Attack of bronchial asthma in children. Non-drug treatment methods. Symptoms of bronchial asthma in children

Unfavorable environmental conditions and bad habits parents (in particular, smoking) both during pregnancy and after the birth of a baby, directly contribute to an increase in the number of cases of asthma.

In fact real reasons emergence bronchial asthma in children is not completely clear. Medicine identifies several factors that increase the risk of developing the disease:

1. genetic predisposition. At risk are children whose parents or relatives are asthmatics;
2. gender The lumens of the bronchial canals in boys are narrower, so most cases of the disease are registered in them;
3. excess weight, due to which the diaphragm has a higher position in the thoracic region and prevents free, full breathing;
4. atopic dermatitis or other allergic diseases of the newborn can trigger the development of asthma;
5. frequent respiratory diseases, occurring with complications in the bronchi (this dependence was detected in 25% of children);
6. parental smoking;
7. unsatisfactory environmental situation.

Non-allergic and allergic bronchial asthma

Depending on the factor causing bronchospasm, asthma is divided into atopic and non-allergic.

The vast majority of children (up to 90%) diagnosed with bronchial asthma have the atopic form. Allergic bronchial asthma involves the presence of a certain substance (allergen) that provokes an attack. These are various particles entering by inhalation:

• pollen and dust;
• cat hair (less often dog hair);
• perfumes, household chemicals and their fragrances;
• insect waste products;
• various types of fungi and mold.

Asthmatic attacks can be triggered by certain food eg protein, chocolate, citrus fruits. But in this case, cross-allergic reactions occur. All allergens have a similar structural structure, so a person with an allergy to birch pollen may develop bronchial spasms after eating apples.

Non-allergic bronchial asthma in children under 3 years of age and older is very rare. In most cases it develops against the background concomitant diseases respiratory tract and without the participation of any “irritants” of an allergic nature.

The reasons for its appearance include:

• chronic infectious diseases upper respiratory tract (sinusitis, sinusitis and others);
• change hormonal balance among women ( premenstrual period, menopause);
• physical and neuropsychic loads;
• reception medicines;
• congenital pathologies (altered bronchial reactivity).

Bronchial asthma in children

Diagnosis of bronchial asthma in children seems somewhat difficult (especially under the age of 3 years), since its symptoms are similar to those of colds or viral diseases(swelling of the mucous membrane, in some cases observed copious discharge sputum). This is due to the structural features of the bronchi at an early age. In addition, young children cannot clearly explain their condition.

However, there are some features asthma in a child:

• it does not imply an increase in temperature, even in the case of very frequent coughing;
• before the attack characteristic symptoms so-called harbingers appear.

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

IN medical practice There is a certain set of analysis methods and techniques that allow you to determine the presence of a disease. Diagnosis of bronchial asthma in children includes the following set of measures:

• collecting information for anamnesis (all details of the child’s life, identifying respiratory tract diseases in parents and relatives, how an asthmatic attack occurs);
• conducting a blood test for an allergen and identifying a compound or group of substances that provoke bronchial spasm. A less preferred analysis is skin test: solutions of the proposed allergens are applied to the forearm. If there is a reaction to the “irritant,” the skin at the point of contact turns red. This method is not used on the day of an asthma attack, as it can cause a worsening of the condition;
• Lung volume measurement or spirometry. Based on the obtained values, the severity of asthma is assessed.

Symptoms of bronchial asthma in children and its precursors

Childhood asthma is characterized by mild early symptoms or warning signs. As a rule, they appear a day or two before the actual symptoms of the disease. Precursors include:

• discharge of watery mucus from the nasal passages after a night's sleep, the child often sneezes and rubs his nose;
• the appearance of a weak dry cough after a few hours;
• worsening cough after lunch or in the afternoon with the release of sputum, and in some cases a very large amount.

(up to 3 years of age or more) are more pronounced than the precursors:

1. paroxysmal cough (occurring before or after sleep), the intensity of which may decrease in an upright position;
2. the appearance of intermittent wheezing, shortness of breath, frequent and short breaths;
3. dry cough that does not go away for quite a long time;
4. inability to take a full breath;
5. before an attack, the baby begins to be capricious due to a stuffy nose.
6. paroxysmal cough begins under the same conditions (the presence of an animal nearby, a visit to the library, from a bouquet of flowers);
7. very rarely skin rashes, lacrimation, itching.

Treatment of bronchial asthma in children

Currently, childhood asthma, like asthma in adults, cannot be controlled complete cure, although there are many effective medicines. With their help, they prevent (stop) the development of bronchial spasm, remove the allergen from the body and relieve inflammation.

Bronchial asthma in a child is not a death sentence. Properly selected treatment, modern medications and new therapeutic methods allow the baby to grow and develop normally. In addition, as the child grows older, bronchial spasms become easier and, in some cases, stop completely.

The first step in treating this disease is to remove the allergen from the patient's environment. Sometimes this is quite enough.

A set of such measures include more frequent wet cleaning of the premises, the use of humidifiers and air purifiers. It is advisable to remove carpeting, pillows and mattresses made from feathers and down, or use special thick covers for bedding with minimal permeability. How Alternative option Down feather filler uses synthetic materials.

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

Medicines for the treatment of childhood asthma are divided into two groups: basic and symptomatic. The latter are used to relieve bronchospasms and increase the lumen of the canals bronchial tree to improve air circulation. They are not prophylactic agents and are used exclusively for emergency care. Available in aerosol form.

Drugs basic therapy, on the contrary, are designed to maintain therapeutic effect, removing allergens from the body, do not have an immediate effect and are used constantly. They relieve and suppress inflammatory processes, reduce the frequency (or completely stop) and intensity of attacks.

Basic drugs for the treatment of bronchial asthma in children are taken in sufficient quantities long time, so the result appears in at least two to three weeks.

New generation drugs include glucocorticoids in inhaled form. They have a minimal list side effects on the body, good tolerability and increased efficiency.

Treatment for asthma is not limited to taking medications. Other treatment methods include:

• physical training according to specially designed programs;
• various types of breathing exercises using equipment;
• easy hardening program (especially important for children 3 years old);
• reflexology (acupuncture, massage);
• specially designed rooms with any natural substances that have positive effect(salt mines, gala chambers).

IN Lately Allergen-specific immunotherapy is gaining popularity. The essence of this method is to administer small doses of the allergen to the patient and control the resulting bronchospasm. As the body “gets used to it,” the concentration of the “irritant” increases, thus the reaction to the allergen becomes less acute.

Studies have shown that 75% of patients who have undergone this type of therapy do not show signs of the disease for 20 years. Despite good results, developments in this direction continue.

Treatment of bronchial asthma in children with folk remedies

Treatment of bronchial asthma folk remedies involves supporting the body between attacks, enriching it with natural micro- and macroelements, reducing the frequency of exacerbations or easing the course of an attack.

There are a great many recipes traditional medicine not only for adults, but also for children:

Infusion based on coltsfoot. It is used for bronchitis and laryngitis in chronic form, bronchial asthma. Pre-crushed and dried coltsfoot leaves (4 teaspoons) are poured with one glass of boiling water and allowed to brew for one hour. Filter the leaves, drink the liquid residue 50 ml no more than three times a day.

A mixture of lemon juice and horseradish. The use is advisable for diseases of the respiratory tract and dilution of sputum. Horseradish is grated, the juice (150 g) is squeezed out, which is poured into a bottle. Lemon juice is also added there, the mixture is infused for 24 hours. The infusion is stored in the refrigerator for up to 2-3 days and taken half a teaspoon before meals for breakfast and dinner.

St. John's wort infusion. A tablespoon of dried or crushed St. John's wort is poured into a glass of boiling water (300 ml) and left for one hour. Take up to 4 times during the day before meals. Applicable as antihistamine up to 40 drops 3-4 times a day.

Children's bronchial asthma and sports

Previously, bronchial asthma was a contraindication to sports. However, properly selected treatment and new generation medications in no way interfere with physical activity.

In particular, exercises aimed at training respiratory muscles, contribute to easier and shorter duration of attacks, prepare the body for hypoxia and develop endurance.

Disability and childhood bronchial asthma

According to domestic regulatory documentation, a child diagnosed with bronchial asthma is assigned a disability only in the case of a severe course of the disease.

If exists favorable prognosis on partial restoration health or the reverse course of the disease, then disability is assigned for 2 years with subsequent re-examination.

If there is no positive prognosis, asthma is hormone dependent and requires constant drug therapy, then disability is established when the child reaches the age of 16 years.

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

Doctor Komarovsky about bronchial asthma in children

The famous pediatrician, whose books have been recognized by millions of parents, clearly talks in a video about how asthma manifests itself in children under 3 years of age and older, about new approaches to understanding it, early symptoms and treatment, how mothers and fathers of a baby with this diagnosis should behave.

Ogulov about the problem of the lungs

Bronchial asthma - inflammatory disease lower respiratory tract. Of particular concern is the fact that in last years There has been a trend towards an increase in the number of people suffering from this disease. According to statistics, about 10% of children suffer from bronchial asthma. There are many specific terms in the description of this disease, I will try to explain them more accessible language. Therefore, let's take a closer look at what kind of disease this bronchial asthma is in children, the symptoms and factors that provoke its development.

What is bronchial asthma and its mechanism of development?

This is a chronic disease of the lower respiratory tract with an inflammatory component. A large number of cellular elements are involved in this process. The main link in the formation of the disease is the narrowing of the lumen of the bronchi (obstruction). The mechanism of disease development is complex. Briefly, it is as follows: specific immunological reactions occur in the child’s body immediate type(increased sensitivity of body tissues to certain allergens) in other words – allergies. If you want to know how bronchial asthma is transmitted, then this process is genetically determined. As a result, all changes lead to periodically recurring attacks of suffocation. The child experiences episodes of shortness of breath, wheezing, and a feeling of compression behind the sternum. With appropriate treatment, the paroxysm stops. The most serious complication of an asthma attack is status asthmaticus.

Risk factors that provoke the development of bronchial asthma in children

Untreated lesions chronic infection in the baby's body.
Frequent colds and acute infectious diseases of the upper and lower respiratory tract (rhinitis, sinusitis, acute tonsillitis bronchitis pneumonia).
Bad unfavourable conditions environment.
Smoking, active or passive.
Taking certain medications: cytostatics, antibiotics.
Long-term living in a house or apartment where mold lives on the walls.
The child has other allergic diseases: atopic dermatitis, allergic rhinitis, frequent obstructive bronchitis.
Allergic reaction to medications, food, household chemicals, insect bites.

But a pediatric medical history of “bronchial asthma” will be recorded by the pediatrician only if all these factors work, i.e. only in the case when there is a genetic “breakdown” in the work immune system and it failed. Such a diagnosis is not made just like that, without obvious reasons.

How does bronchial asthma manifest itself, symptoms in children?

The disease has a paroxysmal course. During the paroxysm itself, the condition of the children is serious. Appears wheezing, paroxysmal cough, the chest is swollen, there is a feeling of lack of air. Children are restless, rush about, do not want to lie in bed, take a semi-sitting position - this makes it easier to breathe. Sometimes, on the contrary, they can be lethargic, it is difficult for them to speak or sit in bed. They experience shortness of breath during exhalation (it is difficult to exhale air) due to blockage of the lumen of the bronchus and narrowing of its lumen. The wings of the nose swell, the veins of the neck swell, the intercostal spaces retract. The pulse is increased. The skin is pale, and blueness may appear around the mouth (perioral cyanosis) and fingers (acrocyanosis).

Bronchial asthma in children is characterized by the fact that attacks occur more often at night and in the early morning hours. This distinctive feature diseases. The cough has its own specifics; during a paroxysm it is dry, but at the end of the attack thick sputum is released. Outside of the attack, the child feels well.

Description of bronchial asthma in children by severity

Easy. Seizures in children occur no more than once a month; they rarely occur at night.
Moderate weight. Attacks are repeated 3-4 times a month, no more than 2-3 times at night.
Heavy. The attacks recur 3-4 times a week, only at night.

You may suspect your child has asthma if, over the past 12 months, they have had following symptoms:

Repetitive, sudden attacks cough, with the appearance of wheezing wheezing audible at a distance (distance wheezing).

Frequent colds accompanied by airway obstruction.

The appearance of cough, remote wheezing, shortness of breath at certain times of the year.

Contact with animals, odorous substances, dust, and nicotine causes coughing.

Higher listed symptoms disappear or become less pronounced when using medications with a bronchodilator effect.

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

Symptoms intensify after minor physical activity and inhalation of cold air.

Bronchial asthma - serious disease, it requires special approach. Need timely diagnosis, complex treatment. Children should be under medical supervision. When the first symptoms of an attack appear, you should definitely contact medical institution or call ambulance on house. Paroxysm must be stopped in time, otherwise it can turn into asthmatic status, which is difficult to treat. And then you will have to work for several years to remove the diagnosis of bronchial asthma.

Almost five centuries ago, on December 8, 1542, Mary Stuart, queen of two states - France and Scotland, was born. Her amazing life, more reminiscent of an adventure novel, was filled with love adventures, palace intrigues, betrayals and passions.....

Mary Stuart. Flyorova Elena Nikolaevna

Ilga

More than a year ago, my husband’s mother died. Left behind are a stepfather (according to the documents, the husband is not adopted) and a maternal brother. His parents saved up for a cottage, but never managed to purchase it; all the property went first to his father, who asked him to write a waiver of the inheritance in order to register the car and so on. The youngest son lives with his father with his girlfriend, I don’t know if he wrote a renunciation of the inheritance. The bottom line is that the money saved up for the cottage (not a small amount) was divided by the father and the youngest according to their accounts, but they didn’t tell us anything, they found out by chance from their brother (he said that they were saving money further for themselves), it turns out that the husband gets nothing from his mother as an inheritance in general. Everything will be registered in the name of my brother. The husband claims that he will earn everything himself (this is unrealistic). His father lied to him that all the money was “burnt.” In general, it was always the case that in all the years my father never called himself, never asked how he was doing, etc. My brother is like that too. But the husband constantly calls them himself, worries about their health, etc. I tell my husband - I wonder if you hadn’t called them yourself, would they have remembered about you and called you? He says - definitely not my father, he was brought up that way (or not brought up, rather)! I feel sorry for my husband that he is abandoned by them and does not understand this, that his father does not act honestly, and did not receive any inheritance from his mother at all, nothing.

Alena Viktorovna

Hi all. I had a fight with my mother and managed to do this - hang a mountain of guilt on me. She lives in the country, she has about 30 cats and several dogs. My favorite dog is a shepherd dog) so aggressive that I don’t even go into the yard of this dacha, he can’t tie him up - he doesn’t like him. The cats are sterilized, but there are not fewer of them: kind people constantly drop someone off or she picks them up... it’s very expensive to maintain this zoo. the mother is retired (she practically never worked), the father works and receives a pension, but they can barely make ends meet. and then someone advised her to go online. It’s so simple - you create a page and that’s it, they start sending you money! She doesn’t understand anything about this, she doesn’t have a computer, it’s a push-button phone. can open Google and make a request. All. what's happened social media seems vague. She came to see me today. Make, he says, a page and lead it. I’m in the city, I have two children, two jobs, the youngest just started kindergarten, she’s constantly sick. She doesn’t sit with the children - she doesn’t want to, she doesn’t have time. What it means to create a page/channel and promote it, how long it takes - she has no idea. and I hate social networks! These groups... I'm not even on Instagram. In general, I went crazy, my mother began to cry that no one wanted to help her, she was asking for such a small thing! I’m trying to explain to her - I need photos, videos, stories about animals... but I can’t even go there. Like this is not a problem - my father takes photographs, I write.
Now I’m sitting, crushed by the feeling of my own insignificance (((buy her good phone? tablet? Will she figure out how to create and develop her blog or page? I definitely don’t want to do this myself. This is an encroachment on the last piece of my personal time (((I don’t have it anyway... children, work, home, and also - I teach at a university, I have to write science articles(now the benefit is “hanging” on me, it’s soon to be handed over, and I’ve been toiling with my youngest child for two weeks - she’s got the flu (((no one ever told me: “Alena, let’s sit with the girls, and you go to the bathhouse!”). No. My father still sees my children if I need to go to work urgently, but my mother never. But to assign more responsibilities to me is yes ((((in general, I’m sitting, I feel like a piece of... organic origin((( (

Squirrel

Do men generally feel sorry for women? Why do they think that a woman is a horse and must plow at work and at home? And don’t whine or complain. In short, plow and laugh with happiness.
I don't know about others. But I’ll tell you for myself, it’s hard to work full time, and weekends don’t feel like rest. How are you?

Olga Veselova

I have a friend. She has been involved in charity work for several years. She has no opportunity to participate financially. But she has the talent to unite people, inspire them, and infect them with an idea. They are involved in helping families in difficult situations and shelters, but their main activity is collecting funds for treatment. There have been many stories over the years. And with children, and a pregnant woman, and even for a man who has been in an accident. She rarely gives details. But then I decided to ask around myself. How does communication develop with the people she helps? After all, for a story to work, you need to be sick of it. They print leaflets, post them around the city, raise all the media, hold charity fairs and concerts. It turned out that after the end of the collection, people never make contact again. They don’t take part in gatherings (to help with putting up leaflets, for example), they don’t congratulate you on your birthday. Some people they meet in the city turn away and pretend that they don’t know each other. I’ll say right away that she has no torment about this. She had long passed the stage when she was fascinated by people. Tries not to get close. Helped on the side too. Usually newbies who make it to the team. at first they are disappointed. So you still need to remember goodness? Do not carry a load and debt on your shoulders, do not approach someone who once helped you in a half-bent position. For example, don’t forget to congratulate him on social networks, or support him when he finds himself in a difficult situation. Most often, when a friend is asked for help, the first words are - we have no one else to turn to

And the reason is personal, for example, my thirty-something nephew. Such a grasshopper, hopping and chirping to itself. No, not a slacker. And the work is not bad, not dusty, and a career is emerging little by little, not like “ah!”, but there is a way to go. And so they offered him a place - super, the salary cannot be compared with the current one, and then - try to grow. No, he says, I don’t want to. I’m still young - I’m looking for what’s mine and haven’t lived to my heart’s content yet. I’m silent, but I don’t think he’s right. Or right?

The article describes in detail the symptoms and treatment of bronchial asthma in children, as well as other nuances of the disease. Parents should study information about this pathology in advance in order to avoid its occurrence, and know the first aid techniques for an attack.

The pathogenesis of bronchial asthma in children is the mechanism of disease formation, which consists of 2 stages:

1. Immunological. At this stage, the allergen that enters the respiratory tract provokes a complex immune reaction.
2. Pathophysiological. At this stage the following happens:

• the bronchial mucosa is affected by an irritant;
• swelling of the mucous membrane occurs;
• arises increased secretion mucus;
• bronchospasm occurs.

Because of the lumen of the bronchi becomes narrow, the asthmatic cannot take deep breaths in and out, an attack of suffocation begins.

Bronchial asthma has several forms:

• infectious-allergic bronchial asthma;
• atopic;
• non-atopic (non-allergenic).

Causes of bronchial asthma in children

Atopic bronchial asthma in children is the most common (90% of cases):

1. Allergens in the form of dust mites, plant pollen, medications, animal fur.
2. Hereditary predisposition. If one of the parents has similar pathology, you should be more attentive to the health of your baby. During the initial medical examination, inform your pediatrician about this.
3. Provocateurs can become gastrointestinal diseases: gastritis, constipation or diarrhea, intestinal dysbiosis.
4. Most common reasons– these are ARVI, bronchitis, diseases infectious origin , cold. Pathogens provoke changes in the bronchial mucosa, as a result of which it becomes more susceptible to allergens.
5. Use of ASPIRIN. Although the medicine itself is not an allergic compound, it can provoke the formation of substances that cause bronchospasm.
6. Excitement, fear, stress.

The first signs of bronchial asthma in a child: after waking up, it appears frequent sneezing, mucus flows from the nasal cavity, after 2 hours a dry cough develops, towards noon the cough becomes productive. Then the main symptoms begin to appear.

Symptoms of bronchial asthma in children

Parents should be alert to the following symptoms:

1. Under 1 year of age:
   • swelling of the tonsils;
   • "sniffling" breathing;
   • sleep disturbance;
   • frequent sneezing, nasal discharge, cough;
   • disruption of the gastrointestinal tract.
2. From 1 to 6 years:
   • if breathing occurs through the mouth, coughing occurs;
   • After any exercise, dry itching appears.
3. Starting from the age of 12 - development of cough in a sleeping state, fear of games.

The main manifestation is an attack of suffocation. Initially, difficulty breathing can occur with a runny nose, coughing (mainly at night), elevated temperature bodies.

Classification and degrees, factors causing exacerbation

The classification of pathology is difficult to determine, as it is accompanied by different symptoms.

The disease is classified by:

• severity at the beginning of treatment;
• asthmatic symptoms;
• flow phases;
• the presence of complications.

There are 4 degrees of the disease:

1. Intermittent. At this stage, suffocation rarely occurs. This degree is characterized by the appearance of wheezing and coughing once a week (no more than 2 times a month).
2. Persistent. At this stage, difficulty breathing occurs more than once in 7 days (not daily).
3. Persistent moderate severity. Daytime attacks occur every day, nighttime attacks several times a week.
4. Severe persistent course of the disease. Provokes the appearance status asthmaticus. Symptoms appear throughout the day.

Diagnosis of the disease

If attacks occur, a visit to the pediatrician is necessary to diagnose bronchial asthma in children. The doctor must conduct an examination and interview the parents about the diseases they have suffered.

This is necessary to clarify the baby’s heredity for development allergic reactions which provoked the attack. Then refer to a pulmonologist or allergist.

It would be a good idea to visit the following doctors:

• immunologist;
• ENT;
• nutritionist;
• physiotherapist;
• dentist (to eliminate chronic infectious foci).

In addition, the doctor prescribes additional examinations as:

• general and biochemical blood test;
• fluorography;
• diagnostic tests;
• spirometry.

Based on the medical history of bronchial asthma, the specialist speaks to the child’s parents clinical guidelines, prescribes therapy. If the pediatrician prescribed glucocorticosteroid drugs for long term, it is worth visiting an endocrinologist periodically to prevent the development of complications in the form of changes in the functioning of the adrenal glands.

First aid: what is prohibited to do

Emergency care for an attack of bronchial asthma consists of inhalation special means for asthmatics. If the parent knows which allergen provokes the development of an attack in the child, it is necessary to eliminate contact with it. After this, call emergency medical assistance.

• mucolytic agents, as they provoke excessive sputum production;
• sedatives that make education difficult take a deep breath and exhalation;
• antibiotics.

Drug treatment

Therapy traditional medicine is divided into 2 groups:

1. Treatment to relieve symptoms. Used to relieve an attack of bronchial asthma, promotes stretching of the bronchi. If an attack occurs, place the patient on the bed and open the window. To eliminate a mild attack of suffocation, inhalations (BEROTEK, ATROVENT) are used. For pathology of moderate severity, medications are used intravenously (SOLUTION OF ZUFILLINE 2.4%), PREDNISOLINE - for severe course illness.
2. Basic therapy, which includes the use of:

• anti-allergy medications (SUPRASTIN);
• antibacterial medications;
• membrane stabilizing agents (INTAL).

Nursing care for bronchial asthma in children is necessary to improve the condition of the asthmatic, develop remission, and prevent complications.

The nursing process for bronchial asthma in children involves:

• introductory conversations;
• preparing the patient for examination;
• monitoring the execution of medical prescriptions;
• planning patient care.

Treatment of the pathology in question should be carried out under the supervision of a doctor.

Non-drug treatment: 6 alternative types

Treatment of bronchial asthma in children with folk remedies is aimed at:

• liquefaction of sputum (coltsfoot, nettle);
• elimination inflammatory processes(yarrow, lungwort, sage, chamomile);
• elimination of spasms (fennel, wild rosemary, chamomile, St. John's wort);
• strengthening the immune system (horsetail, celandine, echinacea).

Treatment of pathology with alternative methods:

Diet therapy. Compliance dietary ration diet with a predominance of foods that contain vitamin E, excluding hypoallergenic foods.

• Physiotherapy. Phonophoresis, inhalation and restoration Airways.
• Breathing exercises. A. N. Strelnikova’s set of exercises is perfect for this.
• Halotherapy. Visit salt cave has a beneficial effect on the body.
• Massage course. Helps reduce the frequency and severity of attacks. effective as additional procedure to thin mucus in the bronchi.

Possible consequences and complications

Complications can be in the form of:

• acute respiratory failure;
• status asthmaticus;
• spontaneous pneumothorax.

There are cardiac, respiratory, cerebral, chronic respiratory, gastrointestinal, and metabolic complications. The most common are atelectasis, emphysema, pneumothorax.

Prevention

To prevent bronchial asthma in children, the following rules must be followed:

1. Contact your pediatrician in a timely manner to prescribe treatment for all pathologies of the respiratory system.
2. Exclude from children's diet food allergic foods.
3. Eliminate contact with potential allergens (animals, plants).
4. Stop smoking in the presence of your child.
5. Regularly ventilate the room and do wet cleaning.
6. Avoid hypothermia child's body(find out how to organize correctly).
7. Use hypoallergenic products to wash your baby's clothes.
8. Eliminate stressful situations.

conclusions

By following preventive measures and treatment prescribed by your pediatrician, you can stop asthmatic attacks for a long time and develop a period of remission. Treatment of the disease is considered complex process, so you can’t treat yourself.

About the most common among children chronic illness– bronchial asthma, says Dr. Komarovsky:

Bronchial asthma is a chronic disease characterized by allergic inflammation and increased sensitivity of the bronchi to substances entering the body from the outside.

In most cases, the disease manifests itself in childhood. This is due to the fact that the structure of the bronchial tree in children has its own characteristics. In almost 50% of cases, the disease is diagnosed by two years of age. In 80% of children, signs of bronchial asthma are detected in school age. The disease occurs twice as often in boys as in girls.

Under the influence of an irritant, the airways narrow, which causes the production of large amounts of mucus. This, in turn, leads to disturbances in the normal flow of air during breathing.

Types of bronchial asthma in children

Bronchial asthma in children is classified according to several criteria.

Depending on the causes of the disease:

• Endogenous – associated with psycho-emotional or physical activity, infection.
• Exogenous – associated with the entry of allergens into the body.
• Atopic – associated with a hereditary predisposition to allergies.
• Mixed genesis - any of the above factors can provoke an attack.

Depending on the severity of the disease:

• Light form. Short asthma attacks occur less than once a week, and at night they are absent or appear very rarely (no more than twice a month).
• Moderate form. Symptoms of the disease occur more often than once a week, but less than once a day. Night attacks occur at least twice a month. During exacerbations of the disease, the child’s sleep is disturbed and depression physical activity.
• Severe form. Attacks occur almost once a day, with night attacks occurring no more than once a week. The child's physical activity and sleep are disturbed.
• Severe persistent form. Attacks of bronchial asthma occur every day during the day and at night. At the same time, physical activity is limited.

Attacks of bronchial asthma in a child can occur under the influence of the following factors:

• Inhalation of allergens (fur particles, pollen, mold), cold or polluted air, including strong odors.
• Emotional stress.
• Some food products and medicines.

Factors that influence the development of the disease:

• Hereditary predisposition. The presence of bronchial asthma in close relatives increases the risk of the disease in a child by 20%.
• Increased sensitivity. Caused by genes located on the fifth chromosome. In this case, the bronchi have increased sensitivity to antigens coming from the environment.
• Environmental factors. The highest incidence of bronchial asthma is observed in areas with high air pollution.
• Acute respiratory diseases in early childhood.
• Maternal smoking during pregnancy or breastfeeding.
• Premature birth, when the baby's respiratory system is underdeveloped.
• Poor nutrition and weight loss.

Symptoms of bronchial asthma in children

To mandatory clinical manifestations bronchial asthma include characteristic attacks suffocation. There are three periods of the disease. During remission, the child does not experience any symptoms. In some cases, he behaves less actively than his peers. If the disease manifests itself at an early age, then constant hypoxia can lead to a lag in neuropsychic development.

Prevention of bronchial asthma in children involves eliminating all potential allergens and strengthening the immune system.

Before the onset of an attack (several days, hours or minutes), the following symptoms of bronchial asthma in children may be observed:

• Increased irritability.
• Lack of appetite.
• Insomnia or drowsiness.
• The appearance of copious mucous discharge from the nose.
• Headache.
• A dry cough that gets worse and wetter over time.

Signs of bronchial asthma in a child:

• Shortness of breath and a feeling of chest compression that prevents him from breathing. It can develop suddenly and reach great strength in a few minutes.
• Wheezing and feeling of lack of air. The inhalation becomes short, but deep and strong, and the exhalation becomes convulsive and slow (3-4 times longer than the inhalation).
• Paroxysmal cough, during which very viscous transparent sputum begins to come out. Sometimes she stands out quite large quantities, which makes breathing easier.
• Bloating chest. The number of breaths per minute is more than 50, in children over 5 years old - more than 40.
• Lack of nasal breathing, the child gasps for air, trying to help himself with his shoulders, torso and neck.
• Forced position in an attempt to ease breathing. The child refuses to lie down. He prefers to sit with his elbows on his knees or a hard surface, sometimes he stands on his elbows and knees with emphasis on his upper limbs.
• Increase in body temperature to 37 °C.

During an attack, the face becomes pale, puffy, with a bluish tint. The child experiences a feeling of fear, breaks out in a cold sweat, and cannot speak. Muscles are involved in the act of breathing abdominal wall, shoulder girdle and backs. Life-threatening signs include turning blue skin, dumb lung, breathing disorder.

The attack can last up to 40 minutes or several hours (in this case, status asthmaticus is diagnosed). After its completion, the child’s breathing gradually normalizes, but weakness remains. With fast and deep exhalation wheezing may persist.

Along with the exacerbation of bronchial asthma, other chronic diseases, such as urticaria, rhinitis, obstructive bronchitis.

It is difficult to recognize the disease in infants. In the prodromal period, the baby has discharge from the nose liquid mucus, sneezing and dry cough occur. The tonsils become swollen and isolated dry rales appear over the lungs.

The child sleeps poorly, becomes nervous and irritable. Problems with bowel movements, constipation or diarrhea may occur. During an attack of bronchial asthma, inhalations are short and frequent, and exhalations are accompanied by noise and whistling, as a result of which breathing begins to resemble a sob. During inhalation, the wings of the nose inflate.

In some cases, simultaneously with attacks of bronchial asthma, a child may experience coughing episodes that appear at night or in the early morning hours and disappear after taking bronchodilators. In children early age Moist wheezing may occur during an asthma attack.

Symptoms of bronchial asthma in children 1–6 years old:

• Sleep disturbances and irritability.
• Periodic coughing during sleep.
• Severe dry cough when breathing through the mouth.
• Intensification or appearance of cough during physical activity.

Bronchial asthma is often combined with allergic rhinitis, which can occur year-round or seasonally, and atopic dermatitis.

Signs of bronchial asthma in a child over 6 years old:

• Cough during sleep.
• Cough after exercise.
• Reducing physical activity.

Diagnostics

At the first signs of the disease, you should seek advice from a pediatrician, therapist, pulmonologist or allergist.

One of severe complications bronchial asthma in children is status asthmaticus. This is a life-threatening condition that occurs as a result of a prolonged attack that is practically uncontrollable.

TO instrumental methods Diagnosis of bronchial asthma in children includes peak flowmetry. A portable tube-like device is used. The child needs to exhale as much air as possible in order to assess the patency of the bronchi. The measurement is carried out in children over 5 years of age. The procedure is performed twice a day, while recording the use of medications and daily routine. This makes it possible to evaluate the effectiveness of therapy and determine the cause of the attacks.

X-ray or CT scan allow to exclude other lung diseases.

Laboratory research methods:

• General and biochemical analysis blood.
• General urine analysis.
• General sputum analysis.
• Bacteriological examination of sputum.
• Determination of protein fractions.
• Allergen analysis.

Differential diagnosis makes it possible to distinguish bronchial asthma from such pathologies as:

• Hyperventilation syndrome.
• Croup
• Diphtheria.
• Foreign body in the respiratory tract.
• Neoplasms in the respiratory tract.

In order to reduce the number of attacks of bronchial asthma in children, it is necessary to exclude the child’s contact with the allergen or carry out specific immunotherapy.

Contraindications to specific immunotherapy:

• Age up to 5 years.
• Lack of clear allergen confirmation.
• Exacerbation of bronchial asthma or other chronic diseases.
• The presence of neoplasms, as well as autoimmune, endocrine and infectious diseases.

For the treatment of bronchial asthma in children, drugs of the following groups are used:

• Beta2-adrenergic agonists.
• Short-acting methylxanthines.
• Systemic glucocorticosteroids.
• Anticholinergics.

These drugs allow you to relax the smooth muscles of the bronchi, and they also reduce swelling of the mucous membrane and vascular permeability, increase the number of contractions of the diaphragm and block the development of bronchospasm.

The drugs can be used in the form of metered inhalations or enterally. In order to prevent bronchospasm, the following means are used:

• Mast cell membrane stabilizers.
• Glucocorticosteroids.
• Cromoglycic acid preparations.
• Leukotriene receptor antagonists.

During an attack you must:

• Place the child in a sitting position.
• Provide him with a flow of fresh air.
• Remove tight clothing.
• Try to calm down.
• Inhale a drug that dilates the bronchi.

A child over 5 years old should be taught to stop attacks of bronchial asthma independently using an inhaler.

In case of severe attacks, seek emergency medical attention.

Complications

One of the severe complications of bronchial asthma in children is status asthmaticus. This is a life-threatening condition that occurs as a result of a prolonged attack that is practically uncontrollable. Its consequence is swelling of the bronchioles and accumulation in them thick mucus, which leads to an increase in suffocation. In 5% of cases the attack ends fatal. With the development of status asthmaticus, emergency hospitalization is indicated. Treatment is carried out in the intensive care unit.

In most cases, by puberty the attacks practically stop, but bronchial hyperreactivity and some impairment of pulmonary function remain.

Also, bronchial asthma in children can cause the following types of complications:

• Respiratory – in the form of pneumonia, spontaneous pneumothorax, acute respiratory failure, atelectasis.
• Chronic respiratory diseases - in the form of emphysema, pneumosclerosis, chronic obstructive bronchitis.
• Cardiac - in the form of myocardial dystrophy, heart failure, arrhythmia, hypotension.
• Gastrointestinal.
• Brain - in the form of respiratory encephalopathy, fainting, neuropsychic disorders.
• Metabolic.

The most a common complication bronchial asthma in children is atelectasis. This is a blockage of the walls of the bronchi resulting from edema. In the absence of timely treatment, a suppurative process may occur in the damaged bronchi.

Forecast

The prognosis of the disease depends on the age at which its first signs appeared. Most children with diagnosed allergic asthma The disease is mild, but serious complications are also possible.

The long-term prognosis of bronchial asthma, the first signs of which appeared in childhood, is favorable. In most cases, by puberty the attacks practically stop, but bronchial hyperreactivity and some impairment of pulmonary function remain.

If the disease begins in adolescence, the prognosis is not so favorable. In general, the disease is slowly progressive and chronic. Correct and timely treatment bronchial asthma in children allows you to eliminate or reduce the number of attacks, but does not affect the cause of the disease. The period of remission can last several years.

Prevention of bronchial asthma in children

Prevention of bronchial asthma in children consists of eliminating all potential allergens and strengthening the immune system:

• Timely treatment of all diseases respiratory system caused by pathogenic microorganisms.
• Quitting smoking during pregnancy and breastfeeding, and also in the future in the presence of the child and in the room where he may be.
• Conducting regular wet cleaning and ventilation of the room where the child lives. Clothes and books should be kept in locked cabinets. From soft toys it is recommended to get rid of it.
• Classes breathing exercises, sports.
• Exclusion from the child’s diet of foods containing harmful additives and potential allergens.
• Elimination of hypothermia.
• Making a child comfortable conditions and minimizing emotional stress.
• Using special hypoallergenic powders for washing children's clothes.

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