Obstructive bronchitis- There is no such person who has never suffered bronchitis in his life. Persons of any age are ill with it. In adults, if bronchitis develops, it proceeds easily and does not bear any health consequences.
Children are more likely to develop severe obstructive bronchitis. The younger the child, the more difficult the disease progresses. It is less treatable. Sometimes it takes a rapid current, which threatens the life of the baby.
Obstructive bronchitis, what is it?
Obstructive bronchitis is referred to as inflammatory lesions of the bronchial tree. It affects the mucous membrane lining the inner part of the bronchi. The edema narrows the lumen of these structures. Inflammation in bronchitis extends to the entire thickness of the bronchial wall. The function of the ciliary epithelium is impaired.
The disease proceeds with obstruction symptoms, which are expressed in impaired bronchial patency. In children, obstructive bronchitis occurs with bouts of unproductive cough, which is accompanied by noisy breathing with a whistle.
Such patients are characterized by forced expiration, rapid breathing, and distant wheezing. Obstructive bronchitis in children develops at any age. More often than other age groups, they suffer from babies aged from six months to 5 years.
The disease is more often recorded in children with allergies, weakened immunity and the presence of a genetic predisposition, frequent and lingering viral respiratory infections. The number of cases of obstructive bronchitis in children is growing steadily.
The structure and function of the bronchi
Bronchi are formations similar to hollow tubes. Their wall consists of three layers – middle, inner, outer. From the inside, they are lined with a mucous membrane, which is richly supplied with blood vessels. The bronchi branch out and form a bronchial tree. The bronchi conduct air into the lung tissue, simultaneously warming, moisturizing and purifying it.
Causes of bronchitis
Viruses are more likely to cause primary obstructive bronchitis in children. The following pathogens affect the bronchial tree:
- parainfluenza virus of the third type;
- respiratory syncytial virus;
- influenza viruses;
Often the manifestation of obstructive bronchitis in a child is preceded by a cold. Again, the disease is caused by other causative agents of persistent infections, which include:
- causative agents of whooping cough, parapertussis;
- mold fungi.
Often, with repeated cases, the conditionally pathogenic microflora of the respiratory tract is activated. Allergic reactions play a significant role in the development of bronchial inflammation in children. Relapses of obstructive bronchitis are facilitated by infection with worms, foci of chronic infection (Sinusitis, tonsillitis, caries). The factors provoking the development of exacerbations include:
- physical overwork;
- neuropsychic stress;
- congenital failure of protective barriers;
- unfavorable climate;
- bad ecological shutdown;
- decreased immunity;
- lack of vitamins.
An important role in the development of obstructive inflammation of the bronchi in children is played by passive smoking, as well as irritation of the ciliary epithelium with dust particles and chemicals.
Pathogenesis of obstructive bronchitis in children
The pathogenesis of the disease has a complex structure. When a virus invades, an inflammatory infiltration of the mucous membrane lining the bronchi occurs. In its tissue, various groups of leukocytes migrate in large numbers. Mediators of inflammation are allocated – histamine, prostaglandin, cytokines. Edema of the bronchial wall develops.
Then the smooth muscle fibers in the bronchial wall contract, which is why bronchospasm develops. Goblet cells activate the secretion of bronchial secretions. Mucus has a high viscosity. There is a breakdown in the work of the ciliated epithelium. Mucociliary insufficiency is formed. The process of coughing up sputum is disrupted.
The airway lumen is blocked by bronchial secretions. This creates ideal conditions for the reproduction of the pathogen of bronchitis. The submucous and muscular layer of the bronchi is inflamed. Peribronchial interstitial tissue is included in the process. Lung tissue is not involved in inflammation.
Classification and stages of development of obstructive bronchitis in children
There are three forms of obstructive bronchitis – bronchiolitis, acute and recurrent. Children under 2 years of age often suffer from bronchiolitis. Their body responds in this way to the introduction of rhinovirus or respiratory syncytial infection. It is preceded by a mild ARVI. When the condition worsens, respiratory and heart failure develops. With this form, characteristic moist fine bubbling rales appear on inhalation and exhalation.
Acute bronchial obstruction is more common in children aged three to five years. It is caused by the parainfluenza and influenza virus, adenovirus. First, the temperature rises to high numbers. Other symptoms of SARS appear. Then the manifestations of respiratory failure increase. The child has difficulty breathing. The breathing process involves the muscles of the neck and shoulders. Whistling wheezing occurs on exhalation. Exhalation is difficult and lengthened.
Recurrent obstructive bronchitis occurs at any age. It is caused by: mycoplasma, cytomegalovirus, herpes virus, Epstein-Barr virus. Bronchial obstruction increases gradually. This occurs at normal or subfebrile temperatures. Nasal congestion, runny nose, and rare coughing are noted. Shortness of breath is moderately expressed. The general condition hardly suffers. In the course of the disease, the following forms are distinguished: acute, protracted, recurrent and continuously recurrent.
Symptoms of obstructive bronchitis in children
At the onset of the disease, the manifestations of ARVI predominate in the clinical picture. Dyspeptic symptoms are possible in toddlers. Bronchial obstruction is often associated with the first day of illness. Bronchitis is manifested by the following symptoms:
- increased breathing rate (up to 60 per minute);
- prolongation of exhalation;
- breathing is noisy, wheezing;
- auxiliary muscles are involved in the act of breathing;
- the anteroposterior chest size increases;
- swollen wings of the nose;
- cough with scanty sputum, paroxysmal character;
- sputum discharge is difficult;
- pale skin;
- cyanosis of the lips;
- cervical lymphadenitis.
Bronchial obstruction persists for up to a week. Then its manifestations gradually subside as the inflammation in the bronchi subsides. Children under six months of age develop acute bronchiolitis. Inflammation in the bronchi with it is accompanied by severe respiratory failure.
Complications of obstructive bronchitis in children
Acute obstructive bronchitis is complicated by the transition to a continuously recurrent form. It is formed against the background of secondary bronchial hyperreactivity. It develops due to various factors: passive smoking, untreated infections, hypothermia or overheating, frequent contact with infected ARVI.
In children under three years of age, bronchitis is complicated by pneumonia. This is associated with difficulties in evacuating thick sputum. It closes the lumen, disrupting ventilation of the pulmonary segment. When the bacterial flora is attached, inflammation develops in it. This complication is rare. It happens only in weakened children.
Diagnosis of obstructive bronchitis in children
To make a diagnosis, the child is examined by a pediatrician or pulmonologist. During the examination, the doctor performs auscultation (listening to the chest with a phonendoscope) and percussion (percussion).
For the diagnosis of obstructive bronchitis, the following are used:
- X-ray (fluorography) – required to detect changes in the pulmonary pattern and exclude pneumonia;
- tracheobronchostopia – a secret, ulceration of the mucous membrane, fibrin overlay is found in the bronchi;
- sputum culture tank – a study of material to search for the pathogen with the determination of sensitivity to antibiotics;
- detection of antibodies to various viruses;
- PCR to isolate viral antigen;
- spirography – a study of the function of external respiration;
- blood gas analysis;
- study of the peak expiratory flow rate;
- spirography – measure the volume and velocity of exhaled air
- allergic skin tests are performed to exclude the allergic nature of the pathology.
The child is prescribed laboratory tests (general analysis and blood biochemistry, the level of C reactive protein).
Treatment of obstructive bronchitis in children
Children with bronchitis are often treated on an outpatient basis. An indication for hospitalization is considered age up to a year, the serious condition of the baby, the presence of concomitant pathologies. The main treatment is etiotropic therapy. It includes antiviral or antibacterial drugs.
Pathogenetic therapy includes selective bronchodilators or inhaled glucocorticosteroids. They are inhaled through a compressor nebulizer. The following agents are prescribed as symptomatic therapy:
- thinning phlegm – they facilitate its evacuation;
- expectorant – activate the movement of the cilia and promote coughing;
- non-steroidal anti-inflammatory;
- fortifying (vitamins, immunomodulators).
In the recovery period, physiotherapy, massage and breathing exercises are prescribed.
About half of children who have had bronchitis tend to relapse within a year after the first episode of the disease. A quarter of babies with relapses are prone to the formation of bronchial asthma. The rest of the children get rid of obstructive bronchitis by school age.
With this disease, it is forbidden to self-medicate. It is imperative that when symptoms of bronchitis appear in a child, immediately consult a doctor.
Prevention measures in children of obstructive bronchitis include:
- prevention of viral diseases;
- timely vaccination;
- hypoallergenic environment;
- health improvement at the resorts.
It is necessary to stop the child for dispensary registration with a pediatrician, pediatric pulmonologist.
The baby has not yet developed the basic defense mechanisms. Their body is susceptible to the rapid development of complications. If symptoms appear, see your doctor immediately. He will insert the correct diagnosis and prescribe treatment.
The article is intended for parents of patients with a diagnosis established by a doctor. It is forbidden to use information from it for self-diagnosis and use as a guide for treatment.