How many asthma attack lasts in children. Signs of bronchial asthma in children

Date: 20.04.2019

An unfavorable environmental situation and the harmful habits of parents (in particular, smoking) both during the period of bearing and after the birth of a baby, directly contribute to an increase in the number of pains of asthma.

Actually true reasons The emergence of bronchial asthma in children is completely unclear. Medicine allocates several factors raising the risk of developing the disease:

genetic predisposition. In the risk group there are children, parents or relatives of which are asthmatics;
sexuality. The lumens of bronchial channels in boys are narrower, so most of the cases of the disease are registered with them;
overweight, as a result of which the diaphragm has a higher location in breast Department and prevents free full breathing;
atopic dermatitis or other allergic diseases of the newborn can provoke the development of asthma;
frequent respiratory diseases leaking with complication to bronchi (this dependence has been detected in 25% of children);
smoking parents;
unsatisfactory environmental situation.

Non-allergic and allergic bronchial asthma

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

The overwhelming majority of children (up to 90%) with a diagnosis of bronchial asthma has exactly the atopic form. Allergic bronchial asthma assumes the presence of a certain substance (allergen) provoking the attack. These are various particles entering inhalation:

pollen plants and dust;
wool cats (less often - dogs);
perfumery, household chemicals and her fragrances;
insect vital activity products;
various types of fungi and mold.

Astmatic seizures can provoke certain food, such as protein, chocolate, citrus. But in this case there are cross-allergic reactions. All allergens have a similar structural structure, so a person with allergies to pollen birch after eating apples is possible the development of bronchial spasms.

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

For reasons, its appearance includes:

chronic infectious diseases upper respiratory tract (sinusitis, sinusitis and others);
change of hormonal balance in women (premenstrual period, climax);
load of physical and neuropsychiatric nature;
reception medicinal preparations;
congenital pathologies (changed reactivity of bronchi).

Bronchial asthma in children

The diagnosis of bronchial asthma in children seems to be somewhat difficult (especially under 3 years), since its symptoms are similar to those with colds or viral diseases (swelling of the mucous membrane, in some cases is observed abundant allocation sputum). This is due to the peculiarities of the Bronchi structure at an early age. In addition, small children can not yet explain their condition.

However, there are some features Asthma in a child:

it does not imply increasing the temperature, even in the case of very frequent cough;
before the offensive characteristic symptoms There are so-called precursors.

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

IN medical practice There is a certain set of methods for analyzing and techniques, which make it possible to determine the presence of the disease. The diagnosis of bronchial asthma in children includes the following set of events:

collecting information for anamnesis (all the details of the child's life, identification of respiratory diseases in parents and relatives, as an asthmatic attack occurs);
conducting blood analysis on allergen and identification of a compound or group of substances provoking bronchial spasm. Less preferred analysis - Skin Sample: Solutions of the allergens proposed on the forearm are applied. If there is a reaction to the "stimulus", then the skin is blushing at the point of contact. This method does not apply on an asthmatic attack day, as it can provoke a deterioration in the state;
measurement of lungs or spirometry. According to the obtained values, the severity of asthma is evaluated.

Symptoms of bronchial asthma in children and its forerunners

For children's asthma, low-rise early symptoms or harbingers are characteristic. As a rule, they appear per day or two to the symptoms of the disease themselves. To the forerunners include:

highlighting water mucus from nasal passes after night sleep, the child often sneezes and rubs her nose;
the occurrence of a weak dry cough in a few hours;
strengthening cough after dinner sleep or in the afternoon with sputum release, and in some cases, very large quantities.

(age up to 3 years and more) are more pronounced than precursors:

parole cough (arising before or after sleep), the intensity of which can be reduced in a vertical position;
the emergence of intermittent whistling breathing, swords, frequent and short breaths;
dry cough, not passing throughout quite a long time;
no possibility of a full breathy;
before the attack, the baby begins to be capricious due to the indoor and nose.
the parlor cough begins at the same conditions (the presence of an animal is nearby, visiting the library, from the bouquet of flowers);
very rarely rash on the skin, tear, itching.

Treatment of bronchial asthma in children

Currently, children's asthma, like asthma in adults, is not amenable to full cure, although there are many effective medicines. With their help prevent (stop) the development of bronchial spasm, remove allergen from the body and remove inflammation.

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

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

A complex of such measures can be attributed to more frequent wet cleaning of the room, the use of humidifiers and air purifiers. It is advisable to remove carpets, pillows and mattresses from the pen and fluff or use special dense bedding covers with minimal permeability. how alternative option Pooker filler use synthetic materials.

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

Drugs for the treatment of children's asthma are divided into two groups: basic and symptomatic. The latter are used to relieve bronchial spasms and increasing the lumen of the bronchial wood channels in order to improve air circulation. They are not preventive tools and are used exclusively for emergency care. Produced in aerosol form.

Preparations of basic therapy, on the contrary, are designed to maintain the therapeutic effect, removal of allergens from the body, do not have instant action and apply constantly. They remove and suppress inflammatory processes, reduce the frequency (or completely stopped) and the intensity of the attacks.

Basic preparations for the treatment of bronchial asthma in children are taking enough for a long timeTherefore, the result is manifested by a minimum in two or three weeks.

The drugs of the new generation include glucocorticoids in inhalation form. They have a minimal list side effects on the body, good tolerance and increased efficiency.

Asthma treatment is not limited to the reception of drugs. To other methods of treatment include:

physical training on specifically developed programs;
different kinds respiratory gymnastics using equipment;
the easy hardening program (especially relevant for children is 3 years old);
reflexotherapy (acupuncture, massage);
specially designed premises with any natural substances possessing positive effect (Salt mines, gala cameras).

Recently, the course of allergen-specific immunotherapy is gaining popularity. The essence of this method is to introduce small doses of allergen to the patient and control of the resulting bronchospasm. As the "addiction" of the body, the concentration of "stimulus" increases, thus, the reaction to the allergen becomes less acute.

Studies have shown that in 75% of patients who have passed such therapy, signs of the disease have not been manifested for 20 years. Despite the good results, the development in this direction continues.

Treatment of bronchial asthma in children by folk remedies

Treatment of bronchial asthma folk remedies Ensures the support of the body between the attacks, its enrichment by natural micro and macroelements, reducing the frequency of exacerbations or the investment of the attack flow.

There is a great many recipes folk Medicine Not only for adults, but also children:

Infusion based on coltsfoot. It is used in bronchitis and laryngitis in chronic form, bronchial asthma. Pre-shredded and dried mother-and-stepmother leaves (4 teaspoons) poured boiling water with one glass, allowed for one hour. Leaves filter, liquid residue drink 50 ml no more than three times a day.

Mix of lemon juice and horseradish. Application is advisable for diseases of the respiratory tract and sputtering of sputum. Strong rubbed on the grater, press juice (150 g), which is drained into the bottle. There is also juice of lemons, the mixture is insisted during the day. Infusion is stored in the refrigerator to 2-3 days and take half a teaspoon before eating for breakfast and dinner.

Nastya Zverkoy. The tablespoon of the dried or crushed Hypericum is poured with a glass of boiling water (300 ml), one hour insist. Take up to 4 times during the day before taking food. It is used as an antihistamine to 40 drops 3-4 times a day.

Children's bronchial asthma and sport

Previously, bronchial asthma was a contraindication to sports. However, correctly selected treatment and drugs of a new generation in no way impede physical culture.

In particular, the exercises aimed at training the respiratory muscles contribute to the easier and less prolonged flow of attacks, prepare the body to hypoxia and develop endurance.

Disability and children's bronchial asthma

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

If there is a favorable forecast for partial recovery Health or the reverse course of the disease, the disability is appointed for 2 years with a subsequent re-evidence.

If there is no positive forecast, asthma is a hormone-dependent and assumes constant medical therapy.The disability is established upon reaching the child of the age of 16.

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

Dr. Komarovsky on bronchial asthma in children

The famous pediatrician, the books of which received recognition of millions of parents, is available in video about how asthma has been manifested in children under 3 years and older, about new approaches to her understanding, early symptoms and treatment, as it is necessary to behave moms and dads kid with this diagnosis.

Ogulov about the problem of lungs

Bronchial asthma in children, the symptoms of the development of which can be easily determined, is increasingly found in childhood or even infant age. In this case, the course of the disease is chronic, accompanied by obstruction or periods of relative calm.

The scheme of development of pathology

In the human body there are bronons that are part respiratory system. Present branched formations inside the lungs. Outside, they are covered with a layer of smooth muscles, the reduction of which causes a decrease in the lumen of the bronchi, and relaxation is the cause of expansion. Similar work of muscle fibers natural for human body. The presence of muscles is needed to increase the lumen, in cases where you want to breathe large quantity air during exercise.

At bronchial asthma there is a violation normal work musculature.

In the presence of an external stimulus, which any allergen can act, excessive physical activity, emotional tension, an involuntary spasm of bronchi appears, manifested in time.

Also, due to the flow of an allergic reaction and concomitant inflammatory processThe swelling of the mucous membrane occurs, accompanied by the appearance of a viscous "vitreous" sputum. This factor multiplies the situation.

Left - bronchi healthy man, in the center - bronchi of a pain of bronchial asthma (BA), right - attack in a patient asthma

The diagnosis of bronchial asthma can be delivered after the first manifestations of the features described in this article, but required full examination To clarify the conclusion of the doctor.

7 The main reasons for the development of bronchial asthma in children

The causes of bronchial asthma in children for the most part are associated with allergic predisposition, or are the consequences of frequent colds.

Mikhailova Love Igorevna, an allergist doctor, 1st city clinical Hospital, Kirov

My profile is allergic, and precisely with this reason the occurrence of asthma children and adults are sent to me. Immediately I will say that the treatment of bronchial asthma in a child is a long and complex process. Reception required for a long time of various drugs.

It is necessary to determine the allergen, which causes the development of the crisis. It is difficult for the child to explain why he can not eat eggs or honey, because he does not understand what is allergic. With certain resistance of the parents, it is possible to exclude "harmful" products from the diet, which helps to cope with asthma "low blood".

For understanding how to treat bronchial asthma in a child, the reasons should be known. Adopted allotment 7 The main causes of the occurrence of this unpleasant disease:

Forms of bronchial asthma and its division into classes

When diagnosing the disease, all pulmonologists should be guided by a document published by WHO. All available varieties of bronchial asthma in this document are divided in accordance with the two criteria:

features of the origin of the disease;
the severity of its flow.

But in the light of the last scientific research, such large division is clearly not sufficient because new methods in the classification of asthma should take into account the large number of nuances, among which:

the severity of the disease until the start of treatment;
there is a response response of the body for the treatment carried out and how significant it is;
is it possible to control the course of the disease in such a way as to extend the periods of remission and prevent the occurrence of new attacks;
is there a relationship between the cause of the occurrence of the disease and the peculiarities of its flow;
possible causes of the manifestation of complications during the course of illness.

A clear definition of the cause of the appearance of a disease can lead not only to effective therapy, but will also help to relocate the attack of bronchial asthma. For reasons, the disease is divided into three large subgroups:

Bronchial asthma - an allergic form

In a similar case, the causative agent of the disease is an external stimulus in the form of an allergen entering children's organism respiratory way or with food, which meets less often. As respiratory allergens are considered:

disputes of mushrooms;
pollen plants;
animal wool;
ticks;
tobacco smoke.

Bronchi Astmatism's bronon is sharply reacting to smoke cigarettes

The initial reaction with a similar form always develops in the field of respiratory tract and is manifested in the form of sinusitis, rhinitis ,.

Against the flow of these accompanying diseases, the atopic bronchial asthma in children begin to develop. Much less often the cause of the development of attacks can be food. It is accompanied by, along with the occurrence of external manifestations, in the form of rash, redness, violations of the chair, cough or attacks of choking.

How to distinguish the usual cough from allergic, see.

In food allergies, the attack of bronchial asthma occurs in children, which can lead to a state known as anaphylactic shock. In this case, required urgent Care With bronchial asthma in children.

Infectious-dependent asthma

Such a disease such as bronchial asthma in children, Komarovsky is also divided into an endogenous variety of illness. In this case, the factors leading to the change in the lumen of the bronchi and causing cough And attacks, microorganisms perform.

In accordance with statistical data, respiratory diseases and bacterial infections of the upper respiratory tract in childhood Can provoke asthmatic seizures.

Identify cases of this variety of asthma is quite simple: All symptoms quickly disappear when conducting hormone therapy and in the case of the use of drugs belonging to the group of broutine.

Mixed asthma

The pathogens of this variety of the disease are both allergens and microorganisms. Factors provoking the disease can be:

bad environmental situation;
stressful situations;
bad habits;
various chemical stimuli.

A separate variety of bronchial asthma, not included in any category, is a cough form of illness. Due to the lack of pronounced symptoms, it is difficult to diagnose.

A similar type is manifested against the background of a permanent cough, which may indicate such diseases as the bronchial obstruction.

The early detection of allergen and its full exception to the child will be the key to rapid recovery. Therefore, you should not pull on a visit to an allergist.

Symptoms, giving the right to suspect the presence of asthma

Cough is protective mechanismwhen the body reacts to the irritation of the respiratory tract

Timely diagnosis of any disease is a faithful chance to provide competent and true treatment. Asthma is no exception to the general rule. Bronchial asthma in children whose symptoms are known - a notch that can be defeated. The first signs that should be a "anxious bell" for parents are as follows:

systematically emerging whistling when child breathing;
frequent no apparent reasons;
coughing or weight gain with direct contact with the source of allergies;
the emergence of whistles in breathing after exercise or emotional shocks;
full absence of the desired efficiency from application.

At the same time there is a division of asthma in gravity of its manifestation:

Easy degree is characterized by short-term and rare manifestations of major symptoms. Attacks are short and well eliminate with the help of appropriate drugs. After physical activity, the child's deterioration is not observed. Night cough is missing.
The average degree is distinguished by the regularity of the emergence of attacks that are weekly. Symptoms in the form of night cough seizures also show periodic character. Physical exercises possible only in limited volume.
A severe degree in which infectious-allergic bronchial asthma occurs, is characterized by very frequent attacks that have a long time. Night cough can cause an attack of a suffocation at bronchial asthma. Practical completely excluded periods of absence of symptoms. Physical activity contraindicated.

In cases where the resulting crisis cannot be eliminated by its own forces, urgent help is required when the bronchial asthma attacks, which doctors may have emerge.

Diagnostic events

Holding diagnostic eventsFor the basis of which the history of the disease is taken (bronchial asthma in a child) includes a whole range of measures aimed at determining the type of illness, the degree of its gravity, and other related parameters.

The first stage of diagnosis is the study of the history, definition external signs The presence of illness.

The next step, with existing suspicions, it is on asthma, is the appointment clinical studieswhich include blood test. During the analysis, the immunological status of the disease is determined, and tests are also carried out on the identification of a group of allergens that are causally significant.

Also during the period of diagnostics, the instrumental parameters are checked. They include checking respiratory function . Also at this stage studies all internal organs, through the ECG, ultrasound.

Bronchial asthma: the history of therapy disease is final stage Diagnostics and is a descriptive part of the history and genesis of the disease, as well as the data obtained research results.

In the future, the pathogenesis of bronchial asthma in children allows not only the treatment of a patient in the event of crises, but also the prevention of bronchial asthma in children during remission periods is also carried out.

Bronchial asthma in children, symptoms and treatment

After laying the diagnosis and definitions that the child suffers from this disease, the basic therapy of bronchial asthma is required in children.

The use of the nebulizer will help ease the attack on the road and at home

There are several treatment options, among which can be distinguished traditional drug methods and folk methods, mainly consisting in the conduct of phytotherapy.

Treatment of bronchial asthma in children people's methods And the use of inhalers cannot be considered the only way to defeat the ailment, and it is able to effectively influence only in the complex with the reception of medicines.

If there is a bronchial asthma in children, clinical recommendations can only give the attending physician on the basis of a number of factors.

With medication treatment, two groups of therapeutic courses are distinguished:

symptomatic when treatment is reduced to the removal of emerging attacks;
the basic when the drugs are taken for a long time aimed at eliminating the cause of the disease.

As drugs, with symptomatic treatment, drugs that have a vasodilatory action are used to quickly increase the lumen of the bronchi and relieve breathing.

It is impossible to use the drug in the exacerbation period more often than once in 20 minutes

This includes drugs:

Bitolterol;
Terbutalin;
Theophylline;
Hipratropy Bromide, and a number of others.

There is an opportunity to accept medication tools In the inhalation form, which simplifies the process of receiving medication, but efficiency is reduced, since most active substance It is settled in the throat, and to the bronchi "gets" only 20%.

Among the existing techniques, to improve the proceeds of the active substance in bronchi when carrying out inhalation treatment, can be noted.

This type of inhalers capable of translating a medicine from liquid form In the fine aerosol, which positively affects the absorption of the active substance.

Kiryanov Mikhail Vladislavovich, a pulmonologist, a clinic of modern medicine "Yunes", Vladimir

The treatment of bronchial asthma is always a rather difficult process, requiring long-term diagnosis and all possible assistance from the parents of the child and the doctor.

For the most part, in my practice there are cases of asthma caused by various allergens. In our clinic, there is an opportunity to quickly pass tests to the definition of allergens, which helps me, as a doctor, to obtain the results and understand what treatment is needed.

One of the discoveries of recent time for me was the drug Erius, which is different greatest efficiency Among other antihistamine drugs. Its use in most cases helps to prevent an attack on the occasion of allergen to the body.

The use of drugs for symptomatic treatment is not distinguished by a long positive effect and in most cases addictive is observed. In order to avoid such an effect, careful compliance with the dosage is required.

Epinephrine is synthetic adrenaline

For basic therapy, several groups of drugs are applied, among which:

designed to reduce allergic manifestations;
antibiotics to get rid of the available infectious pathogens;
preparations of the hormonal spectrum;
promoting the stabilization of the cell membrane.

As drugs from allergies, the greatest efficiency possesses:

Tueva;
Supratine;
Zoda;
Erius.

To stabilize cell membranes, apply:

Ketotifen;
Tillage;
Intal.

In some cases, the attending physician can prescribe such drugs such as acolat or singular, which themselves are not intended to relocate the attack or influence on the lumen of the bronchi, but help to cope the body to high sensitivity to allergens.

The most frequently used drugs, their dosage and features of the reception are shown in the table.

Name	Day dosage in accordance with age	Form release
Salbutamol.	2-6 years - 2 mg 3 times 6-12 years old - 2 mg 4 times \u003e 12 years - 4 mg 3-4 times	Spray can
Bitolterol	\u003e 12 years old - 2 inhalations In case of spasm 3 inhalations every 3 minutes	Spray can
Terbutalin	3-7 years old - 1/4 tab. Three times 7-15 years - 1/2 tab. Three times	Pills
Teophyllin	3-9 years 24 mg / kg weight 9-12 years 20 mg / kg weight 12-16 years 18 mg / kg weight \u003e 16 years old - 900 mg / day	Pills
Epinephrine (when binding an attack)	in childhood 100-500 μg	Injection
Bromide Jiprathopia	<6 лет – 0.4 мл раствора 3-4 раза 6-12 years - 1 ml of solution 3-4 times \u003e 12 years - 2 ml of solution 3-4 times	Solution for inhalation
Tueguil	6-12 years old - 1/2 tab. 2 times \u003e 12 years old - 1 tab. 2 times	Pills
Supratin	1-12 months. - 1/4 tab. 3 times 1-6 years old - 1/4 tab. 3 times 6-14 years old - 1/2 tab. 3 times	Pills
Zoda	6-12 years old - 1 tab. \u003e 12 years old - 1 tab.	Pills
Erius	\u003e 12 years old - 1 tab. 1-5 years - 2.5 ml 6-11 years old - 5 ml \u003e 12 years - 10 ml	Tablets, syrup
Ketotifen	\u003e 3 years - 1 mg 2 times	Pills
Taily Mint	\u003e 2 years - 2 inhalations 2-4 times	Spray can
Intal	\u003e 5 years 2 inhalation 6-8 times	Spray can
Accolat	7-11 years - 10 mg twice \u003e 12 years - 20 mg twice	Pills
Singular	6-14 years old - 5 mg \u003e 15 years - 10 mg	Pills

Nursing process as part of planned treatment

Inhalation from the spacer should be carried out as quickly as possible after spraying aerosols

Highly an important point For the treatment of asthma is nursing process With bronchial asthma in children, carried out in the conditions of moving the child to the hospital.

Nursing care for bronchial asthma in children - the way to improve general state Patient, Treat the attack of bronchial asthma, prevent complications.

Three forms of such a care are distinguished:

dependent when therapy is carried out at the direction of the doctor;
interdependent when the medical sister acts as part of the brigade;
independent when care is carried out as part of monitoring the physical condition of the patient and the observance of the diet.

Nursing care for a sick asthma kid includes:

primary preparation for research and surrender tests;
implementation of the control of the execution of the doctor's instructions;
planning optimal patient care schedule;
organization of leisure. Treatment of children is a special process and requires parents from a medical sister to parents for organizing a child leisure, which includes toys or books to the hospital.

Prevention

As preventive measures, several simple rules are most often recommended:

Regular finding a child in the fresh air.
The elimination of contacting the possibility of contacting potential sources of allergies.
Carrying out preventive measures to improve immunity.
Passing courses of the exercise.
The implementation of regular wet cleaning indoors, where the patient lives.
Failure to surrounding smoking.
The use of synthetic fillers for pillows and blankets, as well as a decrease in the number of upholstered furniture in the apartment.
Constant struggle against rodents and home insects.

Frequency in the fresh air reduces the risk of disease. Therefore, it follows more often to go beyond the city, to be in the forest or village.

Compliance with the rules will minimize the risk of bronchial asthma in a child.

Bronchial asthma - inflammatory disease lower respiratory tract. A particular alarm is the fact that in recent years there has been a tendency to increase the number of people suffering from this ailment. According to statistics, about 10% of children are sick of bronchial asthma. In the description of this disease there are many specific terms, I will try to clarify them with a more affordable language. And so let's consider in more detail what kind of disease is such a bronchial asthma in children, symptoms and factors provoking its development.

What is bronchial asthma, and its development mechanism?

it chronic illness Lower respiratory tract with inflammatory component. In this process, a large number of cellular elements participate. The main link of the formation of the disease is the narrowing of the lumen of the bronchi (obstruction). The mechanism of development of the disease is complex. Briefly, it consists in the following: in the body of the child there are specific immunological reactions of immediate-type (increased sensitivity of the body tissues to certain allergens) Simply put - allergies. If you want to know how bronchial asthma is passed, this process is genetically determined. As a result, all changes lead to the emergence of periodically repetitive attacks of choking. The child appears episodes of shortness of shortness of breath, whistling wheezing, a feeling of sternum. With appropriate treatment, paroxysism is fed. The most terrible complication of the attack of bronchial asthma is asthmatic status.

Risk factors provoking the development of bronchial asthma in children

Not treated foci of chronic infection in the body of the kid.
Frequent colds and acute infectious diseases of the upper and lower respiratory tract (rhinitis, sinusitis, acute tonsillitis bronchitis pneumonia).
Bad adverse conditions ambient.
Smoking is active or passive.
Reception of some drugs: cytotics, antibiotics.
Long stay in a house or apartment where a mold fungus lives on the walls.
The presence of a child of other allergic diseases: atopic dermatitis, allergic rhinitisFrequent obstructive bronchitis.
Allergic reaction to medicines, food, household chemistry, insect bites.

But the history of the disease for pediatrics "Bronchial Asthma" will be headed by a children's doctor only when all these factors work, i.e. only in the case when there is a genetic "breakdown" in work immune system And he gave a failure. Just so, without explicit for that reason, this diagnosis is not put.

How does bronchial asthma manifest, the symptoms in children?

The disease has an approached flow. During the paroxism itself, the condition of children is heavy. A whistling breath appears, the cough parlor, the chest of bloat, there is a sense of air shortness. Kids restless, droopy, they don't want to lie in bed, take a half-sided position - it's easier to breathe. Sometimes, on the contrary, it can be sluggish, it is difficult for them to speak, sit in bed. They have a shortness of breath on exhale (heavily breathe air) due to the blockage of the lumen of the bronchus and the narrowing of his lumen. The wings of the nose are swelling, neck veins swell, intercostal gaps are drawn. Pulse is rapidly. Skin Covers Pale, there may be a bias around the mouth (perioreral cyanosis) and fingers (acricyanosis).

Bronchial asthma in children is characterized by the fact that the attacks are more often at night and in the preliminary clock. it distinctive feature Diseases. Cough has its own specifics, it during paroxysm dry, but the completion of the attack departs a thick wet. Outside the attack, the child feels good.

Description of bronchial asthma in children in the degrees of gravity

Easy. Attacks in children are no more than 1 time in a month, rarely occur at night.
Middle severity. The attacks are repeated 3-4 times a month, at night no more than 2-3 times.
Heavy. The attacks are repeated 3-4 times a week, only at night.

You can suspect bronchial asthma at your child, if in the last 12 months he was observed the following symptoms:

Repeating, sudden cough attacks, with the advent of whistling whears of hearing at a distance (remote wheezes).

Frequent colds accompanied by the obstruction of the respiratory tract.

The appearance of cough, whistling distant wheezes, shortness of breath in a certain time of the year.

Contact with animals, fragile substances, dust, nicotine causes cough.

The above listed symptoms pass or become less pronounced when applying medications with a bronchure effect.

The appearance of cough, whistling breath, shortness of breath at night, closer to the morning.

Symptoms are enhanced after a minor physical activity, inhalation of cold air.

Bronchial asthma is a severe disease, it requires a special approach. We need timely diagnosis, comprehensive treatment. Children should be under the supervision of the doctor. With the manifestation of the first symptoms of the attack, it is necessary to contact a medical institution or call an ambulance at home. Paroxism needs to be stopped in time. Otherwise, it can go to an asthmatic status that is seriously treated. And then on the removal of the diagnosis of bronchial asthma will have to work for several years.

Bronchial asthma in children - the most frequent chronic illness respiratory system. The diagnosis until five years in children is often placed by boys. It is difficult for parents to recognize the first alarming symptoms, the appeal to the doctor is late for several years. Often, disability is immediately issued.

The etiology of the disease is extensive. Possible reasons:

dust pliers;
animal wool;
mold fungi;
pollen plants;
tobacco smoke;
antibiotics (Penicillin).

Smoking mothers during pregnancy - the risk of developing a child of bronchial asthma.

Psychosomatics play a special role among the reasons: children who are strongly tied to mom emotionally, more often sick. Healthy image life during pregnancy - prevention this disease For kid. Otherwise, a child may need disability.

Reception aspirin can provoke an attack of aspirin asthma, which refers to non-allergic form.

Pathogenesis

Pathogenesis consists of stages that flow sequentially:

Sensitization is the first meeting with an allergen. The cells of the immune system produce immunoglobulin E in response to the penetration of allergen. He settles on the fat cells that are in bronchi. Immune cells of the respiratory system remember Allergen and are ready to fight it.
Patochimic. Developed when repeated contact with an allergen. It binds to immunoglobulin on the surface of obese cells. The latter in response to the impact is distinguished by mediators of inflammation, which interact with the cells of the bronchial wall.
Pathophysiological. Inflammatory mediators cause a cellular response. Develops, the edema of the wall of the bronchi and the products of viscous sputum. The lumen of the bronchi is greatly reduced and the air passes along it with difficulty. The attack is developing. The clinic is based on changes in bronchi.

Forms

The aggravation of the disease, in most cases, in children is replaced by remission. The etiology of the disease makes it possible to distinguish the atopic (allergic) and non-allergic forms. The pathogenesis varies them, but the clinic is the same.

Disability is drawn up with any of the forms and allows you to receive benefits.

Atopic

Atopic form is established if the allergic etiology of the disease has been revealed. These include:

anamnesis allergy in a child;
attack at contact with an allergen;
improving immunoglobulin E in blood analysis;
allergic diseases at brothers, sisters, parents and other closest relatives.

Neallergic

It occurs just as allergic, but with a thoroughly examination it is impossible to detect the causes. Factors provoking the attack can be physical activity, inhalation of cold air, sharp smells. The level of immunoglobulin E and remains normal. Pathogenesis has not been studied.

Symptoms

The main symptoms are choking and a sense of light shortage. Children sometimes the only signs are frequent colds of the respiratory system and cough for a long time, especially at night. Frequent ARVIs flowing without temperature should alert the parents. Atopic asthma develops when contacting the trigger.

Other characteristic symptoms:

difficult breathing, especially exhalation;
dry whistling wheezes , audible at a distance;
the child is late in growth or development from peers;
skin sinusiness.

How to remove the attack

The attack develops most often at night or in the pre-understanding hours. Psychosomatics plays an important role: the attack develops during stress. Pathogenesis (if asthma is atopic) is based on the fact that dust pliers live in the mattress and at night there is a close contact with an allergen.

The following symptoms are developing:

suffocation;
the baby is frightened, excited;
exhales with difficulty;
cheerful wheezing;
the skin shines it.

The attack is removed using the inhaler appointed by the doctor. If the attack does not stop, complications will develop.

Diagnostics

The diagnosis of bronchial asthma under five in children is set, given the symptoms and analyzes for immunoglobulin E, sensitivity to allergens. The diagnosis is made in children over five years old using instrumental research. Diagnosis is carried out in the hospital.

The easiest and most common method is picofloumometry.

A small device determines the rate of exhalation of a child. Signs of the disease - a decrease in this indicator by 20% or more. The attack causes the maximum pronounced reduction of strength and respiratory rate.

Severity

Bronchial asthma in children proceeds with different severity. It is estimated: the clinic, as often arises, the seizure, the severity of exacerbations, signs of complications and the results of picofloumetria. Classification:

Easy intermittent (non-permanent). Exacerbations short-term. Picofloumetry rates are 80% of the norm and higher. The forecast is favorable. Disability is not issued.
Easy persistent (constant). Day symptoms several times a week. The exacerbations violate the activity of the child and sleep. Exemption rate is 80% or more. The forecast is favorable.
Average persistent. Day symptoms daily, night attacks several times a week. On picofloumetria is 60-80% of the norm. Disability 3 groups, in the presence of severe concomitant diseases. Forecast is doubtful.
Heavy persistent. Often involved psychosomatics. Attacks every night, daylight symptoms daily. The sleep and activity of the child is significantly violated. The speed of exhalation is less than 60% of the normal. The forecast is unfavorable. With such gravity, there is a disability of 2-3 groups.

The classification allows you to change the degree of gravity when changing the condition of the child.

First aid

The child first needs to calm down. Psychosomatics plays an important role in the development of an attack.

Remove shocking clothes, open a window for fresh air intake (avoid cold).
Give a child inhaler or nebulizer, you can add the Tablet Euphillin.
It is advisable to make a warm bath for hands and legs.

If these measures do not stop the attack for half an hour, call ambulance. Further expectation can lead to the stop of breathing!

Treatment

Treatment depends on the shape, cause and degree of illness. Hospitalization is required for severe exacerbations and if serious complications developed - asthmatic status ,. In other cases, the child is treated at home, under the supervision of parents.

Prevention is based on the removal of allergen from the environment of the child. For this, a daily wet cleaning is carried out, an impenetrable case can be put on the mattress - it facilitates the condition of the child if he has an allergic form.

Preparations

Apply inhalation forms of drugs. Most of them contain glucocorticoids in combination with beta adrenomimetics. Such a combination gives a pronounced anti-inflammatory effect and facilitates breathing. Inhaler, children can use from the age of five. Prior to that, drugs are introduced through a nebulizer or spacer.

See also:

Inhalers are prescribed by a doctor. It is possible to use them only when an attack occurs or on an ongoing basis. To stop signs of attack, Salbutamol is most often used.

Antiallergic drugs Zafirlukast, montelukast, sodium crumoglycat is prescribed in the form of tablets. Used as prevention and treatment of exacerbations. Sometimes assigned to a constant reception if the effect of inhalation is insufficient.

There are benefits for drugs if disability is decorated.

Folk remedies

It can be used as auxiliary method or prevention. Treatment is carried out using embedded herbs, ginger, propolis preparations. From herbs most effective "chest collection", licorice root, chamomile decoction.

Be sure to read:

Treatment by folk methods is contraindicated in the presence of allergies on the components of the means - this can cause a very heavy attack of asthma, a serious aggravation and subsequent disability.

Exacerbation

Cases of exacerbation often arise in children during ARS. Pathogenesis - enhancing inflammation in respiratory tract. If etiology is pollen of plants, then the atopic asthma is exacerbated during their flowering. Classification of exacerbations takes into account many factors. Symptoms of exacerbation:

problems with feeding due to shortness of breath;
the child is less active, prefers to sit or lie;
in severe exacerbation, he speaks only individual words;
baby is excited;
cheerful wheezing become louder, breathing frequent and superficial.

See also:

Pathogenesis of exacerbation periods requires an increase in dose of drugs. The prevention of exacerbations includes vaccination against influenza, pneumococcus and hemophilic sticks. Heavy exacerbations - reason to arrange disability and benefits.

Rehabilitation

Rehabilitation of children with bronchial asthma includes therapeutic physical culture, hardening, draining massage. It is carried out when there is no clinic. Significantly improves the forecast, prevents complications.

Sanatorium

Fresh air, mineral water, wellness treatments, climate - effective prevention of exacerbations in the diagnosis of bronchial asthma in children. Benefits to receive trips are possible if disabilities are decorated. Before the trip, be sure to cure acute diseases and complications of chronic.

Bronchial asthma is a chronic disease that develops on the soil of an allergic inflammatory process in the air-and-axial paths of the child. There is an acute spasm of bronchi and amplification of the discharge of mucus. The accumulation of mucus in bronchi against the background of their spasm leads to bronchial obstruction (impassability of bronchi).

Bronchial asthma is enough dangerous disease; It can develop in any, even infant, age.

There are atopic (allergic) and nonopic (nonallergic) forms of bronchial asthma. Atopic form prevails, it is celebrated in 90% of children with this disease. The disease has chronic flow With alternation of exacerbations and intergreacy periods.

Causes of bronchial asthma

Allergic diseases of the child increase the likelihood of a bronchial asthma.

Hereditary predisposition to the atopic form of the disease: if one of the parents suffers from bronchial asthma - the likelihood of asthma in a child is 25-30%, if both parents are up to 75-80%.
The presence of a child or members of his family of an allergic disease (atopic dermatitis, polynosis, food or drug allergies) is a signal: bronchial asthma can develop. In 60% of children with bronchial asthma, relatives suffer from allergic diseases.

In the first year of life, the children of allergens penetrate the body through the gastrointestinal tract ( food allergy), and more older children prevail polynomy. Often the cause of this disease becomes a pathological response to home dust, pollen of plants, drugs and food products. Allergens from pollen of herbs and trees can have a seasonal allergizing effect (from May to September).

The most pronounced ability to provoke bronchial spasms have microscopic ticks living in home dust, carpets, soft toys and bedding. A high sensitizing role also play the fluff and feather of birds in blankets and pillows, mold on the walls of raw rooms. Wool and saliva pets (dogs, cats, guinea pigs, hamsters), dry food for aquarium fish, fluff and feathers of domestic birds also often contribute to the child allergy. Even after the removal of an animal from the room, the concentration of allergens in the apartment decreases gradually, for several years.

Environmental factor: inhalation with air harmful substances (exhaust gases, soot, industrial emissions, household aerosols) - a frequent cause of asthma development due to immune disorders in the body.

An important factor of the risk of asthma is smoking (for young children - passive smoking, or by being near the smoking man). Tobacco smoke is a strong allergen, so if at least one of the parents smokes, the risk of asthma in the child is significantly (ten times!) Increases.

Viruses and bacteria, causing the defeat of respiratory organs (, ORZ, ARVI), contribute to the penetration of allergens in the walls of the bronchial tree and the development of the obstruction of the bronchi. Often repeated obstructive bronchitis can be a starting mechanism for bronchial asthma. Individual increased sensitivity only for infectious allergens causes the development of a nonopic bronchial asthma.

Factors of physical impact on the body (overheating, supercooling, physical activity, a sharp change of weather with atmospheric pressure drops) can trigger the attack of suffocation.

Asthma can be a consequence psycho-emotional tension child (stress, fright, constant scandals in the family, conflicts in school, etc.).

A separate form of the disease is "aspirin" asthma: the attack of a suffocation occurs after the use of aspirin (acetylsalicylic acid). The drug itself is not an allergen. When it is used, active biological substances are distinguished, they cause bronchial spasms.

The occurrence of attacks can be facilitated by taking non-steroidal anti-inflammatory agents and a number of other drugs, drugs in color capsules. as well as foods containing food dyes.

Aggravate the severity of bronchial asthma maybe digestive tract:,. The emergence of an asthma attack at night may be associated with casts of gastric content in the esophagus (duoden-garbage reflux).
The reason for the emergence of asthma in the first months of the life of the baby can be smoking a woman when entering a child, excessive use of allergizing products (honey, chocolate, fish, citrus, eggs, etc.), infectious diseases During pregnancy and the use of medicines.

Symptoms of bronchial asthma

The disease can begin with imperceptibly, with manifestations, poorly treatable. Bronchial asthma develops more often in children until three years, boys are more often sick.

A wrapping of parents and make suggestion the development of a bronchial asthma should have such manifestations:

periodically emerging whistling breathing;
cough appearance, mainly at night;
the appearance of cough or whistling breathing after contact with the allergen;
cough with whistling breathing after emotional or exercise;
lack of effect from antitussive preparations and the effectiveness of anti-asthma agents.

The main manifestation of bronchial asthma is an attack of suffocation. Usually such an attack appears on the background of ARVI. Initially, breathing may occur when high temperatures, cough (especially at night), runny nose. Then the attacks of difficulty whistling breathing becomes more often, there is no connection to cold illness - When contacting an animal or with exercise, near plants with a sharp smell or when changing the weather.

In the occurrence of the attack of bronchial asthma, the exhalation is difficult in children. Normally, the duration of the inhalation and exhalation is the same in time, and with asthma, the breath is twice as long. Breathing is a rapid, whistling, noisy, audible at a distance. The chest during an attack is somewhat bloated, the face acquires a crimson tint.

The child takes a forced pose: Sitting, leaning a little, leaning on his hands, the head is drawn, the shoulders are raised (so called. "Coucher's posture"). Inhale short, not providing advent of sufficient oxygen. With a long-term attack, pain in the lower chest departments may appear, the cause of which is an increased load on the diaphragm. The attack can last from a few minutes to several hours. The cough at the same time is at first dry, painful, and then thick, viscous springs can be released.

Sometimes the atypical species of bronchial asthma is developing - the cough version: the classic attack of the suffocation does not occur, the symptom of the disease is a painful cough with a thick and viscous sputum, which occurs mainly at night.

Older children complain about the lack of air, and the kids cry, concern. The attack is more often developing very quickly, instantly after contact with the allergen. But some children may precede the "precursors": nasal congestion, complaints of itching in the throat, cough, rash on the skin and skin itch, as well as irritability, drowsiness or anxiety.

Oxygen starvation of fabrics (including brain) contributes to the lag behind a child suffering from bronchial asthma, in intellectual, physical and sexual development. Such children are emotionally labils, neurosis can develop.

Classification

According to the classification of bronchial asthma, children distinguish a lightweight, medigative and severe course of the disease, depending on the frequency of attacks, their severity and the need to use anti-asthma medicines.

Easy degree:

symptoms arise episodically;
asthma attacks are short-lived, arise spontaneously and bought by the reception of bronchodilics;
at night there are no diseases or they are rare;
physical exertion is transferred normally or with minor violations;
during the remission, the function of external respiration is not violated, there is no manifestation of the disease.

Medium-heavy degree:

attacks arise once a week;
the seizures are moderate, often requires the use of bronchoditics;
night symptoms are regular;
it is noted to restrict the portability of physical exertion;
without conducting basic therapy, remission is incomplete.

Heavy degree:

attacks are celebrated several times a week (may occur daily);
the attacks have a heavy, protracted character, the daily use of bronchodiolitic corticosteroids is necessary;
night manifestations are repeated every night, even several times per night, sleep is broken;
dramatically reduces the tolerability of exercise;
there are no periods of remission.

If the attack fails for a few hours - this is an asthmatic status that requires immediate hospitalization of the child.

Treatment

First of all, it is necessary to identify an allergen that provokes the bouts of bronchial asthma, and try to exclude or at least minimize the contact of the child with him.

To begin with, install an allergen (provoking factor) and completely eliminate any contact of the child with it:

regularly carry out wet cleaning of the room (if necessary with anticipating agents); When cleaning, use the vacuum cleaner with a water filter; apply air cleaners for air filtration;
purchase for a child pillows and blankets with hypoallergenic synthetic fillers;
eliminate games with soft toys;
place books in glazed cabinets;
remove extra upholstered furniture, and the needy to hide the fabric without a pile;
in the case of significant air pollution, change the place of residence;
during the flowering period of provoking asthmatic attacks of plants to minimize the child's stay in the fresh air - only in the evening, after the dew drops, or after the rain; Spend a special grid on the windows;
with "asthma of physical effort" significantly reduce the load, including jumping and running;
when "aspirin" asthma, exclude the use of provoking drug attacks.

Medicia treatment

Medical treatment of bronchial asthma is divided into two groups: symptomatic treatment (stopping the attack of suffocation) and basic therapy.

Treatment of bronchial asthma in children quite difficult process: Medicaseous treatment can choose only a doctor. It is impossible to engage in self-treatment, since the improper use of drugs can aggravate the course of the disease, lead to a longer and frequent attacks of choking, the development of respiratory failure.

Symptomatic treatment Includes preparations that have bronighting effect: Ventoline, Berretk, Salbutamol. For severe course Corticosteroid preparations are also used. It is important not only the choice of the drug, and the method of its introduction.

The most frequently used method is inhalation (the medicine enters the lungs in the form of an aerosol). But it is difficult for small children to use an inhaler's balloon: a child may not understand the instructions and incorrectly inhale the drug. In addition, with this method of administration, most of the medication remains on back wall Things (no more than 20% of the drug reaches bronchi).

Currently, there are a number of devices that allow you to improve the delivery of the medication into the lungs. For the treatment of children, these devices are optimal: they allow you to use a medicine in a smaller dose, which reduces the risk of side effects.

Spacer is a special camera, an intermediate tank for an aerosol. The medicine in the chamber comes from the can, and it is already inhaled by a child. This allows you to make several inhales, 30% of the drug in the form of an aerosol fall into the lungs. The spacer is not used to introduce a medication in the form of a powder.

Together with the spacer, the system "Light breathing" is used: the inhaler turns on automatically (there is no need to press the inhaler on the chamber of the valve at the moment of inhalation). The aerosol cloud is thrown away at a lesser speed and the medicine does not settle in the throat, in the lungs penetrate two times more medication.

Cyclohelher, dischecher, Turbukhaler is the same as the spacer, fixtures, only for the introduction of powder.

Nebulizer (inhaler) is an apparatus that allows you to translate medication into an aerosol. There are compressor (inkjet and pneumatic) and ultrasound nebulizers. They allow inhalation drug solid During a long time.

Unfortunately, the preparations for symptomatic treatment have a temporary effect. Frequent, uncontrolled application of bronchoranting drugs can provoke the development of asthmatic status, when bronchi no longer react to the drug. Therefore, the older children who independently use inhalers should be clearly monitored by the dose of medication - children due to the fear of the development of the attack can overdose the bronchoranty drug.

As base therapy Several groups of drugs are used: antihistamines (TAVEGIL, Supratin, Claritin, Loratadine, etc.); Preparations that stabilize cell membrane (ketotifen, tillage, intral et al.); Antibiotics (for rehanging chronic foci of infection). May be appointed by I. hormonal drugs For the treatment of inflammation in bronchi and preventing asthma exacerbation. The basic therapy also selects the doctor individually, taking into account the characteristics of the child's body and the severity of Asthma.

Lakeotriene inhibitors (acolat, sigular) and cromons (ketoprofen, cromoglycat, etc.) are also used. They do not affect the lumen of the bronchi and do not stop the attack. These drugs reduce the individual sensitivity of the child's body to allergens.

The prescribed supporting therapy or basic therapy parents should not be canceled independently. It should not be arbitrary to change the dosage of drugs, especially if appointed. The reduction in the dose is carried out when there was not a single attack within six months. If remission is observed for two years, the doctor cancels the drug completely. If after stopping the preparation of the drug, the attack occurs - the treatment is started again.

Important is timely treatment Chronic foci of infection (, sinusitis), diseases of the organs of the digestive tract.

Non-media treatment

Of non-drug methods Treatment should be indicated by physiotherapeutic treatment, therapeutic physical culture, massage, needleflexotherapy, various breathing techniques, hardening the child, the use of a special microclimate of mountains and salt caves. During the remission applied spa treatment (The season and view of the resort consistent with the doctor) at the resorts of the southern coast of Crimea, in Kislovodsk, Elbrus, etc.

There is another type of bronchial asthma: allergen-specific immunotherapy (ASIT). It can receive children over the age of five. The essence of the method: introduced into the body a very small dose of Allergen, which causes an attack of an asthma in a child. Gradually, the dose of the injected allergen increases, as if "involve" the body to Allergen. The course of treatment lasts 3 and more months. As a result of treatment, asthma attacks stop.

Fitotherapy complements and improves efficiency traditional treatment Medications contribute to a longer period of remission. It uses phytosborgs of nettle leaves and mother-and-stepmother, herbs of a richness, licorice roots and nine. Fresh decoctions should be prepared daily. Take ragners for a long time, use and doses agree with the attending physician. Parents should not test alternative treatments on their own!

With exacerbations and when attacks of bronchial asthma, you can use champs and infusions from plants with an expectorant action (plantain, horsetail, chamomile, dandelion, dealer, calendula, nettle, yarrow, holly ward, licorice root, mother-and-stepmother). During the rehabilitation period, you can take the infusion of licorice root, Glyciram, Pervertiss for the month.

For aromatherapy, you can recommend the aromalamp of 10 minutes a day. Essential oils (lavender, tea tree, thyme) use very carefully, in microodos. You can, for example, 5 drops essential oil Add on 10 ml of massage oil and rub chest Child.

Homeopathic treatment is also used in the treatment of bronchial asthma. A competent homeopath doctor picks up an individual treatment scheme. Alone, the same parents give drugs purchased in a homeopathic pharmacy, it is impossible!

Special asthma schools are open in Russia, in which sick children and parents are taught: learn to assist during an attack, explain the essence of rehabilitation, the rules of massage and therapeutic physical education, they are also talking about non-traditional treatment methods. Children are taught to properly use the inhaler. In such a school, psychologists work with children.

A child suffering from bronchial asthma, it is necessary to ensure diet food:

Vegetable and cereal soups should be prepared on the beef of the second broth;

Rabbit, low-fat beef allowed in boiled form (or a couple);

Fats: sunflower, olive and butter;

Porridge: rice, buckwheat, oatmeal;

Boiled potatoes;

Fresh fruits and green vegetables;

Fermented dairy products;

White bread.

It should be limited to the use of carbohydrates (confectionery, sugar, baking, sweets). It is recommended to exclude from the ration of allergens (honey, citrus, strawberries, chocolate, raspberry, chicken eggs, fish, canned food, seafood). It is also better to do without chewing gum.

Parents can conduct a food diary, where all the products eaten by the child are fixed during the day. Comparing the resulting power and appearance of attacks, the nutritional allergens of the child can be revealed.

Bronchial asthma, which arose in childhood, even a severe form with frequent attacks, may completely disappear in the adolescence. Self-intake comes, unfortunately, only in 30-50% of cases.

A timely diagnosed bronchial asthma in a child, a clear fulfillment of all therapeutic and preventive measures - the key to success.

To which doctor to turn

From the use of allergenic products to a child suffering from bronchial asthma, one should refuse.

When the child appears, it is necessary to contact the pediatrician. He will send the kid to an allergist or a pulmonologist. Additionally, a consultation of a nutritionist, a specialist in therapeutic physical education, physiotherapist, an immunologist, an ENT doctor, a dentist (to eliminate chronic infection foci) will be useful. For long reception glucocorticosteroids, even in inhalation form, it is necessary to periodically consult an endocrinologist in order not to miss the oppression of the function of the child's own adrenal glands. (votes - 1 , average: 5,00 out of 5)