Contributes to the development of bronchiolitis. Bronchiolitis in children of different ages: causes, symptoms, treatment and other features. Causes of development and risk group

A newborn child often has an incompletely formed immune system; the respiratory organs may be underdeveloped, which can lead to frequent infection of the bronchioles by viruses and the occurrence of bronchiolitis. In the article we will look in detail at the etiology, symptoms and methods of treating the disease.

Description of the disease

An inflammatory process that affects the lower respiratory tract, namely the small bronchi, and is accompanied by bronchial obstruction (blockage resulting in obstruction) is called bronchiolitis.

Bronchiolitis is fundamentally different from bronchitis. Firstly, with bronchitis, medium and large bronchi are affected, and secondly, this pathology develops much more slowly. Bronchiolitis spreads rapidly, affecting the terminal branches of the bronchial tree - bronchioles, the diameter of which does not exceed 1 mm. They participate in filling the blood with oxygen, distributing air flow into the alveolar ducts of the lungs, so their blockage (obstruction) leads to oxygen starvation and the development of shortness of breath.

Statistics show that bronchiolitis usually affects newborns. Most often, the disease strikes a child between the ages of 1.5 and 7 months, and in 95% of cases, bronchiolitis in infants appears after influenza or acute respiratory viral infection (ARVI). Pediatricians believe that the cause of this complication is the fragile immunity of the newborn, which is unable to contain the spread of viruses in the body, as a result of which they actively penetrate deep into the walls of the bronchi.

According to statistics, boys are more susceptible to such complications than girls.

The disease is very dangerous not only due to the rate at which symptoms increase, but also due to the high mortality rate of children due to untimely or unqualified medical care.

Causes

In addition to influenza and viruses, there are some other factors that provoke the appearance of bronchiolitis in newborns:

• the child's predisposition to allergies;
• excess weight baby due to poor nutrition with a predominance of flour (high in fast carbohydrates) and dairy products in the diet, plus vitamin deficiency;
• metabolic disease;
• feeding with artificial formulas;
• weak immunity from the first days of life;
• birth of a child earlier than expected obstetric terms;
• presence of cardiovascular and pulmonary diseases;
• congenital brain pathologies;
• proliferation of the thymus gland;
• poor living conditions: dirty premises, dampness, mustiness, mold damage;
• smoking parents;
• being close to relatives and friends who attend school and preschool institutions and could potentially be carriers of infection.

Types and forms

There are several types of disease. It depends on the pathogen, namely:

• Infectious. Caused by viruses. This is exactly what very young children often get sick with. As a rule, it develops as a complication after an untreated acute respiratory viral infection.
• Medication. Manifests itself against the background of taking certain medicines.
• Respiratory. Occurs when harmful gases, dust, or cigarette (tobacco) smoke enter the respiratory tract.
• Independent. In this case, it is difficult to identify the specific reasons why bronchiolitis develops in an infant. The pathology can be paired with other pulmonary and lymphatic diseases, or independent.
• Constructive. Heavy viral disease caused by progressive obstruction of the bronchioles.

There are also acute and chronic bronchiolitis:

• in the chronic course of the disease, significant structural changes are observed in the lungs and bronchioles. In this situation, the thinnest branches of the bronchial tree gradually narrow, which can lead to their complete closure. This is a life-threatening condition;
• the acute form manifests itself against the background of a bacterial, viral or fungal infection. Characterized by rapid development. Symptoms are observed immediately after infection and increase progressively. The disease can last for several months and become chronic.

Symptoms

Acute bronchiolitis in an infant is manifested by the following symptoms:

• loss of appetite or lack thereof;
• pale skin with a bluish tint;
• increased sweating;
• the child is mopey, sleeps poorly;
• rises heat;
• stuffy nose, runny nose;
• the baby rarely pees, experiences dry mouth, cries without tears;
• there is a cough, sometimes with sputum;
• wheezing and shortness of breath can be clearly heard;
• rapid breathing and heart rate are observed;
• the baby rushes around the crib, spins in his arms, cannot find a place for himself due to the fact that he does not have enough oxygen.

With bronchiolitis, spontaneous respiratory arrest (apnea) may occur. It occurs more often in premature babies.

At the onset of the disease, acute bronchiolitis can easily be confused with ARVI due to the characteristic manifestations: a stuffy nose in the baby and a runny nose, sore throat, increased temperature, and as a result, the child feels unwell. After a couple of days, coughing, wheezing (noisy, clearly difficult breathing) and shortness of breath appear. The wheezing is so strong that even a person without medical education can hear it without a phonendoscope. General state The baby's condition is rapidly deteriorating and sweating increases.

During the course of the disease, mucus accumulates in the lumen of the bronchioles, closing the passages in the bronchi

Mucus plugs lead to shortness of breath and poor ventilation of the lungs. So, if during obstructive bronchitis there is spasm of the bronchi, then during acute bronchiolitis in a child, poor airway patency is caused by swelling of the walls of the bronchioles and accumulation of mucus in the passages.

Lung aeration and gas exchange are maintained by increased respiratory rate, but not for long. When respiratory failure intensifies, there is a lack of oxygen and an excess carbon dioxide, areas of the lungs begin to swell.

With rapid diagnosis and proper treatment of acute bronchiolitis, the pathology disappears within 3 to 4 days, while bronchial obstruction is observed for another couple of weeks.

During chronic bronchiolitis in newborns, the main symptom is shortness of breath with intense growth and a dry cough.

It should be summarized and noted that the main difference between bronchiolitis is acute respiratory failure, which is extremely dangerous due to the risk of suffocation, and in the worst case can occur death. Therefore, a child suspected of having such a pathology should be quickly diagnosed and, based on its results, promptly provided professional help doctors

Diagnosis and treatment

For staging correct diagnosis a comprehensive examination is required, consisting of the following stages:

• listening with a stethoscope;
• general urine and blood tests;
• nasopharyngeal swab;
• chest x-ray;
• in severe cases, a tomogram of the lungs.

Children under 1 year of age must be hospitalized to avoid complications.

The appointment depends on the severity of the baby’s condition, but the basis of treatment must include:

• blood oxygen saturation;
• taking antibiotics, antiviral and anti-inflammatory drugs, as well as drugs that relieve pulmonary edema;
• inhalation with a nebulizer, as this is the most quick way“delivery” of medicine to the site of inflammation;
• monitoring the amount of fluid in the body and taking diuretics. Monitoring fluid intake is mandatory in this situation, because bronchiolitis in infants provokes serious fluid retention, which leads to severe swelling of the bronchi.

It is important to understand that during a child’s illness it is strictly prohibited:

• treat the baby at home without qualified supervision by a pediatrician or simply wait for the condition to improve;
• independently prescribe medications to your child;
• give herbal decoctions, because this may further provoke shortness of breath;
• give the child compresses, mustard plasters and apply warming ointments.

You should definitely remember that you should not vaccinate for 5-6 months after the illness, since the child’s immunity is still weakened.

Important! Bronchiolitis in an infant is a very serious disease that can lead to the death of the baby in just a week.

Complications

The consequence of bronchiolitis is cardiac and respiratory failure. This is especially true for premature babies and children with weakened immune systems.

Against the background of illness and general weakening of the body, a secondary bacterial infection which will lead to pneumonia. Bronchial asthma is also a common complication.

It should be noted that even after complete relief from bronchiolitis, the sensitivity of the bronchi to infections and the tendency to relapse remain

Therefore, after recovery, observation by a pediatrician, allergist and pulmonologist is simply necessary for at least six months.

Prevention

It is known that it is easier to prevent a disease from entering than to cure it. That's why good care for the baby breast-feeding, timely and competent complementary feeding, walks fresh air, gymnastics and developmental exercises will help parents strengthen the child’s immunity, and therefore protect him from many diseases, including bronchiolitis.

Pediatricians give general advice on how to prevent bronchiolitis in infants:

• seek medical help in a timely manner so as not to develop severe respiratory diseases;
• provide the child with fortified and balanced nutrition;
• If possible, avoid communication with other ARVI patients as much as possible;
• avoid contact with allergens;
• keep the house clean;
• Avoid tobacco smoke near the child.

Bronchiolitis – complex disease for kids early age, requiring timely and competent treatment. Under no circumstances should the disease be ignored. Contacting doctors for initial stage and proper therapy will reduce the risk possible complications and transformation of the disease into a chronic stage, and will also help to get rid of the pathology forever and without consequences.

When a child is sick, parents always worry. Particular concern arises if the doctor makes a diagnosis that is not the most popular, for example, bronchiolitis. What is this disease and how does it manifest itself?

Causes of the disease

Experts consider respiratory syncytial virus to be the leading causative agent of acute bronchiolitis.

Bronchiolitis is an inflammation of the smallest branches of the bronchi - bronchioles. This disease most often affects children under 3 years of age. More than 60% of young patients are boys.

According to the nature of the disease, it can be:

• acute – lasts no more than 5 weeks,
• chronic – lasts for 3 months or longer.

The culprit of acute bronchiolitis in most cases is respiratory syncytial virus (RSV). Similarly, this infection likes to “walk” during the cold season - from October to April. However, unlike the common cold, RSV hits the lower respiratory tract rather than the upper respiratory tract.

Infection usually occurs by airborne droplets. This means that the virus is transferred from sick people to healthy people through sneezing and communication. Less commonly, the infection is transmitted through dirty hands, shared towels, and toys.

In a small number of children, other microorganisms become causative agents of the disease:

• influenza viruses,
• adenoviruses,
• parainfluenza,
• mycoplasma.

Chronic bronchiolitis can develop as a consequence of acute bronchiolitis, but usually it is an independent disease caused by prolonged inhalation of irritating gases. Very often this disease is found in children living in smoking families.

The rapid development of inflammation is promoted by:

• low baby weight,
• weakened immunity,
• age under 3 months,
• diseases of the cardiovascular system,
• congenital defects of the respiratory tract,
• visiting a nursery/kindergarten,
• smoking by parents in the presence of the baby.

Among newborns, children who are bottle-fed are more likely to get sick. Their body is more susceptible to infections due to the fact that it does not receive antibodies from mother's milk.

Clinical picture

The initial symptoms of the disease are similar to a cold. Children develop a dry cough and fever. After a few days the condition worsens. The temperature continues to rise (up to 39 degrees), appetite decreases. But the main thing is that respiratory failure develops.

Inhaling air, the child wheezes, the wings of his nose swell and the nasolabial triangle turns blue. Shortness of breath and rapid heartbeat are added. Vomiting may occur after severe coughing attacks. It is most difficult for infants, because due to anatomical features chest they are unable to cough properly.

In severe cases:

• "bloating of the chest,
• sudden holding of breath (apnea),
• swelling.

Development can be a dangerous complication of the disease.

Diagnostics

To make a diagnosis, the doctor only needs to examine the child and listen to the parents’ complaints. To distinguish bronchiolitis from other pathologies (for example, pneumonia), the doctor may order a chest x-ray.

The causative agent of the disease is identified by a general blood test. For viral infections, the results show increased amount lymphocytes and monocytes. The neutrophil content is below normal. With bacterial infections, the number of leukocytes and neutrophils increases.

To detect respiratory syncytial virus, rapid diagnostic methods are used. Swabs from the nasal cavity are taken as material for analysis. They are applied to special test systems that react to the presence of RSV by changing color.

In case of severe shortness of breath, pulse oximetry is performed - a test that helps determine the degree of oxygen saturation in the blood. Values ​​below 95% indicate respiratory failure.

Therapy methods

The child is prescribed ultrasonic inhalations with saline solution, and in severe cases, with corticosteroids.

In case of bronchiolitis, the child must be hospitalized. Treatment tactics are aimed at maintaining normal breathing and preventing complications.

If RSV is detected, a specific antiviral drug is prescribed - Ribavirin. It blocks the reproduction of the pathogen and prevents further development diseases.

If a bacterial infection has been established, the child is prescribed antibiotics. Preference is given to drugs from the group of penicillins and cephalosporins (Ampicillin, Cefotaxime). Medicines are administered intramuscularly for 7–10 days.

If necessary, the doctor recommends sputum thinners (mucolytics - Ambroxol, Bromhexine). To facilitate the passage of mucus, it is also prescribed. In severe cases, inhalations with corticosteroids (Dexamethasone) are added, which have an anti-inflammatory effect.

In addition to medications, a mixture of oxygen and helium is given through a mask. This allows you to reduce the manifestations of respiratory failure and improve the patient’s well-being.

Since babies lose a lot of fluid due to rapid breathing, they are advised to drink plenty of fluids. Liquids give 2 times more compared to daily requirement. If the child refuses to drink, he is given saline solution through an IV.

For 5 years after bronchiolitis, children retain high susceptibility of the bronchi to the action of negative factors. Such babies are more prone to bronchitis and bronchial asthma Therefore, they require long-term observation by a specialist.

The child’s immune system is not fully formed, so they susceptible various diseases . Bronchiolitis in children occurs and develops for certain reasons.

This disease affects the respiratory system of the body, negatively affecting not only the respiratory organs, but the functioning of the entire body. To help the child, it is necessary to start treatment as early as possible.

Concept and characteristics

Bronchiolitis is acute inflammatory disease, affecting the lower respiratory tract. The bronchioles, which belong to the final smallest bifurcations of the bronchi in the pulmonary lobules, are primarily affected.

The disease is characterized by symptoms of respiratory failure and impaired pulmonary ventilation.

Most often, the disease occurs in autumn and winter, when the child’s immunity is weakened.

Causes of development and risk group

The main causes of the occurrence and development of the disease are:

1. Viral infection. It penetrates the child’s body and begins to actively influence the body, which leads to pathology.
2. Low immunity. If the child’s body is weakened and unable to resist, the disease develops quickly.
3. Incompletely formed respiratory system child. The protective properties are poorly developed, so the virus easily penetrates the body and develops.
4. The child's tendency to. Increases the likelihood of bronchiolitis several times.
5. Unfavorable living conditions for children's bodies: dampness, cold, poor hygiene, dirt. Significantly increase the likelihood of illness.
6. Artificial feeding. Reduces the protective properties of the child’s body and increases the likelihood of bronchiolitis.

The risk group includes newborns, infants, whose immune system is just developing.

Children at this age are vulnerable to infections and viruses. If harmful microorganisms have entered the baby’s body, the reaction will occur instantly.

The child will immediately get sick. Newborns and infants the disease is very difficult to bear, so they need increased attention from parents and doctors.

What are the causes of bronchiolitis in young children? At an early age, pathology appears due to an immature immune system. The body can be weakened, so it is easily attacked by infections.

The disease often occurs in premature babies whose respiratory system is not fully developed. In this case, it is easier for pathogenic microorganisms to penetrate the body and have a negative impact.

Forms and classification

Experts distinguish two forms of pathology:

• acute. Appears due to infection and develops quickly. Lasts up to five months, then disappears or becomes chronic;
• chronic. Happening qualitative changes in bronchioles and lungs. The lumen narrows greatly, blockage may occur, which makes breathing very difficult and may lead to a lack of oxygen.

Depending on the pathogen, there are several types of disease:

How is bronchopulmonary dysplasia treated in premature babies? find out right now.

Features of obliterating

Features of the pathology include:

1. Dyspnea. It can occur even in a calm state.
2. Presence of dry unproductive cough. Sometimes there is sputum.
3. Wheezing, whistling when breathing.
4. There is a narrowing of the lumen of the small bronchi and bronchioles. It leads to impairment of pulmonary blood flow, which leads to the development of a pathological process in the lungs.

Bronchiolitis obliterans is a chronic form of bronchiolitis. It is difficult to tolerate and leads to serious illnesses Not only respiratory system, but also cardiovascular.

Clinical picture and symptoms

Experts consider the symptoms of the disease to be:

Consequences and complications

If the disease is not treated, it may develop complications and undesirable consequences:

• cardiovascular failure;
• pulmonary hypertension;
• emphysema;
• prolonged pauses in breathing;
• renal failure;
• pneumonia.

Treatment methods

How to treat bronchiolitis in children? To eliminate pathology they are used different ways treatment. First of all, the following drugs are prescribed:

• Ribavirin;
• Anaferon.

These medications are antiviral. They fight harmful microorganisms and stop the development of the disease. The child should be given one tablet 2-3 times a day. The duration of medication is prescribed by the doctor.

If the disease is caused by pathogens bacteria, you must take:

• Macropen;
• Clarithromycin.

These medications are very effective, so the dosage is determined by the doctor. Typically, patients take one tablet 1-2 times a day.

It is taken one teaspoon 2-3 times a day. With its help, it is possible to relieve swelling, cough, and stop the development of the disease. Duration of taking the drug prescribed by a doctor.

Folk remedies

You can treat a child not only with medications, but also folk remedies, which are no less effective.

Will help you recover carrot juice. To do this, fresh carrots are washed, peeled, and grated.

Juice is extracted from the pulp. It is diluted in equal parts with warm boiled water. You need to add to the solution two teaspoons of honey. The finished medicine is taken one tablespoon 3-4 times a day before meals.

Fights the disease infusion of coltsfoot. To do this, mix several leaves of the plant and a glass of boiling water. The solution is infused for thirty minutes, then filtered. The finished product is consumed two tablespoons 2-3 times a day.

To do this, fatty and fatty foods are excluded from the diet. fried foods, sweets and baked goods. We need to add more fruits, vegetables, vegetable soups, vitamin teas. If your baby is sick, mother follows the diet.

Prevention

This disease causes harm to the child’s body and is accompanied by unpleasant symptoms. The child should be treated as early as possible, otherwise complications and negative consequences will arise.

Lecture on bronchiolitis in young children in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Respiratory diseases are very common in children, infants and newborns are especially susceptible to them, which is explained by the immune system not yet being fully formed. One of the diseases that affects the lungs is bronchiolitis. How to quickly recognize pathology and provide qualified assistance to a child?

What is bronchiolitis

Bronchiolitis is an acute inflammatory disease of the lower respiratory tract, which affects the bronchioles - the final tiny bifurcations of the bronchi in the pulmonary lobules. The pathology is accompanied by symptoms of respiratory failure, or broncho-obstruction, and clinical signs similar to the manifestations of ARVI.

Bronchoobstruction is a clinical syndrome characterized by impaired pulmonary ventilation and difficulty in clearing mucus.

Bronchiolitis is inflammatory process which occurs in the bronchioles

Most often, the disease is caused by viruses, and the peak incidence of its development occurs in the autumn-winter period. Diagnosing bronchiolitis today is not difficult, but ignoring the disease can lead to serious complications.

Classification and causes of the disease

Depending on the cause that provoked the development of the disease, the following types of bronchiolitis are distinguished:

• post-infectious. It is most often diagnosed at an early age. Infection occurs by airborne droplets;
• inhalation Found in children who are forced to constantly inhale tobacco smoke;
• drug. May develop after a course of antibiotic therapy;
• obliterating. It has the most severe course. It is extremely rare in children;
• idiopathic. Combined with other pathological conditions, such as lymphoma, idiopathic pulmonary fibrosis and others.

Children prone to allergic reactions are more susceptible to bronchiolitis than others.

Based on the nature of the disease, it is customary to distinguish:

1. Acute bronchiolitis - develops within 2–3 days after infection, and a pronounced clinical picture is observed. The acute period of the disease lasts 5–7 days.
2. Chronic - as a result of prolonged exposure to negative factors, the tissues of the bronchioles undergo destructive changes. In most cases it develops in older children.

Causes and causative agents of the disease at an early age - table

Type of bronchiolitis	Pathogen/cause
Post-infectious	respiratory syncytial virus (RSV); adenovirus; influenza virus, parainfluenza; mumps virus; rhinovirus; virus
Inhalation	gas (carbon dioxide, sulfur dioxide, etc.); acid evaporation; tobacco smoke; dust, etc.
Drug	Preparations containing the following active ingredients: penicillin; interferon; cephalosporins; bleomycin; amiodarone.
Obliterative	cytomegalovirus; legionella; HIV infection; herpes virus; Klebsiella etc.
Idiopathic	reason unknown

Risk factors

There are a number of factors that significantly increase the risk of developing bronchiolitis in children:

• child's age up to 3 months;
• prematurity;
• low weight of the newborn;
• improper treatment of respiratory diseases in a baby;
• the presence of other lung diseases or pathologies of the cardiovascular system;
• immunodeficiency states;
• hypothermia.

The fact that this disease mainly affects young children is explained by the following:

1. The bronchial tree in infants is not yet fully formed, so inflammation of even a small number of bronchioles can lead to serious consequences for the child.
2. Unprotected immune system. Interferon and immunoglobulin A are produced in insufficient quantities in the respiratory organs.

Symptoms and signs

The first manifestations of acute bronchiolitis are:

• nasal congestion;
• cough.

Then the disease spreads to the small bronchi, and the following symptoms appear:

• irritability;
• lethargy;
• rapid breathing;
• dry wheezing;
• weight loss associated with the child’s refusal to eat;
• shortness of breath, which is very disturbing when eating.

The patient's condition deteriorates very quickly.

Easiest to treat early bronchiolitis, and with a late form of the disease, symptoms may persist for more than 3 months

As for chronic bronchiolitis, shortness of breath is its constant companion. Body temperature constantly rises and falls. There is weakness, sputum is produced when coughing, and the skin has a bluish tint. The fingers become like drumsticks.

Features of the disease in infants and newborns

Most often, children under the age of one year suffer from bronchiolitis. Infants suffer from this disease much more severely, so when the first signs appear, it is necessary to seek medical help.

Babies, including newborns, experience the following symptoms:

• attacks of asphyxia (temporary cessation of breathing);
• watery nasal discharge;
• cough;
• difficulty breathing (a sick child makes considerable efforts to exhale);
• lack of appetite;
• retraction of the large fontanel (against the background of dehydration);
• increase in body temperature up to 39 degrees;
• excessive excitement or, conversely, drowsiness.

Diagnostics

The diagnosis is made by a pulmonologist based on a physical examination and auscultation (listening).

When examining patients with bronchiolitis, the doctor pays attention to the frequency and nature of breathing, the presence of cyanosis of the skin, retraction of yielding places in the chest (the spaces between the ribs and near the collarbones), and the duration of exhalation.

If there is an increased risk of complications, additional examinations are prescribed, in particular:

• biochemical and general blood tests (with bronchiolitis there is an increase in the number of leukocytes);
• general urine analysis;
• bacteriological examination of mucus from the nose and throat (to exclude the bacterial nature of the disease);
• CT scan;
• spirometry, or spirography (allows you to measure the volume of the respiratory system);
• blood gas test (carried out to detect insufficient oxygen supply to the body);
• chest x-ray (to exclude acute pulmonary emphysema).

Treatment of bronchiolitis in children

The essence of therapy is to eliminate respiratory failure and overcome infection. In acute cases of the disease, it is necessary to hospitalize the child in the hospital.

Treatment of bronchiolitis requires integrated approach and includes:

1. Bed rest (until body temperature normalizes).
2. Limiting the amount of liquid the child consumes.
3. Drug therapy, in particular:
   • antiviral agents (Ribavirin);
   • expectorant medications (Lazolvan, Bromhexine);
     

     Such drugs cannot be used in the treatment of infants, as this can lead to blockage of the bronchi with mucus.

   • saline solutions (Otrivin Baby);
   • bronchodilators;
   • inhalations with corticosteroids;
   • antibacterial drugs (Sumamed, Macropen, Clarithromycin).
     

     Antibiotic therapy is indicated only if the bacterial nature of bronchiolitis is identified. Prescribed at the discretion of the attending physician.

4. Breathing exercises. It is necessary to apply light pressure on the baby's chest and tummy as you exhale.
5. Vibration massage, which consists of light tapping movements with the edge of the palm in the direction from the bottom of the chest to the top. The baby is placed in such a way that the butt is slightly higher than the head.
6. Oxygen therapy (to eliminate respiratory distress syndrome).

Since bronchiolitis is transmitted by airborne droplets, the patient should be isolated. As a rule, when the baby’s appetite is restored, body temperature returns to normal and there is no need for oxygen therapy, the child is allowed to go home from the hospital.

Drugs for the treatment of the disease - gallery

Prognosis and possible complications

With timely diagnosis of the disease and compliance with all doctor’s recommendations, treatment has a favorable prognosis. Otherwise, the following complications may occur:

• pulmonary hypertension;
• cardiovascular failure;
• prolonged pauses in breathing;
• emphysema;
• renal failure;
• bronchial asthma;
• pneumonia.

Complications from bronchiolitis are most often observed in premature infants, as well as in those who suffer chronic diseases heart or lungs.

Prevention

To avoid bronchiolitis, you must:

• exclude contacts of healthy children with sick ones;
• harden the child, provide him with adequate nutrition and organize a healthy daily routine;
• monitor the condition of the baby’s nasopharynx, clean it of crusts and remove mucus;
• avoid hypothermia;
• promptly treat infectious and viral diseases;
• Avoid crowded places during ARVI outbreaks.

Doctor Komarovsky about cough in children - video

Bronchiolitis is a serious disease that often occurs in young children. Timely diagnosis and proper treatment will help avoid serious complications. Therefore, if the first symptoms occur, consult a doctor immediately. Health to you and your baby!

Bronchiolitis is an inflammatory process that occurs in the respiratory canals, resulting in partial or complete blockage of bronchioles and small bronchi. Why do young children develop this disease, how to distinguish bronchiolitis from other diseases of the bronchopulmonary system, and what methods medicine uses to diagnose and treat this disease, read the article.

Why do children of early age and older develop bronchiolitis: the main reasons

It is believed that infants and children under 3 years of age are most often affected by this disease. This is due to the fact that children of this age have not yet fully strengthened their immune system. Parents should be especially careful in late autumn and early winter; doctors say that this is when the peak of this disease occurs. The most vulnerable are children who are prone to allergic reactions. The disease is caused by a virus or bacterial-viral infection.

Factors that provoke the development of bronchiolitis:

• poisoning or any intoxication of the child’s body;
• heart or lung transplant surgery, after which complications arise;
• the presence of mycoplasma in the child’s body;
• connective tissue disorders;
• inflammatory processes of the digestive system;
• carrying out radiation therapy;
• hypothermia of the body;
• entry of cold air into the respiratory tract.

Various children may encounter similar factors, but many children's bodies resist the viruses of this disease well.

A child is at risk for bronchiolitis if:

• the baby's weight is very small;
• the child is bottle-fed;
• baby under 3 months;
• there are chronic or congenital diseases of the heart and respiratory tract;
• for some reason the child’s immune system is weakened;
• The baby grows up in a smoking family.

Types of bronchiolitis in children: signs of acute and obliterating forms of the disease

Types of bronchiolitis in children:

• Inhalation– bronchiolitis, which is formed as a result of inhalation of dust, gases and all kinds of chemicals.
• Drug- appears as a result medicines, which are taken for any other disease. Particular care should be taken when taking interferon, bleomycin, and cephalosporin.
• Post-infectious – viruses can enter the respiratory tract, causing this disease. It is transmitted by airborne droplets and is most common in children.
• Obliterative– such bronchiolitis is provoked by other viral diseases, such as herpes, HIV, pneumocystitis and others. Its course is considered the most difficult.
• Idiopathic– the causes of this bronchiolitis cannot be determined. Combined with other diseases (lymphoma, iliopathic pulmonary fibrosis and others).

Bronchiolitis can occur in acute and chronic forms:

• With an acute illness, the child may be ill for a month or less. The symptoms are pronounced. In this case, the baby experiences a sharp deterioration in his condition and an acute problem with breathing.
• In the chronic form, the symptoms are mild and noticeable only with careful monitoring of the state of health. The duration of the disease can stretch up to 3 months or more.

Bronchiolitis obliterans is most severe in its acute form. Most often it affects children from 2 to 6 months, sometimes up to 1 year. To provide quick help, you need to know the signs of this disease.

Signs of bronchiolitis obliterans:

• breathing problems are clearly visible - there is shortness of breath, strong intake of air, groans;
• cases of apnea - stopping breathing - cannot be excluded;
• the baby refuses to eat;
• refusal of water;
• the child’s skin becomes pale, with a bluish tint;
• crying, restless sleep, agitated state;
• urination is rare;
• bouts of dry cough;
• the temperature is not too high.

With these signs, it is necessary to get help from pediatricians as soon as possible.

How to determine bronchiolitis in a child: diagnostic methods

In order to begin treatment, it is necessary to make a correct diagnosis. In the case of bronchiolitis, an x-ray will not help, since this disease does not affect the lungs and this method is not effective. To make an accurate diagnosis, it is necessary to rely on the main symptoms, and a number of studies are carried out to confirm the presumptive diagnosis.

Diagnostic methods for determining bronchiolitis

• Ascultation (listening to the patient to detect wheezing).
• . In this case, the ratio of oxygen and carbon dioxide in the blood is considered. In case of illness it is disrupted the right balance. Using the same analysis, information about ESR, hypoxemia and leukocytosis is obtained.
• Percussion (tapping with fingers) in order to identify the nature of the sound.

How to distinguish bronchiolitis from asthma and pneumonia during diagnosis?

In order not to confuse bronchiolitis with pneumonia or asthma, differential diagnosis is carried out. It is as follows:

1. Detection of acute respiratory infections in people who surround a sick child (it is the acute respiratory infections of those around them that cause the baby’s illness).
2. Identification of an allergic history (if, for example, parents suffer from asthma, then the child may have the same disease).
3. The child is prescribed a β-adrenergic drug. The child's reaction to treatment with this drug indicates whether he has asthma.
4. An x-ray is taken. It does not show bronchiolitis, but pneumonia can be excluded, or its manifestation can be detected. X-rays are effective in detecting pneumonia.
5. A blood test is done to further confirm or rule out asthma.

What is worse, bronchiolitis, pneumonia or obstructive bronchitis: what is the difference?

Effective methods of treating bronchiolitis in children

Due to the fact that bronchiolitis is a disease of very young children, self-medication is extremely dangerous. Regardless of the form of the disease (acute or chronic), treatment should only be prescribed by a doctor.

It is the doctor who will be able to correctly select the methods that will be most productive at a given age and with a certain severity of the disease. If the child is in an acute form of the disease, he is hospitalized. If the form of bronchiolitis is mild, home treatment is prescribed.

Treatment of bronchiolitis consists of the following steps:

1. For treatment, the doctor uses medications aimed at eliminating the underlying cause of the disease. For this purpose, drugs are prescribed that are destructive to the virus or bacteria, depending on the origin of the disease.
2. After eliminating the causes, the eradication of symptoms begins - the cough itself is eliminated. Inhalations (ultrasonic nebulizers are used), mucolytic drugs, and oxygen masks are very effective. At the same time, the child must be given plenty of fluids (2 times more than usual).
3. After the child has fully recovered, the doctor prescribes preventive measures that parents must take (hardening, mandatory regimen, proper nutrition, preventing child hypothermia).