🐳 📉 🧔🏼 Acute bronchitis in a child: symptoms, treatment and prevention of the disease 🗼 🧑 👨🏾

The inflammatory process that occurs in the bronchi with a primary lesion of their mucous membrane is called bronchitis. The pathological process in which inflammation affects the walls and mucous membranes of the bronchi is acute bronchitis. Symptoms in a child develop rapidly, on the second or third day from the onset of acute respiratory viral infections, which is often the cause of bronchitis. With a complicated and protracted course of the disease, the lesion affects the fibro-muscular tissue of the walls of the organ. Acute bronchitis ranks first in frequency of occurrence and second in severity. Every year, about a hundred and fifty thousand children get sick with it.

general information

The bronchi, or bronchial tree, are part of the respiratory system of an individual. Thanks to the cilia, which are lined with their surface, the air is cleaned of dust and microorganisms.

When inhaling, air enters through the larynx and trachea, and then passes into the branched system of the bronchi, which deliver oxygen to the lungs. Plots of bronchi called bronchioles are adjacent directly to the lungs. On exhalation, gas exchange products formed in the lungs through the bronchi and trachea are excreted. Therefore, violations of their patency negatively affect the breathing process and lead to insufficient supply of oxygen to the body. The mechanism of the development of the disease is as follows. The causative agent, once on the wall of the bronchi, provokes an immune response in the form of:

swelling
increased volume of mucus produced;
increased blood supply to the affected area.

Thus, the body takes actions aimed at neutralizing a bacterial, viral or other pathogenic agent.

Acute bronchitis in a child: causes

The viral etiology of the pathology differs depending on the age category of the children. The provocateurs of the disease are:

Up to two years old - rino, entero, cytomegaloviruses, as well as herpes virus and respiratory syncytial.
Up to three years - parainfluenza and influenza viruses.
Children of the third year of life - corona-, adeno-, rhinoviruses and parainfluenza, respiratory syncytial virus.
In children from five to eight years old - influenza viruses and adenoviruses.

An independent cause of acute bronchitis in a child 3 years old or older is viruses, in contrast to infants and babies up to three years. In this age category, they are joined by a bacterial infection, which is represented by the following microorganisms: streptococci, pneumococci, Pseudomonas aeruginosa and Escherichia coli, Mycoplasma.

In addition, the causes of the disease are: congenital anomalies, parasitic pathogens, fungi, adverse factors - severe gas contamination, industrial and tobacco smoke, low air temperature, various allergens and other factors.

Acute bronchitis is also a symptom of another disease, for example, flu, diphtheria, measles.

Thus, in newborns and infants, mixed and bacterial nature is dominated by acute bronchitis. In a 5-year-old child, the development of the disease occurs due to the negative influence of allergic, physical and chemical factors. In older children and adolescents, viruses act as provocateurs.

In the epidemiological plan, seasonal outbreaks of influenza and SARS, the cold season, and being in children's groups are important. Polluted air, passive smoking, hypothermia, or vice versa overheating, are also considered provocateurs of the disease.

Risk factors

The following factors increase the likelihood of developing acute bronchitis:

in young children, a chronic digestive upset, with an existing shortage of body weight and exhaustion;
prematurity;
birth injuries;
congenital malformations of the respiratory system;
abnormalities of the nasopharynx - curvature of the nasal septum, adenoids;
frequent respiratory diseases - tracheitis, rhinitis, pharyngitis, laryngitis;
diathesis;
chronic infections - tonsillitis;
seasonal epidemics of SARS and influenza;
finding a child in children's organizations;
autumn-winter period;
insufficiently good social conditions.

Diagnostics

A preliminary diagnosis is made by a pediatrician, specifying - an allergist-immunologist or pulmonologist. The following methods are used for diagnosis:

General blood test - the following indicators are analyzed: ESR, lymphocytes, white blood cells, neutrophils.
Microscopic examination, PCR - secret (sputum) is examined. Using this analysis, infection with Koch's bacillus is excluded.
X-ray of the lungs - in the pictures is an increase in the vascular pattern in the lower lobes of the lungs. With bronchiolitis and obstructive bronchitis, bloating of the lung tissue, flattening of the diaphragm, and expansion of the intercostal spaces are observed.
The study of the functions of external respiration is carried out in older children.

Classification

According to the presence of complications and a variety of symptoms, acute bronchitis in a child is divided into types such as:

Simple - a viral infection is considered to be his provocateur. An ailment proceeds without signs of impaired air patency and does not give complications. It affects a child of any age.
Obstructive - there are symptoms of obstruction, which can lead to a malfunction of gas exchange in the lungs and contribute to the occurrence of hypoxia. Obstruction develops due to swelling of the mucosa, increased synthesis of mucus, thickening of the walls of the bronchi and their spasm. This form of bronchitis is most often diagnosed in children two to three years old.
Bronchiolitis - in this case, the smallest bronchi are affected. In children, there is severe respiratory failure, air patency failure. Often they suffer from crumbs up to a year.
Obliterating - bronchioles, small bronchi, alveoli are affected.
Relapsing - cases of acute bronchitis occurring against the background of respiratory viral infections are repeated several times during the year. This variety is often found in children four to five years old.

Depending on the nature of the pathogen, acute bronchitis can be caused by:

Bacteria - mainly pneumococci, in rare cases - a hemophilic bacillus.
Viruses - adenovirus, parainfluenza virus and PC virus (common pathogens), influenza viruses, measles, rhinoviruses. In children in the first three months of life - entero-, cytomegaloviruses and herpes viruses.
Bacteria and viruses.
Viruses and fungi.
Mycoplasma and chlamydia.

Non-infectious acute bronchitis is divided into:

Irrigation - occurs when the negative influence of physical or chemical factors that have an irritating and traumatic effect on the respiratory system. A cough in a child with acute bronchitis in this case is observed with the release of profuse watery sputum. In addition, there is swelling of the mucosa.
Allergic - the cause of its appearance is allergens that penetrate with the air into the respiratory tract. The occurrence of bronchospasm is not excluded. As a result of narrowing of the lumen of the bronchi, mucus accumulates in them, which is especially good for the multiplication of pathogens. Therefore, its course is often complicated by the accession of infection.

Signs of illness

The main symptom of acute bronchitis in children is a cough. Depending on the severity of the course of the disease, as well as the causes that caused it, other signs differ slightly:

Allergic - has a chronic nature, proceeds without temperature. During exacerbations, sweating, malaise, and coughing appear. Atopic dermatitis and conjunctivitis often join. Before prescribing therapy, an allergen is detected. There is a high risk of developing bronchial asthma.
Simple acute bronchitis - the child’s temperature rises, nausea, cough, general weakness appear. These symptoms last about three days. If bronchitis is caused by mycoplasma or adenovirus, then fever occurs within a week. Changes in breathing and wheezing are not observed.
Relapsing or chronic - the main symptom is cough, during the period of the weakening of the disease it becomes dry, and with exacerbation, i.e., exacerbation, it is wet. The secret with purulent impregnations departs in small numbers and with great difficulties.

Clinical picture

Let us consider in more detail the clinical manifestations of different types of acute bronchitis in children: simple, bronchitis, obstructive. In the first case:

External signs - weakness, excessive sweating, hoarseness, auxiliary muscles are not involved in breathing.
Breathing is hard with wheezing and prolonged exhalation. Respiratory failure and shortness of breath are found only in the smallest patients.
Pain syndrome - behind the sternum, in the throat, headache. In addition, sore throat and burning.
The cough is initially frequent and dry, by the fifth day it becomes moist and then gradually disappears.
Temperature - rises to thirty-eight degrees.
Concomitant symptoms - pharyngitis, rhinitis, conjunctivitis, laryngitis.

The duration of the disease is from five to fourteen days.

In acute bronchiolitis, the following clinic is observed:

External signs - during breathing, the chest is retracted, the wings of the nose swell, the nasolabial region and the body are bluish in color, additional muscles are involved in breathing.
Respiration is heavy and with severe shortness of breath, respiratory failure is present, and when listening to wheezing, it is crisp and moist.
Pain syndrome - in the abdomen and chest.
Cough - in periods, sometimes with a secret.
Temperature - in most cases, normal or subfebrile.
Concomitant symptoms - rapid breathing without rhythm failure, tachycardia, intoxication, pharyngitis, fever, rhinitis.

The duration of the disease is up to five months.

Symptoms of acute obstructive bronchitis in children:

External signs - the chest is swollen, auxiliary muscles, pale skin integument, cyanosis around the lips participate in breathing.
Breathing - with a whistle that is heard from a distance. It is difficult to exhale, there is no obvious shortness of breath. There are scattered wheezing in the lungs.
Pain syndrome - in rare cases, headache. Sore throat and soreness.
Cough - persistent, paroxysmal, dry. After a few days, it may become wet.
Symptoms of acute bronchitis in children without fever are observed only after a few days. In the initial phase of the disease, it is high.
Concomitant signs - moderate fever, pharyngitis, rhinitis, laryngitis.

A distinctive feature - with auscultation, an extended exhalation and wheezing. When tapping the lungs, low tympanitis is possible. On the x-ray, the position of the ribs changes, they acquire a horizontal position, and the diaphragm, its dome is flattened and lowered, the pulmonary field becomes more transparent. The duration of the disease is from ten to twenty days.

Bronchiolitis

In the youngest children, it is this form of acute bronchitis that develops. Symptoms in children under 2 years of age are as follows:

hyperthermia;
cough with a lot of sputum, and sometimes with an admixture of blood;
dyspnea;
bronchial spasm with wheezing dry rales;
cyanosis of the dermis in the region of the nasolabial triangle;
the clinic of respiratory failure develops rapidly in the absence of adequate therapy.

In addition, the baby's general well-being worsens, weakness and anxiety appear, increased sweating, sneezing, and rhinitis are observed.

The reason for the defeat by viruses of the small bronchi and bronchioles at this age is unformed immunity and underdevelopment of the respiratory organs.

Therapeutic measures are carried out in stationary conditions and include:

Strict bed rest.
For infants, the number of feedings is increased by two. For other children, the daily volume is reduced by half, while they give balanced, high-calorie and hypoallergenic food.
The amount of fluid is increased by one and a half times.
Antiviral drugs.
Bronchodilators are inhaled.
Antibiotics in rare cases.

As additional funds for the treatment of symptoms of acute bronchitis in children under 2 years of age, medicines of the following pharmacological groups are used: mucolytics, expectorant, antipyretic, antihistamines. As well as breathing exercises, vibration massage, physiotherapy exercises.

Uncomplicated form of bronchiolitis lasts no more than three weeks. However, a prolonged period after recovery in the baby persists lingering cough. The reason for this phenomenon is the increased sensitivity of the bronchi.

Mechanisms of bronchial patency failure

The phenomena of obstruction in acute bronchitis in a child depend on age:

2 years - a large amount of mucus produced is considered the leading cause. The muscles of the bronchi and epithelial cells are not able to cope with its excretion, as a result, it accumulates and blocks the lumen of the bronchi.
At the age of three to seven years - narrowing of the lumen is associated with swelling of the walls of the organ.
Schoolchildren often form a sharp reduction in the bronchi, i.e. bronchospasm.

Acute obstructive bronchitis in children, the clinical protocols of treatment of which are known to any therapist, is manifested by noisy breathing with wheezing exhale. It can be heard even from a distance. The origin of this phenomenon is caused by the following reason: in connection with the existing obstacle in the large bronchi and trachea, turbulent air movement occurs. In addition, there is a hypothesis that bronchial obstructive syndrome plays a protective role, that is, it prevents the penetration of infection into the respiratory parts of the lungs.

Drug and non-drug therapy

It is carried out under the supervision of a pediatrician. Consider how to treat acute bronchitis in a child using drugs of different pharmacological groups:

Antipyretic - they are recommended only at temperatures above thirty-eight degrees and in the absence of contraindications to their intake. The most sought after recognized "Paracetamol." Acetic-water rubbing also helps to cope with a fever.
Antitussive - they are used to relieve an obsessive dry cough.
Mucolytics and expectorants - have proven themselves with a viscous secret and unproductive cough, and in addition, they contribute to the accelerated elimination of sputum with a productive cough. Most often, children are recommended - “Ambroxol”, “Acetylcysteic acid”, “Bromhexine”, as well as preparations with sodium and potassium iodide, based on licorice or marshmallow root, and breast collection from medicinal plant materials.
Antiviral - they are effective in the first three days of malaise.
Antihistamines - used for swelling of the mucosa and in the case of the allergic nature of acute bronchitis.
Antibiotics - drugs of this group are shown only with a confirmed bacterial nature of the infection. However, crumbs (up to six months) with a burdened history, for example, prematurity or birth injury, are sometimes prescribed macrolides and cephalosporins to prevent the infection from joining.
Antispasmodics and bronchodilators are indicated for the obstructive form of the disease and hormones in the absence of a result.
Glucocorticoids, antibiotics and cardiotonics are mandatory for acute bronchiolitis.

Additionally, to increase the effectiveness of pharmacotherapy, physiotherapeutic treatment is used:

physiotherapy;
inhalation;
electrophoresis with iodine, calcium, magnesium;
light therapy;
vibrating chest massage;
giving the body special provisions in which the secretion is improved, i.e. postural drainage;
mustard plasters;
UHF

Unconventional methods

As an adjunct therapy, in the treatment of acute bronchitis in children, the symptoms of which are described in the article, the use of folk remedies is allowed. However, before using them, a consultation with the attending doctor is mandatory, and it should also be noted that:

Any thermal manipulations - steam inhalations, rubbing, warming compresses, wraps are contraindicated at high temperature. In addition, when exposed to heat, exclude the region of the heart.
All drinks that are given to the child should be warm.
Steam inhalations are effective only in diseases of the upper respiratory tract, and not with bronchitis.
Honey products and medicinal plants are allergens, so before using them you need to make sure that the child does not have an increased sensitivity to them.

The following are several popular recipes that are most often used to relieve symptoms of acute bronchitis in a child:

To facilitate dry cough - fresh cranberry juice with sugar or honey, infusions of viburnum, linden, coltsfoot, black currant. .
, .
Coiling the chest, with the exception of the heart, with any vegetable oil that is preheated. Thin cloth or cheesecloth, folded in several layers, is impregnated with it, covered with wax coated paper on top.

The treatment courses and doses will be recommended by a physician depending on the age of the child.

Acute bronchitis in children: clinical guidelines for treatment

According to them, to cure an ailment, the use of:

antiallergic drugs;
electrical procedures;
mustard plaster;
cans;
plasters with a burning effect;
antibiotics for viral uncomplicated form.

According to the protocol, treatment is carried out on an outpatient basis. Recommended for a child:

Warm, plentiful drink in the amount of up to one hundred milliliters per kilogram of body weight per day.
Breathing exercises.
Stimulation of the cough reflex with its decrease.
Chest drainage.

With a dry, painful and excruciating cough (in the absence of signs of obstruction) - central antitussive medicines with a short course.

Additionally, the administration of other drugs is allowed according to the indications:

Antiviral - for signs of flu.
Expectorant and mucolytic - with difficult to separate viscous sputum.
Antibiotics - while maintaining the temperature for more than three days. In addition, it is necessary to further examine the child.

Such treatment is described in clinical guidelines.

Acute obstructive bronchitis in children - in this case, drug therapy depends on the severity of respiratory failure. Bronchodilators are used, for example, Salbutamol or combined - Berodual. Their introduction is carried out through a nebulizer. After use, the clinical effect is evaluated. If it is not, then inhaled corticosteroids are indicated.

With a disease caused by chlamydia or mycoplasma, macrolides, and with obstruction, inhaled B2 agonists or combined agents with a bronchodilator effect.

Due to the fact that cough is considered the main symptom of acute bronchitis in children, its treatment should be full, aimed at:

destruction of the inflammatory process;
removal of compression of the smooth muscles of the bronchi;
activation of expectoration;
dilution of a thick secret.

The reason for choosing this tactic is explained by the following reasons. The process of expectoration in young patients is much more complicated than in adults, and the secretion secreted by the consistency is rather viscous, and the respiratory muscles that push the mucous masses are not fully formed. In addition, it complicates the separation of sputum:

bronchospasm;
weak coughing;
swelling of the mucosa;
anatomical narrow lumen of the bronchi.

Coughing fits can be accompanied by discomfort in the sternum.

General recommendations for child care

Regular ventilation, at least four times a day, and maintaining the optimum temperature, not more than 19 degrees and air humidity in the room where the sick child is located, greatly facilitates his condition and contributes to the fastest cure.

Oxygen therapy is necessary with a pronounced sharp decrease in the flow of oxygen into the body of an individual. In this case, it is fed through the Bobrov apparatus or the children are for some time in a special device called an oxygen tent. It is used for oxygen therapy in bed. Gas mixtures or mechanical ventilation (mechanical ventilation) is indicated for a high degree of respiratory failure.

If one of the symptoms of acute bronchitis in a child is an accumulation of mucus, then it is sucked off using an electric suction device or a rubber syringe. In the case of a high viscosity secret, it is pre-liquefied. For this purpose, inhalations with mucolytics or with alkaline solutions are performed.

Bed rest is observed with fever and about three days after normalization of temperature. During this period, it is necessary to give the baby a lot of fluid, its consumption should exceed the age norm by fifty - one hundred percent. Doctors recommend the following drinks - alkaline mineral water, fruit drink, lemon tea, decoctions of herbs. During dehydration, during the period of temperature rise, the use of "Rehydron" is allowed.

During the treatment of symptoms of acute bronchitis in children, food should be light and quickly absorbed. The amount of food must be reduced by almost half. Grudnichkov, if they have respiratory failure, is often fed little by little. Lures are temporarily canceled.

Prognosis and complications

The disease itself is not dangerous, the prognosis for this disease is favorable. In most cases, full recovery can be achieved in about two weeks. Bronchitis with a lesion of small bronchi and obstruction phenomena is somewhat more difficult. In these cases, serious treatment is required.

The threat is the complications that arise with improper therapy. For example, the appointment of antibiotics for the viral nature of the disease. Depending on the state of immunity, the age of the child and the type of pathogen, the severity of the consequences varies. The following are possible complications of different forms of acute bronchitis in children:

Simple - bronchial asthma or pneumonia.
Recurrent - chronic pathology of the respiratory system in adulthood.
Bronchiolitis - severe cardiac and respiratory failure, failure of gas exchange of blood, i.e. low oxygen content in it.
Obstructive - pulmonary emphysema, in which there is bloating and expansion of the alveoli.

Preventive actions

Often acute bronchitis in children (ICD 10: J20) is a consequence of SARS. Therefore, we must deal with the prevention of these ailments:

Strengthen the immune system: temper, abide by the regimen, eat well, walk daily. Limit visits to public places during the rise of viral infections.
Do not overcool or overheat, and both negatively affect immunity.
Do not contact sick children or adults.
Passive smoking negatively affects the health of children and helps to weaken the immune system. In addition, it not only increases the risk of asthma and bronchitis, but also affects the intellect.
Maintaining optimal air temperature in the room where the child is.
From the first days to treat acute bronchitis in a child, and the doctor will tell you how to do this. Protect the child from contact with irritating substances and allergens. These actions will help prevent the inflammatory process of a non-infectious nature.

Of course, warm sea air is also useful for the respiratory system, especially if babies often suffer from bronchitis. Therefore, it is advisable to take the child to the sea. Trekking in coniferous forests is also of great benefit. The needles of trees secrete volatile, substances endowed with antimicrobial properties.

Acute bronchitis in a child: symptoms, treatment and prevention of the disease