in the treatment of children. It comes in the form of a syrup, which is convenient to give to a child, and even kids like the pleasant taste. The main active ingredient in the syrup is carbocysteine ​​lysine salt, it helps to liquefy and remove mucus from the lungs. Fluifort restores the structure of the mucous membranes of the respiratory system, facilitates breathing, and significantly reduces the frequency and intensity of cough. The effect of the drug is noticeable within the first hour after use and lasts up to 8 hours. The neutral pH of the syrup makes it completely safe.

Warning: Children under 2 years of age should never be given expectorants. Taking them will intensify the coughing attack. Liquefied mucus can enter the airways and lungs, leading to even more serious complications.

Antipyretics. Panadol (paracetamol), nurofen (ibuprofen), and ibuclin are used in the form of tablets, suspensions, suppositories - in forms convenient for children of any age.

Antihistamines(Zyrtec - for children over 6 months, Erius - from 1 year, Claritin - from 2 years). They are used in the treatment of allergic bronchitis in children.

Preparations for inhalation. Used for obstructive acute bronchitis. The procedures are carried out using a special inhaler. Such agents as salbutamol and Atrovent are used.

Additional procedures include chest massage, therapeutic breathing exercises, and physiotherapeutic treatment (ultraviolet irradiation, electrophoresis). Procedures are not performed during the period of exacerbation of the disease.

Video: Therapeutic massage for coughs

The use of traditional methods for bronchitis

Traditional medicines based on natural ingredients help alleviate a child’s condition with bronchitis, carry out preventive treatment to prevent relapses, and strengthen the immune system. Such drugs, after consultation with the doctor, are taken as an addition to drug treatment.

Note: The famous Moscow doctor, chief pulmonologist of Russia, Professor L. M. Roshal, strongly recommends using the “Monastic Collection”, composed of 16 herbs (sage, string, wormwood and others) for chronic bronchitis. Herbal remedies, mustard, honey and other medicinal components used in traditional medicine cause allergies in many people. Therefore, they cannot be used by everyone.

A decoction of coltsfoot can be used as an expectorant; a decoction of St. John's wort, which has a bactericidal and anti-inflammatory effect, is good for soothing coughs in cases of simple bronchitis. A well-known cure for cough for bronchitis and pneumonia is baked radish with honey, oatmeal broth. Soda inhalations also help.

Effective home treatment methods include warming and distracting procedures (foot baths, mustard plasters, cupping, warming compresses on the right side of the chest are used).

The most important measure to prevent bronchitis is timely treatment of colds, runny nose, infectious diseases of the throat and upper respiratory tract. The child must be hardened, accustomed to physical education, and he must spend a lot of time in the fresh air. It is necessary to add vitamins to your diet all year round.

It is important for parents to ensure that the apartment always has clean, cool, sufficiently humid air.


Obstructive bronchitis is a disease of the upper respiratory tract, in which the mucous membranes of the trachea and bronchial tree are most actively affected.

It can manifest itself in an acute form, acquire the characteristic features of chronic obstructive bronchitis and develop into. The development of the disease is mainly caused by bacterial and viral infections.

The bronchi are an extensive network of tubes of different diameters that allow air to pass through. It enters, passing through the larynx, bronchi and into the lungs. When an infection gets into the bronchi and they become inflamed, air circulation is disrupted and the movement of air to the lungs becomes difficult. Obstructive bronchitis is essentially acute bronchitis, which occurs with bronchial obstruction syndrome.

To prevent obstructive bronchitis in children from acquiring an acute or chronic form, you need to know about its causes, treatment methods (Dr. Komarovsky’s advice will help with this) and features of prevention.

What reasons contribute to the development of the disease?

Let's first look at the word “obstructive” itself. This name comes from the word obstruction, which means squeezing, narrowing or spasm. The concept of “bronchitis” comes from the word bronchi, which means the name of the pulmonary section in the human body.

Let's summarize: obstructive bronchitis is a narrowing of the bronchi or a spasm, as a result of which the accumulated mucus cannot come out and thereby makes breathing difficult.

The causes of obstructive bronchitis in children include;

  • allergic inflammation of the bronchi - associated with an allergic reaction of the child (dust, pollen, animal hair, etc.);
  • viral infections;
  • hypothermia or overheating;
  • passive smoking - in addition to the fact that in general, inhaling tobacco smoke leads to a decrease in immunity, smoke also provokes excessive secretion of mucus, which can become bronchial obstruction;
  • polluted environmental situation;
  • frequent crying, during which natural breathing functions are disrupted;
  • birth injuries and health status in the first 2 years of a child’s life;
  • high humidity in the room leads to the formation of fungus, which provokes bronchial obstruction;

It is necessary to take measures immediately after diagnosis. How to treat obstructive bronchitis in children will depend on the severity of the symptoms, as well as the age of the child and his well-being.

Signs

The first signs of bronchitis are a runny nose and a runny nose that gets worse at night. A sick child feels weakness, pain in the chest, they are usually very restless, capricious, and there is increased nervous excitability.

Additional signs:

  1. Signs of difficult expiratory breathing appear, its frequency and duration of exhalation increases, it is noisy and is accompanied by a whistle that can be heard from a distance.
  2. Sometimes the child's chest visually increases in size.
  3. Pallor of the skin appears.
  4. The cough is initially unproductive and infrequent.
  5. Body temperature is low or normal.
  6. In the later stages of the disease, moist rales occur.
  7. X-ray shows signs of swelling of the lungs.

In older children, acute obstructive bronchitis is sometimes accompanied by sore throat or cervical lymphadenitis; it has a protracted course.

Symptoms of obstructive bronchitis in children

Most often, the first episode of obstructive bronchitis develops in a child in the 2-3rd year of life. In the initial period, the clinical picture is determined by increased body temperature, sore throat, runny nose, and general malaise. Young children often develop dyspeptic symptoms.

Bronchial obstruction can occur already on the first day of the disease or after 2-3 days. In this case, there is an increase in the respiratory rate (up to 50-60 per minute) and the duration of exhalation, which becomes noisy, whistling, and audible at a distance.

In addition to tachypnea, expiratory or mixed shortness of breath in children with obstructive bronchitis, the involvement of auxiliary muscles in the act of breathing, an increase in the anteroposterior size of the chest, retraction of its compliant places during breathing, and swelling of the wings of the nose are noted.

The cough in children with obstructive bronchitis is unproductive, with scanty sputum, sometimes painful, paroxysmal, and does not bring relief. Even with a wet cough, phlegm is difficult to clear.

Pallor of the skin or perioral cyanosis is noted. Manifestations of obstructive bronchitis in children may be accompanied by cervical lymphadenitis. Bronchoobstruction lasts 3-7 days and disappears gradually as the inflammatory changes in the bronchi subside.

Prevention

First of all, the prevention of obstructive bronchitis in children consists of strengthening the immune system: maintaining breastfeeding for at least a year, more walks in the fresh air, a varied and healthy diet, taking vitamins, and hardening.

In addition, it is very important to treat colds promptly and correctly, preventing the development of complications. Self-medication is the first enemy of health. Although the consequences may not appear immediately. This misleads parents about the harm of their actions.

Treatment of obstructive bronchitis in children: Komarovsky

A well-known specialist, Dr. Komarovsky, will tell you in detail about the symptoms, as well as how to treat obstructive bronchitis in children. We recommend viewing to all parents.

Stages of treatment

Acute obstructive bronchitis in children is a serious pathology that does not go away without treatment for a long time or is complicated by pneumonia, the development of respiratory failure and metabolic disorders in body tissues.

There are several situations when the presence of obstructive bronchitis in children requires urgent treatment in a hospital:

  1. Presence of obstruction in the infant.
  2. If, against the background of the disease, symptoms such as very high fever, general drowsiness and lethargy, nausea and loss of appetite develop.
  3. The appearance of signs of respiratory failure, such as acrocyanosis and severe shortness of breath.

Hospitalization and treatment of obstructive bronchitis in a child with the above symptoms in a hospital cannot be avoided, because Under the mask of ordinary bronchitis, a dangerous acute bronchitis may be hiding.

The goal of therapy for this disease is to eliminate the causes that caused it, relieve bronchial obstruction, improve the functioning of the respiratory system, and symptomatic treatment depending on the manifestations. First of all, measures are taken to cleanse the bronchi of mucus, and bronchodilator and anti-inflammatory measures are prescribed.

Medicines

Indicated in the first days of illness. For young children, suppositories (Genferon), nasal drops (Grippferon), syrups (Orvirem) are used; from the age of 3, tablet forms can be used (Arbidol, Kagocel, etc.).

Antibacterial therapy is not a mandatory component of the treatment of obstructive bronchitis, and the prescription and choice of the drug should be made only by a doctor. Indications for the use of antibiotics are:

  1. High fever for more than 3 days;
  2. Severe intoxication;
  3. Inflammatory changes in blood tests;
  4. Purulent (yellow, yellow-green) sputum is a sign of bacterial damage to the bronchi;
  5. The pediatrician listens for moist rales or other signs of possible pneumonia.

Inhalations

In order to reduce swelling and facilitate the passage of mucus, inhalation is used using a nebulizer inhaler using special solutions, which creates cold steam from tiny particles that are delivered to the lungs. This procedure is easy to use.

A dry, painful cough and difficult to separate sputum are treated with mucolytic drugs; such drugs stimulate the production of sputum in the child and have an anti-inflammatory effect. For children, a solution or syrup is used; such drugs are administered orally. Mucolytic drugs should be discontinued if a child develops a productive cough with sputum production.

After such treatment, the cough goes from paroxysmal, painful to wet. The sputum is less viscous, but does not come off easily. At this stage, mucoregulators are replaced by expectorants.

Preference is given to herbal medicines:

  1. "Bronchosan";
  2. "Bronchicum";
  3. "Gedelix";
  4. "Bronchipret";
  5. "Tussin";
  6. "Doctor Theiss."

Antitussive drugs containing codeine are not indicated and can be recommended (only by a doctor) for obsessive paroxysmal dry cough with mandatory monitoring of the child’s condition and correction of treatment.

Massage and breathing exercises

Massage is very useful for removing mucus. The baby needs to lightly tap the back of his hand with the edge of his hand. The older children are told to inhale and exhale slowly, smoothly, during which they tap.