Respiratory disturbances in children: sleep apnea and first aid

It's about breathing disorders in a child of central origin. The more we know about the physiological characteristics of the child's organism, the better we can prevent the development of severe conditions in children, leading to a threat to their lives and to provide first aid.

We know that the very first breath of a newborn baby starts the most important function of the human body - breathing. In children of the first year of life, precisely this function is most often subjected to various disorders: from simple nasal congestion to the complete cessation of breathing in a dream called sleep apnea, which can lead to sudden death.

CONTENTS

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Child's breathing regulation is normal

There are numerous receptors inside the blood vessels that react to changes in blood composition. Once they fix the decrease in oxygen level and the increase in the carbon dioxide content, they send a signal leading to the excitation of the respiratory center located in the medulla oblongata. The respiratory center gives an order to the respiratory muscles( diaphragm, intercostal muscles), causing them to contract and make a breath. At this time, the chest expands. And exhalation with quiet breathing is carried out passively, and the thorax returns to its original state. Failure at any link in this chain entails a violation of breathing.

The central( brain) and peripheral( the receptors and the nerve trunks, through which the impulses go from the center to the respiratory musculature) control the nervous system.

In young children, the regulation of breathing is automatic.

Adults and older children are able to consciously delay inhalation or exhalation, carry out deep or shallow, frequent or rare breathing. Then the leadership moves to the cerebral cortex, and the respiratory center takes a subordinate position.

Causes of breathing disorder

In the first year of life, especially in premature infants, the function of breathing during sleep is very unstable.

This sad circumstance is explained by the physiological immaturity of the central and peripheral mechanisms of regulation of respiration. The instability of breathing creates the prerequisites for its frequent disturbances during sleep and the development of conditions called apnea of prematurity and apnea in infants.

Apnea - absence, or complete arrest of respiration

Almost half of premature babies during sleep have breathing stops lasting up to 20 seconds, which is primarily due to the immaturity of the respiratory center, although peripheral receptors as well as pulmonary reflexes can not be discounted. The weaker the premature, the more pathological conditions accompany it from birth( anemia, sepsis, hypoxia, heart defects, convulsions, etc.), the more often it stops breathing in a dream.

Symptoms and signs

But the child born in time is not immune from the stopping of breathing in sleep, which are called apnea of the baby. The duration of respiratory pauses reaches 20 or more seconds and is accompanied by a sudden appearance of pallor or cyanosis, a rare heart beat, a decrease in muscle tone. The observant mother will say to the doctor with alarm: "He stopped breathing, turned pale, turned blue and all went limp."

Associated diseases( perinatal encephalopathy, convulsive syndrome, sepsis), anatomical defects of the facial skeleton( cleavage of the upper lip and hard palate, underdevelopment of the lower jaw) contribute to the development of infant apnea, and the reception of some medicinal products( narcotic, hypnotic, sedative) by the mother.

Scientists have reliably proven the direct relationship between a mother's smoking during pregnancy and the occurrence of sleep apnea in a child.

The more cigarettes a day a mother smoked, the more frequent and prolonged respiratory pauses are observed in the child.

What to do: first aid

If prolonged respiratory arrest is accompanied by pallor and / or cyanosis, a decrease in muscle tone( "limp"), lack of movement, then shake, slow down the child, blow on his face to excite the respiratory center. In most cases, these actions help to restore breathing. If they are ineffective, immediately start resuscitation: open your mouth to the baby, tighten your nose tightly around his nose and mouth and blow air into his respiratory tract, while doing an indirect heart massage.

Frequent and prolonged apnea dictates the need for constant monitoring of the baby's breathing. In such cases, the dream of mom and baby in one bed is welcomed, facilitating observation of the condition of his breathing and rendering immediate assistance.

Many parents have heard about the existence of a tragic phenomenon - the syndrome of sudden child death. Scientists suggest that the most likely cause of this syndrome is sleep apnea.

In some newborns, again, more often in premature babies, on the background of expressed anxiety and a prolonged cry, breathing stops may be noted, which people call "rolls": "he cries so much that he even rolls himself up".Such attacks can be observed not only in newborns, but also in children of the first 2-3 years of life. They are called respiratory-affective, are short-term and stop on their own, but their recurrence dictates the need to contact a neurologist.

Obstruction of the upper respiratory tract

Respiration is the most important function of a living organism, providing oxygenation of the blood and removing carbon dioxide from it. The inhaled air enters the nasal cavity, then into the nasopharynx, trachea, bronchi and into the lung tissue. Nasal congestion in the baby, adenoids and chronic tonsillitis, underdevelopment of the lower jaw, laryngeal edema, foreign bodies of the respiratory tract - these conditions also often lead to respiratory failure in children, and moms must be aware of this and take timely measures.

Fortunately, nature rewards its children with protective mechanisms that can protect them from many troubles and tragedies.

So, the pharynx in its location resembles a crossroads of three roads: to the right you will go - into the nose you will get, on the left you will go - in the larynx you will come, and directly you will go - you will appear in an esophagus. But it is not without reason that the central nervous system has a leading role in the management of all processes in the body. As the regulator at a busy intersection distributes the streams of machines along the directions, the nervous system also ensures that the pharynx fulfills its main function-the separation: during swallowing, the epiglottis closes the entrance to the respiratory tract, and the food enters the esophagus, and not into the larynx. When inhaling, the entrance to the esophagus falls, blocking the airway into the stomach. During regurgitation or vomiting, the nasopharynx and the larynx reliably close, and the vomit rushes into the oral cavity.

If the coordination of these movements is disturbed by some pathological process, such as stroke, myasthenia gravis, botulism, cleavage of the hard palate in a newborn, then food is poured into the nasal cavity, the patient poppers, coughs, liquid food poured through the nose.

If food gets into the larynx, instant death from suffocation can occur or aspiration pneumonia develop if small food particles have flown into the bronchial tree.

But in these cases, nature has provided a favorable development of events, rewarding a person in general and the child in particular with the ability to release the respiratory tract from a foreign body with the help of coughing, sneezing and vomiting.

The "children's remote control" of the "First Aid" often receives calls to infants with occasions "drowned", "choked", "choked", "stopped breathing".All these challenges are united by the same reason: during feeding( especially when milk is "poured by the river") or regurgitation( vomiting), the milk is "in the wrong throat".

At this moment, instantaneous reflex closure of the glottis occurs, preventing the ingress of foreign particles( milk, vomit) into the respiratory tract. Despite the fact that this reaction is protective, there is no limit to the panic of parents. Of course, to watch how your little one stopped breathing and turned blue is very scary. But the condition lasts a few seconds and passes by itself, as soon as the cause that stopped the breathing has been eliminated.

What if my baby chokes / choked?

Hold the baby firmly by the legs and turn it upside down. Milk will flow out of the throat, and eliminating the cause leads to the opening of the larynx and the restoration of breathing. Such a short respiratory pause does not harm the child, but, on the contrary, protects him from the development of aspiration pneumonia.

Sometimes the stop of breathing lasts longer, the child turns blue, and the heartbeat becomes rare. Perhaps a few drops of milk hit the larynx and caused a prolonged apnea. Turn it upside down, tap on the back.

Sit on a chair, put your baby's belly on his left thigh head down, knock on the back. With your right finger, press down on the root of the tongue or tickle the back of the pharynx to cause a cough reflex. Cough will help clear the airways, and breathing will recover. If a vomiting occurs along with a cough, it's not too bad. There will be a more complete liberation of the larynx and pharynx from foreign objects.

In a critical situation, it is important not to succumb to panic, but be able to carry out resuscitation measures to a baby with a stoppage of breathing: closed heart massage and mouth-to-mouth breathing.