Obstructive bronchitis symptoms and treatment | How to treat obstructive bronchitis
Bronchitis is an inflammation of the bronchi. In many people, respiratory system diseases are accompanied by a bronchoobstructive character. Obstruction in medicine means blockage or constriction. One type of conventional bronchitis is the obstructive form of the disease, the symptoms and treatment of which we will consider today. How to treat obstructive bronchitis, read further in the article.Yandex. Direct
Slitting Machine.Delivery across Russia!Slitting Machinemetal GOST. Installments! Press it! Installment 0% CatalogPrice listContactsstanki48.ruAdres and phone Hide the ad|
Treatment of obstructive bronchitisATSTS liquefies and displays phlegm, helping to quickly get rid of a cough! Properties of the ACCS Forms of the release of the cough of diseases. Acclong. There are contraindications. Talk to your doctor. Hide Ad|
Symptoms of obstructive bronchitis
Inflammatory disease, which is accompanied by obstruction or narrowing of the bronchi, which causes mucus does not go from the lungs is called obstructive bronchitis. The main sign of the disease is an incessant cough with yellowish-greenish phlegm.
Coughing is protecting the body against bacterial disease. Only more useful is a wet cough, when liquid mucus easily leaves the bronchi, facilitating the respiratory system. Obstructive bronchitis is very difficult and can last from a week to a month. Clinical symptoms of obstructive bronchitis include:
1. strong wet cough with discharge of opaque or with blood sputum;
2. dry "barking" cough with whistling, paroxysmal and long;
3. because of accumulated mucus, breathing becomes difficult and dyspnea occurs;
4. the appearance of wheezing in the bronchi;
5. whistling when breathing;
6. high body temperature (above 38.0 degrees) for 3 days;
7. discomfort, sore throat;
8. soreness and sensation of a spasm or lump in the throat;
9. in obstructive bronchitis, the thorax can also swell;
10. feeling tired;
12. prolonged fever as a symptom of obstructive bronchitis;
Diagnostic signs of obstructive bronchitis
The following results of bronchitis are indicated:
1. the blood test changes, which indicates the presence of a viral infection;
2. at a roentgen of lungs against a background of an obstructive bronchitis: increase of a transparency of pulmonary contours, elongation of pulmonary contours, strengthening of roots of lungs;
3. when listening to the lungs with an exhalation of air, a dry wheezing sound is audible.
The phases of manifestation of obstructive bronchitis
In addition to previous symptoms such as weakness, general malaise, throat swelling, runny nose, early and first sign of acute bronchitis is a dry, protracted, painful cough. The clinical picture of obstructive bronchitis consists of three phases:
1. phase of dry cough;
2. sputum expectoration phase;
3. the phase of restoration of bronchial function.
Treatment of acute obstructive bronchitis
Treatment of the disease should be comprehensive, aimed both at fighting infection and restoring the patency of the bronchi.
How to treat acute obstructive bronchitis with drugs?
The suppression of the activity of microbes with symptoms of obstructive bronchitis is directed primarily to the use of antibiotics and sulfonamide preparations. Also, in the complex treatment of obstructive bronchitis, prescribe the intake of vitamins and drugs that extend the bronchi. A good effect in the first days of the disease can be achieved by applying hot foot baths, mustard plasters, cans. Also, the use of medicinal collections and herbs shows itself well. In the first few days of the disease, bed rest is shown. Hospitalization, as a rule, is not carried out, and the treatment takes place at home. A mandatory condition for adults is a complete refusal to smoke at least for the duration of treatment.
In the treatment of the most important - elimination of spasm in the bronchi, dilution of sputum and its removal outward. This process takes a long time, because in some cases, the cause of chronic bronchitis is smoking. And the first thing you need to do is to give up smoking. It is also necessary to start taking bronchodilator drugs that perfectly dilute sputum and promote its isolation from the bronchi (synthetic mucosal drugs), anti-infective drugs. Also, immunostimulating drugs may be prescribed for the treatment of obstructive bronchitis to increase the protective forces of the body, breathing exercises, nasopharyngeal washing, inhalation. When the disease takes a severe form - prescribe a course of antibiotic treatment.
How to treat the disease in the phase of recovery?
In the phase of recovery and recovery of bronchial function, it is recommended to actively engage in physical therapy, receive massages, and perform general restorative therapy. Frequent walks in the open air, acceptable physical activity are also necessary. Obviously, with timely treatment, acute bronchitis does not go into the chronic stage and passes without complications. Especially considering the fact that modern drugs are fast-acting fighters! Timely reception of drugs and the correct implementation of all the recommendations of a doctor will lead to a speedy recovery.
To achieve positive results in the treatment of obstructive bronchitis can be with timely treatment in a medical institution. Not a small role plays in the treatment of the disease and the desire of the patient, for this you need to lead a healthy lifestyle.
Causes of obstructive bronchitis
Obstructive bronchitis is acute and chronic. Chronic diseases are mainly sick adults, and acute bronchitis children (passive smoking).
The main cause of the disease is smoking, a high concentration of gases and dust in the air, as well as pathological insufficiency alpha-1-antitrypinas by means of which the inflammatory process in the lungs takes place (pneumonia, recurrent bronchitis). In 90% of cases, the beginning for the disease is nicotine, and a third of patients with obstructive bronchitis - never smoked, but were passive smokers, thanks to their loved ones. Abnormal processes in the lungs in the chronic form of the disease develop over many years and decades, and the consequences of the disease are severe for treatment.
There is obstructive bronchitis due to a viral or infectious disease, in heavy smokers, allergies (animal hair, paint, flowering bushes and trees), ingestion of certain foods, hypothermia, prolonged acute bronchitis, pathology of ENT organs, and in small children - in connection with trauma during childbirth.
Provoking factors of obstructive bronchitis
1. Disease of the nasopharynx;
2. Acute viral infections;
3. Unfavorable working conditions;
6. Genetic predisposition and many other factors.
Bronchitis is an inflammatory disease of the respiratory system, which results in coughing, sputum separation, shortness of breath and respiratory failure. Obstructive bronchitis develops as a result of the narrowing of the lumen of the bronchi, resulting from spasm, edema of the bronchial mucosa and obstruction of the airway of the respiratory tract by sputum. This type of bronchitis often develops as a complication of influenza or viral infection in children of the first years of life, but also adults suffer from this disease.
The frequency of the disease in young children is associated with the peculiarities of the anatomical structure of the bronchi - a narrow lumen respiratory tract, imperfection of children's immunity and frequency of occurrence of viral infections.
Obstructive bronchitis is a serious and dangerous disease that can lead to complications and become a cause of respiratory distress, especially in young children. Parents may underestimate the severity of the child's condition and do not pay enough attention to treatment, often this leads to a chronic process or the development of complications.
Causes and mechanism of disease development
Obstructive bronchitis develops against the background of viral infections, most often this disease affects children under 3 years old ARVI or influenza caused by the PC infection, adenoviruses, influenza A viruses or mycoplasmal and chlamydial infections.
When a viral agent enters the upper respiratory tract, inflammation of the bronchial mucosa develops, inflammatory mediators are released, which provokes mucus edema and sputum production. The narrowing of the bronchi in children is mainly caused by the edema of all the walls of the bronchi and the clogging of their phlegm, and bronchospasm often causes obstruction in adults.
Acute and chronic course of the disease
Acute obstructive bronchitis - occurs in childhood, occurs against the background of a previous viral infection and with proper treatment, takes place within a few weeks. That is why it is very important to cure all diseases to the end, so that it does not become chronic.
Chronic obstructive bronchitis - develops gradually, this disease affects mainly adults, the cause of its development are bad habits (smoker's bronchitis), occupational hazards (when working with harmful substances or with the constant inhalation of dust), adverse environmental factors and hereditary predisposition. The diagnosis of "chronic obstructive bronchitis" is set in the event that the symptoms of the disease - cough with sputum, are diagnosed in the patient for 3 months a year for 2 years, in the absence of other bronchopulmonary diseases.
The main symptoms of the disease
Acute obstructive bronchitis and exacerbation of chronic bronchitis occur approximately equally - against a background of mild ailment or a viral infection, the patient has the following symptoms:
- A severe painful cough is the main symptom of the disease, at first a rare dry cough develops into long, painful attacks, which greatly exhaust the patient, do not bring relief and cause pain in the chest. This cough intensifies at night and prevents the patient from sleeping peacefully.
- Shortness of breath - difficulty with bronchitis occurs during exhalation, a person begins to gasp, can not breathe out quietly because of narrowing the lumen of the bronchi and clogging them with mucus, this causes a gradual fatigue of the patient and leads to the development of emphysema. Emphysematous lungs are excessively stretched and air-filled lungs, if obstructive bronchitis is chronic, the thorax the person gradually changes - it becomes barrel-shaped, the lower ribs expand, respiratory failure and emphysematous disease occur.
- Coryza - except for difficulty breathing in the bronchi, with bronchitis, nasal breathing can be disturbed, which further exacerbates the situation.
- Body temperature rise - with bronchitis the body temperature can remain normal, but more often is on the numbers 33-37.5 degrees.
- Headache, weakness, poor health - as the disease develops, the patient's condition may deteriorate severely, lack of air, painful coughing attacks, constant fatigue due to shortness of breath, lack of sleep - all this makes the sick weak and strongly affects the overall well-being.
- Redness of the throat - bronchitis also inflames the palatine tonsils and the back wall of the throat, except for a cough and runny nose, the patient may complain of a sore throat and the inability to swallow anything.
Chronic bronchitis, even during an exacerbation, may not give such a vivid clinical picture, most often patients suffer from constant dry or wet cough, periodically they have shortness of breath and lack of air and general deterioration of the condition. But, since, chronic bronchitis can last for years, the person no longer pays attention to such symptoms and takes for granted a constant cough and chest pain.
And instead of conducting a full-fledged treatment and finding out what factors provoke an exacerbation, such patients try mitigate the symptoms of the disease, not caring about what provokes the development of respiratory failure. So do not wait until the disease goes into a more severe form, take all measures to get rid of this disease and improve your body.
Principles of treatment of obstructive bronchitisTreatment of obstructive bronchitis both in children and in adults should necessarily be complex, it is necessary to use several methods of treatment. Good results are obtained by the simultaneous use of antibiotics, mucolytics, expectorants, physiotherapy, massage and traditional medicine.
Treatment of obstructive bronchitis in children will require a lot of cares and efforts from parents. If your child has been exposed to such a diagnosis, then in no case can not start treatment on its own or hope to get by taking antibiotics and antipyretics. Complex treatment includes all the necessary procedures and is carried out until all the signs of the disease disappear. Treatment of obstructive bronchitis should appoint a doctor, do not try to cope with the disease, especially in young children, it can lead to serious complications.
- Bed rest regime - the child should always be in bed and avoid any physical exertion.
- A plentiful warm drink and light nutritious food - it is necessary to provide the child with a lot of warm alkaline drink, this will help him to soften the throat and make up moisture reserves in the body. Food during illness should be light and nutritious, if the patient has no appetite, it is better not to force him to eat, but to offer fresh fruits and vegetables or dairy products.
- Antibiotic therapy - despite the fact that the most common cause of infection are viruses, do not deny from the use of antibiotics, too high a risk of developing bacterial complications against the background of obstruction. When taking any antibiotics, one should not forget that they violate the intestinal microflora, simultaneously with antibiotics you need to take lineks, hilak-forte, bifidobacterin or other drugs to combat dysbiosis.
- Mucolytics and expectorants - to dilute the accumulation of sputum in the bronchi and ensure its removal therefrom, it is recommended to conduct steam inhalations with any alkaline solutions. You can also use aerosols that help to soften the throat and dilute sputum - it is especially convenient to use aerosol inhalation in young children. It is also necessary to take expectorants - licorice root, althea, ipecacuanas, thermopsis solution, breastfeeding, broncholitin, mucaltin and others.
- It is necessary to try to get rid of mucus and rinse the nasopharynx - with the accumulation of mucus it is prescribed to take it from the nasal passages with the help of a rubber pear or electric suction, this is of great importance in the treatment of children of the first years of life who do not yet know how to clean their noses and do not give a gargle. To wash the nasopharynx in older children, saline solution, Borjomi and washing facilities can be used.
- To reduce the common cold, it is possible to use vasoconstrictors suitable for the child's age. For infants it is recommended to use Aquamaris - drops containing only a little salt or nazivin for children over 1 year, all these drugs can not be used more than 2-3 times a day and not more than 3 days in a row.
- Breathing exercises and massage - help restore normal breathing and drainage function of the bronchi. Any person can do the usual vibrating massage, it is enough to knock the ribs of the palm along the back and chest painfully, several times a day, to get the effect of vibration. But much more benefit will be with a professional massage, great value massage has for the treatment of young children who have an outflow of phlegm is very difficult, in this case you need to seek help from professional masseurs who specialize in children's massage.
Traditional methods of treatment
For the treatment of bronchitis, folk medicine offers the following recipes:
- Inhalation - with eucalyptus leaves (2 teaspoons for 0, 5 cups of boiling water), with collection (30 grams of chamomile and elderberry, mixed with 25 g of lime-colored and peppermint.
- To facilitate the departure of phlegm, cranberry juice mixed with honey in equal proportions is used.
- Treatment of bronchitis with the help of fat - melt fresh fat, better interior, on slow heat and drink warm 1-2 tablespoons 5-6 times a day.
- Compress of oil with honey - take 1 tablespoon of oil and honey, warm in a water bath and spread a mixture of chest and back. Compresses do daily until the end of the course of treatment.
Preventing the disease is much easier than treating the consequences:
- Increased immunity - the intake of vitamins, the constant presence in the menu of fresh vegetables and fruits,
- Hardening - helps to avoid viral infections and colds,
- Timely treatment of ARVI and other infections.
- Walking in the fresh air and physical training.
Obstructive bronchitis - Dr. Komarovsky
Bronchitis in children: acute, obstructive bronchitis, symptoms, treatment
Bronchitis in children most often occurs in the form of complications against the background of acute respiratory viral infection, influenza or a severe cold, hypothermia. The provoking factors of bronchitis are seasonal sharp temperature changes, especially periods of rain with high humidity, so this disease usually occurs in the fall or spring.
In form, all bronchitis in children are divided into: Acute, Prolonged and Recurrent.
For reasons of occurrence, depends on the pathogen of inflammation and is divided into:
- Viral - influenza, adenoviruses, parainfluenza
- Bacterial - can be acute and obstructive (the causative agent is streptococcus, staphylococcus, moraxelly, hemophilic rod, as well as mycoplasma and chlamydia)
- Allergic, obstructive, asthmatic - arises from irritating chemical or physical factors, such as household chemicals, home dust (read about the symptoms of allergy to dust), animal hair, pollen of plants, etc.
Bronchitis in a child up to a year - symptoms and treatment
Children who are breastfed and who do not have contact with sick children and adults should not have any respiratory illnesses. However, if the child was born prematurely, has congenital malformations of the respiratory organs and other diseases, and also in the family there is children of preschool age who attend kindergartens and are often ill - the development of bronchitis in a child up to a year is possible for the following reasons:
- narrower than the adult, bronchi, a more dry and vulnerable mucosa of the respiratory tract
- existing congenital malformations
- after a viral or bacterial infection
- the presence of individual sensitivity to chemical and physical stimuli - an allergy to anything.
The most basic symptoms of developing bronchitis are a severe dry cough, paroxysmal, accompanied by difficulty breathing, shortness of breath. Gradually, the cough becomes moist, but mucus, sputum during bronchitis in a child up to a year makes it difficult breathing, the normal functioning of the lungs is disrupted, since the airways in infancy are narrow. Bronchitis in children up to a year and even up to 3-4 years is most often the following:
- Acute bronchitis simple
- Obstructive bronchitis
On acute and obstructive bronchitis, we will dwell in more detail below. And now consider the most common in children under one year oldbronchiolitis.
Bronchitis in children under one year of age - bronchiolitis
This bronchitis affects both small bronchi and bronchioles, develops more often against the background of acute respiratory viral infections, influenza viruses with the subsequent reproduction of pneumococci (and so on. streptococci). In case of inhalation of icy air or sharp concentrations of various gases, bronchiolitis can develop as an independent disease. The danger of such bronchitis is a pronounced bronchoobstructive syndrome with the development of sometimes even acute respiratory failure:
- Characteristic of dry cough attacks, pronounced dyspnea of a mixed or expiratory form with syndromes of swelling of the wings of the nose, with the participation of ancillary muscles, retraction of intercostal spaces of the chest, pallor of the skin, cyanosis.
- The child has dry mouth, no tears when crying.
- The child eats less and drinks than usual, respectively, and his urination is more rare.
- Increased body temperature, but unlike pneumonia, it is less pronounced (see. whether it is necessary to bring down the temperature).
- Shortness of breath to 60-80 breaths per minute, while breathing is grunting, superficial.
- On both sides are heard diffuse wet ringing finely bubbling and crepitating rales.
- Symptoms of intoxication in bronchiolitis in children are not expressed.
- X-ray is determined by the sharp transparency of the lung tissue, the variegation of the pattern, the horizontal standing of the ribs, the absence of infiltrative changes in the lungs.
- If at first there was a simple bronchitis, the attachment of bronchiolitis after a while manifests a sharp deterioration general state of the child, cough becomes more painful and intense, with scant sputum.
- Children are usually very restless, moody, excited.
- The blood test can be slightly changed, a slight leukocytosis and an increase in ESR are possible.
- Usually bronchiolitis in children up to a year has a long course of up to 1-1.5 months.
- The causes of acute bronchiolitis in children are similar to the causes of development of obstructive bronchitis in children older than 2-4 years. The local immune system of the respiratory tract in children under 2 years is weak, protection against viruses is not enough, so they easily penetrate deep into bronchioles and small bronchi.
Treatment of bronchiolitis in children
At home, you can not cure bronchiolitis. When a bronchiolitis occurs, the infant is usually shown hospitalization, so that the child is under the supervision of doctors. In the hospital pediatricians, pulmonologists will establish an accurate diagnosis and prescribe appropriate treatment. What should my mom do before the ambulance arrives?
You can only alleviate the symptoms of colds - create optimally comfortable air in the room, turn on the humidifier, air purifier.
If there is no high temperature in the child, you can ease breathing with warming creams and ointments, spread them legs, calves. Only with this you need to be cautious if the child has not had any allergic manifestations before, then it helps a lot if a child allergic, warming ointments should be excluded.
To cough softer, you can do steam inhalation-above a boiling pot with a weak saline solution, hold the baby in her arms. Or sit him down at the table and cover with a towel over a cup of hot medical solution.
Try to force the baby to drink more to avoid dehydration, if the child refuses the breast or mixture, give the child just pure water.
In the hospital to relieve the signs of respiratory failure, the baby is given inhalations with bronchodilators and allowed to breathe oxygen. Also at the doctor's discretion, an antibiotic is selected - Sumamed, Macroben, Augmentin, Amoxiclav. It is possible to use various drugs with interferon. Necessarily prescribe antihistamines for the removal of edema at the site of inflammation and a possible allergic reaction to treatment. If symptoms of dehydration are observed, then the necessary rehydration therapy is performed.
Acute bronchitis in children - symptoms
Bronchitis in children is the most common form of respiratory tract disease. Acute bronchitis is an acute inflammation of the bronchial mucosa without symptoms of inflammation of the lung tissue. Simple bronchitis in children is 20% self-contained bacterial disease, 80% - either in the program of viruses (virus Coxsackie, adenovirus, influenza, parainfluenza) or as a bacterial complication after these viral infections.
Clinical symptoms of bronchitis in children are as follows:
First, the child has general weakness, malaise, headache, lack of appetite, then there is a dry cough or cough with phlegm, the intensity of which is rapidly increasing, when listening to dry dry or diffuse wet rales are determined. Sometimes there may be a barking cough in a child whose treatment is slightly different.
In the first 2 days, the temperature rises to 38 ° C, but with a light form, the temperature can be 37-37.2.
After 6-7 days, the dry cough becomes wet, the sputum discharge facilitates the child's condition and is a good sign that the body is coping with the infection and the virus.
On average, the duration of acute bronchitis in children is 7-21 days, but the nature of the disease, the severity of the inflammatory process depend on the child's age, the strength of his immune system, the presence of concomitant chronic and systemic diseases. In case of inadequate or untimely treatment, acute bronchitis can lead to addition - bronchiolitis, pneumonia.
Sometimes after the flu, for some time, the child's condition improves, and then a sharp deterioration, a rise in temperature, a rise in the cough - this is due to the weakening of the immune system in the fight against the virus and the attachment of a bacterial infection, in which case an antibiotic is indicated.
With mycoplasmal or adenoviral acute bronchitis in children, the symptoms of intoxication, such as high fever, headaches, chills, lack of appetite, can be about a week. Usually acute bronchitis is bilateral, however, with mycoplasma bronchitis it is most often one-sided, sometimes combined with conjunctivitis.
Acute bronchitis in children - treatment
Most often, the duration of acute bronchitis in children, whose treatment is correct and carried out on time, should not be more than 14 days, however, in infants, cough can persist for up to a month, as well as for older children with atypical-mycoplasma bronchitis. If suddenly the bronchitis in the child is delayed, it is necessary to exclude a number of diseases:
- aspiration of food
- cystic fibrosis
- foreign body in bronchi
- tuberculosis infection
A pediatrician prescribes a full treatment package. In addition to implementing all the recommendations of the doctor, you should provide the child with special nutrition and quality care. It is desirable to create in the room the optimum humidity and purity, for this purpose it is convenient to use a humidifier and a cleaner air, often ventilate the room and conduct daily wet cleaning in the room in which the child is. And:
- Abundant drink
Ensure abundant reception of fluids in a warm form. To soften the cough, warm milk with butter or Borjomi mineral water helps, can be replaced with honey.
With fever, the temperature just above 38C should take antipyretics - paracetamol in syrup.
Antibiotics for bronchitis in children, if recommended by a doctor, should be given strictly by the hour. If taking antibacterial drugs is necessary 3 times a day, this does not mean that you should drink from breakfast, lunch and dinner, which means, that their reception should be 24/3 = 8, every 8 hours, if 1 time per day, then give it only at the same time, for example at 9 o'clock in the morning. 11 rules - how to take antibiotics correctly.
- Cough medicine
With a dry cough, the child can be given antitussive medicines as prescribed by the doctor, and when it becomes wet to go on expectorants. With a dry cough, the means can be combined (Sinekod). If the cough is wet, then expectorants are shown - Mucaltin, Bromhexin, Gedelix, Alpine syrup, Thermopsis herb infusion or its dry extract, Bronchicum, Evcabal, Prospan, breastfeeds.
Inhalation in bronchitis in children, the symptoms of which are very pronounced, are well helped by inhalation with the usual food soda, called over hot pots, inhalation of sodium bicarbonate using a nebulizer, inhaler.
- For babies
For small and infants who do not know how to clear themselves, doctors advise turning the child more often from one side to the other. In this case, sputum is shifted downward, irritating the bronchial wall, this leads to reflex cough.
For older children, cans, mustards, hot foot baths, they still help, and if the child has strong immunity, such procedures will help to avoid taking antibiotics. You can soar the baby's legs after 1 year, and also rub them with warming agents - turpentine ointments, Barsukor, Pulmaks baby, etc., but only in the case when there is no high temperature, after rubbing, you should warm your feet and wrap up your baby. However, in case of an allergic bronchitis in a child, neither the mustard nor the warming ointments can be used, since the composition of ointments and mustard can worsen the child's condition.
When bronchitis in children, the treatment is helped by compresses from warm oil. Warm sunflower oil to 40 ° C and moisten them with gauze folded several times. This compress should be imposed only on the right side and back of the baby, from above put a plastic bag and a layer of cotton wool, bandage the child around several times. Dress warm clothes, do this procedure for the night, if there is no temperature in the child.
- Folk remedies
Old folk way - radish juice with honey, cabbage juice, turnip juice - any of these juices should be given 1 teaspoon 4 times a day. You can give and cranberry juice, mixing it with honey in a ratio of 3/1, a tablespoon 3 times a day.
The first week is well helped by chest massage, older children would be good at performing breathing exercises.
Physiotherapy with bronchitis
In children, these procedures are prescribed and conducted only at the physician's discretion, these are physiotherapy methods that promote the fastest recovery, since they have an anti-inflammatory effect, however, they can not be performed more than 2 times a year:
- Ultraviolet irradiation of the chest
- Mud, paraffin applications on the chest and between the shoulder blades
- Inductometry on the same areas
- Electrophoresis with calcium
- SOLLUX ON THE BREAST
- Aeronisation by the hydroionizer of the respiratory tract with solutions of chamomile, antibiotics.
Prevention of acute bronchitis in children:
Do not allow a prolonged runny nose in a child, timely treatment of any cold and infectious diseases will be the best preventative against penetration of the infection into the lower respiratory tract.
Walking in the fresh air in the park, playing at the cottage, physical exercise in nature, tempering, daily the intake of natural vitamins in fruits and vegetables, and not in tablets is the way to your child's health.
Obstructive bronchitis in children - symptoms
In young children, usually up to 3-4 years of acute bronchitis may be accompanied by an obstructive syndrome - this is an acute obstructive bronchitis. In children, the symptoms of such bronchitis begin more often after viral infections or allergic manifestations on the stimulus.
The main symptoms of obstructive bronchitis:
- Harsh, audible long breath with whistling
- Coughing with attacks, before vomiting, debilitating
- During inhalation, the intercostal spaces are drawn in and chest is swollen with breathing
When obstructive allergic bronchitis in children there is no temperature, it starts because of an allergic reaction to the strongest irritant for the child, and parents can often recall, that recently they bought something for the child - a feather pillow or a blanket made of wool of a camel or a sheep, houses were inhaled with paint from repair or went to visit, where there are cats.
In obstructive bronchitis in children, symptoms can begin on the 3rd-4th day of the flu or ARVI, and may also be caused by other bacteria, which is manifested in the appearance of expiratory dyspnea - an increase in the respiratory rate to 60 per minute, and there are also difficulties in inspiration.
The child begins wheezing, noisy breathing, especially a prolonged wheezing exhale, which is heard by persons near the baby. The thorax is as if swollen, that is, the ribs are horizontally arranged. Cough is dry, obtrusive, bouts, arises suddenly, it does not bring relief and intensifies at night.
If this disease develops not after ARI, then the temperature in the early days is not increased.
Headache, weakness and nausea, are very rare.
When listening there are dry wheezing in the lungs.
X-ray revealed increased transparency, increased pulmonary pattern, in the absence of infiltrative changes in the lungs.
The analysis of blood as a viral infection - lymphocytosis, leukopenia. accelerated ESR, if allergic bronchitis in a child, then eosinophilia.
Almost always obstructive bronchitis is associated with a virus or mycoplasmal infection, relapses of obstructive bronchitis in children most often spontaneously stop by 4 years.
If the bronchioles and small bronchi are affected, then this is an acute bronchiolitis.
Obstructive bronchitis in children differs from asthma attacks, in that obstruction develops slowly, and with asthma the child abruptly begins to suffocate. Although the first attacks of bronchial asthma in children also begin during ARVI. If the obstruction occurs several times a year, it is a signal that the child is at risk for developing bronchial asthma in the future.
Obstructive bronchitis in a child can be due to passive smoking, it can be distinguished by a strong cough with a whistle in the morning, while the child's condition is quite satisfactory. Obstruction with allergies occurs when contact with an allergen and recently it becomes a very frequent manifestation in children prone to allergies, these bronchitis are recurrent and are threatened by the development of bronchial asthma.
Allergic and obstructive bronchitis in children - treatment
In obstructive bronchitis in children up to a year or 2 years, treatment should be performed in a hospital under the supervision of a pediatrician, in other cases at the discretion of the doctor and parents. Treatment is best done in a hospital if:
- In addition to obstruction in the child, the symptoms of intoxication are decreased appetite, fever, nausea, general weakness.
- Signs of respiratory failure. This is shortness of breath, when the frequency of breathing increases by 10% of the age norm, counting is better done at night, and not during games or crying. In children under 6 months, the respiration rate should not exceed 60 per minute, 6-12 months - 50 breaths, 1-5 years, 40 breaths. Acrocyanosis is a sign of respiratory failure, manifested by cyanotic nasolabial triangle, nails, that is, the body experiences oxygen deficiency.
- It is not uncommon for obstructive bronchitis in children to mask pneumonia, so if the doctor suspects pneumonia from hospitalization can not be denied.
Bronchiolithics extend the bronchi, so they are designed to relieve obstruction. To date, they are presented in various forms in the pharma industry:
- In the form of syrups (Salmeterol, Clenbuterol, Ascoril), which are convenient for young children, their disadvantage is the development of tremors and palpitations.
- In the form of solutions for inhalation (see. Berodual for inhalation) - this is the most convenient way for young children, diluting the drug solution fiz.rastvorom, inhalation 2-3 times a day, after the improvement, it is possible to use only at night. The multiplicity and dosage, as well as the course of treatment is determined only by the pediatrician.
- Inhalers-aerosols can be used only for older children (Berodual, Salbutamol).
- Such tableted forms of bronchodilators, like theophylline (Theopack, Euphyllin) are not indicated for the treatment of children with obstructive bronchitis, they have more pronounced side effects, are more toxic than local inhalation forms.
Can be used to reduce bronchial spasms. This is papaverine or Drotaverin, No-shpa. Their reception can be carried out with the help of an inhaler, orally in the form of tablets or intravenously in a hospital.
Means for coughing
To sputum better departed, various mucoregulatory drugs are used, they help dilute sputum and accelerate its excretion:
- These are preparations with active substance ambroksol (Lazolvan, Ambrobene). These drugs can not be taken for more than 10 days, it is most convenient to use them in the form of inhalations, as well as carbocisteine preparations (Fluiditek, Bronhobos, Mukosol).
- After the cough became wet, the seizures became less intense, the sputum diluted, but it departs badly, ambroxol should be changed to expectorants means for coughing for children, which should be given no more than 5-10 days, including Gedelix, Bronchicum, Prospan, Bronhosan, Herbion (see p. herbion from dry and wet cough), Tussin, Bronchipret, breastfeeding , ,, .
- Codeine-containing drugs for children should not be taken if the child has a seizure-like compulsive cough, as directed the doctor can use Sinekod, Stoptusin Fito, Libexin (with caution in childhood), Bronhicum, Broncholitin.
- Erespal - promotes and removes obstruction, and reduces sputum production, and it also has anti-inflammatory activity, is applied from the first days of the disease, reduces the risk of complications, is contraindicated in children under 2 years old.
To facilitate the departure of sputum, parents can themselves do their child massage the collar zone, chest, back. Especially strong massage should be done for the muscles of the back along the spine. Useful for obstructive bronchitis in children postural massage - that is, efflorescence of the baby's back in the morning, it is necessary to suspend the child from the bed upside down (padding the pillow under his tummy) and tapping the palms folded in the boat for 10-15 minutes. For older children, with a massage, ask the child to take a deep breath, and on an exhalation, tap. Useful and additional exercises such as inflating balloons, blowing out candles.
AntihistaminesAntihistamines are prescribed to children in the presence of allergic reactions. Such medicines for allergies like Eryus in syrup can be taken to children from 1 year, with the half a year it is possible to use Claritin and Zirtek, from 2 years in syrups and drops Cetrin, Zodak, Parlazin (cf. list of medicines for allergies). Such antihistamines of the 1st generation as Suprastin and Tavegil are used less often, only for drying with abundant liquid sputum.
Allergy or virus
If the obstruction is caused by an allergy or a virus - antibiotics can not be used, and even dangerous (see. antibiotics for colds and orgs). The appointment of antibiotics is possible only with the proven infectious origin of bronchitis in children.
When antibiotics are indicated
Treatment of bronchial obstruction with antibiotics is not indicated, only if the child has a fever over 4 days, or has occurred the second temperature jump to 39C after 4-5 days after the onset of the disease, is accompanied by severe intoxication, a strong cough, if with adequate the child suddenly becomes apathetic, sluggish, refuses to eat, has weakness, nausea, headaches and even vomiting. In such cases, the use of antibiotics is justified. They are prescribed only by a pediatrician on the basis of a clinical picture, the presence of purulent sputum (indicating bacterial bronchitis), inflammatory changes in the analysis of blood, as well as with other signs of bacterial bronchitis or pneumonia (wheezing, x-ray signs).
Most doctors recommend that for ARVI and flu, take antiviral drugs, for babies, candles Genferon, Viferon, and also in the form of drops Gripferon, Interferon, take syrups by Orvire (remantadine), and after three years of age tableted forms such as Kagocel and Arbidol, Cytovir 3. But it is worth remembering that if in a family history (close relatives) there are any autoimmune diseases (Sjogren's syndrome, rheumatoid arthritis, systemic lupus erythematosus, diffuse toxic goiter, vitiligo, multiple sclerosis, pernicious anemia, insulin-dependent diabetes mellitus, myasthenia gravis, uveitis, Addison's disease, primary biliary cirrhosis, autoimmune hepatitis, scleroderma), it is impossible to take immunostimulants (Kagocel, Tsitovir, Amiksin), it can cause a debut of an autoimmune disease in a child, perhaps not now, but later (see. more antiviral drugs for orvi).
Hormonal therapyHormonal drugs, such as Pulcicort, are indicated only in severe or moderate-onset obstructive bronchitis (usually with the help of a nebulizer), they quickly stop obstruction and inflammation, they are prescribed only by a doctor.
What not to do
When obstructive bronchitis in children - treatment by rubbing and smearing the body of the child with various warming ointments (ointment Dr. Mom, ointments with medicinal plants, essential oils), the use of mustard plasters is unacceptable, since they cause an even more allergic reaction and bronchospasm, especially in children under 3 years old. Also categorically it is impossible to carry out inhalations with bronchitis with various medicinal herbs and essential oils. It is only possible to use such folk remedies for warming up - heat compresses with potatoes, salt, buckwheat.
PhysiotherapyPhysiotherapeutic procedures in the acute period are contraindicated, when the obstruction is already stopped, it is possible to perform UHF, electrophoresis or laser.
Hypoallergenic diet and plentiful drink
Any natural drinks - mineral water with milk, tea, broth of a dogrose, it is necessary to drink to the child as often as possible. The diet should be hypoallergenic, but at the same time maximally vitaminized, high in protein and fat content. Exclude from the diet of the child anything that can cause an allergic reaction:
- citrus, red and orange fruit
- purchased spices, sweets, milk cheeses, yoghurts, carbonated drinks, sausages and sausages - everything that contains dyes, flavors, preservatives and flavor enhancers
- honey and other beekeeping products
- fish, grown on fish farms, broiler chickens, as they are stuffed with hormones and antibiotics, which causes allergies.
When caring for a child, you should daily aerate, moisten the room where the child is. It's hot in the apartment should not be, it's better to have a cool, fresh, clean air. After the recovery of the child should be put on a dispensary record with an allergist.
Chronic obstructive bronchitis - Symptoms
The clinical picture of COPD consists of a different combination of several interrelated pathological syndromes.
For COPD, a slow progressive progression of the disease is characteristic, which is why most patients turn to the doctor late, at the age of 40-50 years, when there are already quite pronounced clinical signs of chronic inflammation of bronchi and bronchial obstructive syndrome in the form of cough, shortness of breath and reduced tolerance for daily exercise.
When questioning, as a rule, it is possible to find out that the appearance of these symptoms is preceded by cigarette smoking throughout not less than 15-20 years and / or more or less prolonged exposure to the relevant production hazards. Often the patient notes frequent bronchopulmonary infections ("cold" diseases, viral infections, "acute bronchitis, etc.), as well as chronic diseases of the ENT organs or aggravating heredity.
In most cases it is important to conduct a semi-quantitative assessment of one of the most important risk factors for COPD - smoking. For this purpose, the so-called index of a smoker is counted. To do this, the average number of cigarettes smoked per day is multiplied by the number of months in a year, i.e. at 12. If the index exceeds 160, smoking in this patient is considered a serious risk factor for COPD. If the index exceeds 200, such a patient should be classified as a "malicious" smoker.
Other methods of quantitative evaluation of smoking are suggested. For example, to determine the total number of so-called "packs / years" of smoking, the average number of cigarettes smoked per day is multiplied by the amount years, during which the patient continues to smoke, and divide the result by 20 (the number of cigarettes in a standard pack). If the number of "packs / years" reaches 10, the patient is considered an "unconditional" smoker. If this figure exceeds 25 "packs / years", the patient belongs to the category of "malicious" smokers.
It is very important to find out in detail the possible impact on the patient of various adverse environmental factors and production hazards, in particular, long-term residence in ecologically unfavorable terrain, work in harmful production, contact with volatile pollutants, etc.
Finally, no less important is the information about frequent "cold" diseases, primarily respiratory viral infections that have a powerful damaging effect on the respiratory mucosa and lung parenchyma.
The earliest symptom that appears in COPD patients at a young age, long before seeking medical help, is a cough with a small compartment of mucous or mucopurulent sputum, which for a long time only appear in the morning ("morning smoker's cough"). Just like in patients with chronic non-obstructive bronchitis, cough is an important mechanism of bronchial cleansing from excess bronchial secret, which is formed due to the insufficiency of mucociliary transport, which manifests itself at first only at night. The immediate cause of coughing is irritation of cough reflexogenic zones located at the places of division of large bronchi and in the region of bifurcation of the trachea.
Over time, cough becomes "habitual" and worries the patient during the day and especially at night, when patients occupy a horizontal position in bed. Cough usually intensifies during the cold and damp season, when the most frequent exacerbations of COPD occur. As a rule, such exacerbations differ relatively poor in symptoms and occur with normal or slightly elevated subfebrile body temperature. Nevertheless, even during this period, patients noted difficulty in breathing, dyspnea, as well as malaise, general weakness, rapid muscle fatigue, decreased efficiency. Cough intensifies, becomes more permanent. The sputum becomes purulent, the amount of it increases. The duration of such exacerbations is increasing and reaches 3-4 weeks, especially if they developed against the background of respiratory viral infections.
Especially severe exacerbations of chronic purulent bronchitis, which is characterized by febrile body temperature, marked intoxication and Laboratory of inflammation (leukocytosis, shifting the blood formula to the left, increasing ESR, increasing the blood levels of acute inflammation proteins, etc.).
The immediate causes of exacerbation of chronic bronchitis are "supercooling", viral infections, massive effects of volatile irritants (for example, excessive intensive smoking or exposure to industrial or household pollutants), as well as severe intercurrent illnesses, physical fatigue, etc.
The second mandatory symptom, characteristic for almost all COPD patients, is shortness of breath, which indicates the formation of bronchial obstructive syndrome and lesion of the respiratory parts of the lungs.
In most cases in COPD patients, shortness of breath appears after several years from the onset of the disease, i.e. significantly after the appearance of cough with phlegm. Often, the initial manifestations of obstructive syndrome and respiratory failure are perceived by patients Only as a small difficulty in breathing, respiratory comfort, arising from physical exertion. Moreover, patients during this period can not independently complain of shortness of breath or shortness of breath, and only an attentive the analysis of all subjective sensations of the patient allows the doctor to initiate the initial manifestations of respiratory failure.
In these cases, patients with COPD can observe an increasing decrease in exercise tolerance, which is manifested by an intuitive decrease in the rate of walking, the need to stop for Rest, for example, when climbing stairs, etc. Often, there is a feeling of pronounced muscular fatigue during the performance of the usual exercise for a given patient
Over time, the difficulty of breathing becomes more and more specific and the patients themselves pay attention to this important symptom of the disease. Moreover, dyspnea becomes the main complaint of a COPD patient. In the expanded stage, dyspnea becomes expiratory, intensifying with physical exertion and exacerbations of chronic bronchitis. Inhalation of cold air, lowering of atmospheric pressure (high mountains, airplane flights) also cause an increase in dyspnea.
Finally, in severe cases, bronchoobstructive syndrome, manifested by attacks of a superficial, low-productivity cough, diagnostic and prognostic the significance of which is fundamentally different from the cough caused by mucociliary transport deficiency and hypersecretion of mucus. Attacks are often accompanied by a brief increase in signs of obstructive respiratory failure - dyspnea, cyanosis, tachycardia, as well as swelling of the cervical veins, which may be due to the manifestation of an early expiratory collapse of small bronchi. As you know, this mechanism of bronchial obstruction is based on two main reasons:
- If there is a difficulty in the movement of air through the small bronchi due to the presence of sputum, edema of the mucous membrane or bronchospasm during expiration, intrapulmonary pressure, which leads to an additional compression of small bronchi and an even greater increase in their resistance to air flow. The role of this mechanism increases with attacks of painful, unproductive cough and emphysema, accompanied by a marked decrease in the elasticity of the lung tissue.
- The phenomenon of Bernoulli is the second most important mechanism of early expiratory collapse of the bronchi in narrowing them. The sum of the air pressure along the longitudinal axis and the lateral pressure on the bronchial wall is constant. With normal bronchial lumen and a relatively small linear air flow rate during exhalation lateral air pressure on the wall of the bronchi is large enough that prevents their early collapse.
With narrowing of the bronchi and during cough, the linear velocity of the air flow increases, and the lateral pressure sharply decreases, which contributes to the early collapse of small airways at the very beginning of exhalation.
Thus, the most characteristic sign of COPD is the early appearance of cough with phlegm, and only after a few years - the attachment of expiratory dyspnoea. Only in rare cases, dyspnea may be a manifesting symptom of the disease that occurs simultaneously with a productive cough. This feature of the development of clinical manifestations of COPD is typical for patients who are prone to the simultaneous intense action of several risk factors, such as malicious smoking in combination with work in hazardous production in the atmosphere of volatile pollutants.
When general examination of COPD patients in the initial stages of the disease, significant differences from the norm, as a rule, do not show. With further progression of the disease, the formation of bronchial obstructive syndrome and severe respiratory failure in COPD patients, cyanosis appears. As a result of arterial hypoxemia, reduction of oxyhemoglobin and an increase in the concentration of reduced hemoglobin in the blood, flowing from the lungs, cyanosis usually acquires a diffuse character and has a peculiar grayish hue (diffuse gray cyanosis). Mostly it is noticeable on the face, the upper half of the trunk. The skin is warm to the touch, if there are no signs of cardiac decompensation in patients with a chronic pulmonary heart. It should be remembered that there is no direct correlation between the degree of respiratory failure and the severity of cyanosis.
In the presence of concomitant bronchiectasis or chronic purulent bronchitis, in some cases, when examined, you can identify a kind of thickening end phalanges of fingers in the form of tympanic sticks and change of nails in the form of hour glasses (a symptom of "drum sticks" and "watch glass").
Finally, the development of decompensated chronic pulmonary heart disease and right ventricular failure may be accompanied by the appearance of peripheral edema, as well as a change in character cyanosis - it becomes mixed: against a background of diffuse coloring of the skin, a more intense cyanosis of the lips, fingertips, and the like is revealed. (acrocyanosis).
Practically all COPD patients have an emphysematous thoracic mark when examined. In typical cases, it is observed:
- an increase in the transverse and especially anteroposterior size of the thorax (in some cases it becomes "barrel-like");
- "Short neck" due to the fact that the chest is frozen at the height of inspiration;
- deployed (more than 90 °) epigastric angle;
- smoothness or swelling of the supraclavicular pits;
- more horizontal direction of the ribs and an increase in intercostal spaces;
- tight fit of the blades to the chest, etc.
Voice tremor due to the development of emphysema is weakened, but equally in the symmetrical areas of the chest.
Percussion over the whole surface of the lungs determine the box percussion sound. The lower borders of the lungs are shifted downward, and the upper ones are upward. The respiratory excursion of the lower edge of the lung, normally 6-8 cm, is reduced.
With auscultation, weakened vesicular breathing is more likely to occur, acquiring a particularly low shade (cotton breath), which is also associated with the presence of m emphysema of the lungs. Attenuation of respiration, as a rule, is expressed equally over symmetrical sites of the lungs. There is also an extension of the exhalation phase due to the presence of bronchial obstructive syndrome (normally the ratio of inspiration and expiration is 1: 1.1 or 1: 1.2). At the initial stages of COPD development, when inflammatory changes in the bronchi predominate, and emphysema of the lungs is not so pronounced, hard lungs can be heard above the pulmonary fields.
The most characteristic auscultative sign of chronic obstructive bronchitis is scattered dry wheezes. Their tonality depends on the caliber of the bronchi in which they form. High (treble) dry wheezes indicate a significant narrowing of the distal (small) bronchi due to the presence there of a large amount of viscous sputum, mucosal edema or spasm of small bronchi. Chryps are better heard during the exhalation and change when you cough (the bowl disappears or decreases). The forced exhalation, on the contrary, leads to the intensification or appearance of high-toned dry wheezes.
Low (bass) buzzing and "buzzing" dry wheezes indicate a presence of viscous sputum in proximal (large and medium) bronchi.
In some, relatively rare cases, patients with COPD can be listened to and moist small- and medium-vesicle rales, which indicates the presence of liquid sputum in the bronchi or in the cavity associated with the bronchi. In these cases, most often we are talking about the presence of bronchiectasises.
An important auscultatory phenomenon in patients with chronic obstructive bronchitis and COPD is remotely audible at a distance. They usually have the character of long, prolonged, multi-tone dry wheezes, usually more pronounced in exhalation.
When the syndrome of bronchial obstruction is expressed, remote rales are often audible much better than dry wheezing revealed during chest auscultation.
In patients with COPD, it is always important to correctly assess the physical data obtained in the study of cardiovascular systems that may indicate the presence of pulmonary arterial hypertension and pulmonary heart. Among these signs include increased and diffuse cardiac shock and epigastric pulsation, indicating the presence of severe hypertrophy and dilatation of the right ventricle. With percussion in these cases, you can find a rightward right shift of the relative stupidity of the heart (dilatation of the right ventricle and right atrium), and in auscultation, weakening I tone and mild systolic murmur of tricuspid regurgitation, which, as a rule, develops with pronounced dilatation of the right ventricle in patients with a decompressed pulmonary heart. Noise is often amplified during a deep inspiration (symptom Rivero-Corvallo), because during this period of the respiratory cycle increases the flow of blood to the right heart and, accordingly, the volume of blood regurgitating in the right atrium.
In severe disease, accompanied by the formation of pulmonary arterial hypertension and pulmonary heart disease in patients with COPD can be to reveal a paradoxical pulse - a decrease in systolic blood pressure during a calm deep inspiration of more than 10 mm Hg. Art. The mechanism of this phenomenon and its diagnostic significance are described in detail in Chapter 13 of the first volume of this manual.
It should be noted that most of these symptoms appear with the development of pronounced signs of the pulmonary heart and chronic heart failure. Sensitivity of the most characteristic clinical sign of hypertrophy of the right ventricle - enhanced cardiac shock and epigastric pulsations - even in severe cases, does not exceed 50-60%.
The most characteristic signs of bronchoobstructive syndrome in COPD patients are:
- Dyspnoea, predominantly of an expiratory nature, appearing or intensifying with physical exertion and coughing.
- Attacks of a superficial, low-productivity cough, in which a small number of sputum requires a large number of coughing thrusts, the strength of each of which decreases markedly.
- Extension of the exhalation phase with calm and especially forced breathing.
- Secondary emphysema of the lungs.
- Scattered high-toned dry wheezing in the lungs, heard with calm or forced breathing, and also remote rales.
Thus, chronic obstructive bronchitis is a slowly progressing disease with a gradual increase severity of clinical symptoms and mandatory occurrence at different stages of disease progression:
- syndrome of mucociliary transport disorders (cough, sputum);
- bronchoobstructive syndrome;
- respiratory failure according to the obstructive type, accompanied by arterial hypoxemia, and then hypercapnia;
- pulmonary arterial hypertension;
- compensated and decompensated chronic pulmonary heart.
The possibility of a different combination of clinical manifestations of these syndromes explains the diversity of the individual clinical course of the disease.
Of practical importance are different combinations of signs of chronic bronchitis and emphysema, depending on which the bottom of the main clinical types of XOBL are isolated:
Emphysematous type (type A, "dyspnea," "pink puffer" - "pink puffing") is characterized by a significant predominance of morphological and functional signs of pulmonary emphysema, whereas the symptoms of chronic bronchitis proper are much less pronounced. Emphysematous type COPD more often develops in individuals with asthenic build and reduced body weight. Increase in the airyness of the lungs is provided by the valve mechanism ("air trap"): on inhalation, the airflow enters the alveoli, and in the beginning or in the middle of exhalation the small airways are closed due to the expiratory collapse of the small bronchi. On exhalation, thus, the resistance of the respiratory tract to the air flow increases substantially.
The presence of severe, usually panacinar, emphysema of the lungs and increased extensibility of the lung tissue, which does not have a noticeable resistance to inspiration, causes a significant increase in alveolar ventilation and a minute volume of respiration. Therefore, respiration at rest, as a rule, is rare and deep (hypoventilation is absent).
Thus, in patients with emphysematous type of COPD, a normal vertical gradient of ventilation and blood flow in the lungs is preserved, so there is no rest at rest significant violations of ventilation-perfusion relations and, accordingly, the violation of gas exchange and the normal gas composition of blood is preserved.
Nevertheless, the diffusion capacity of the lungs and the reserve volume of ventilation are sharply reduced due to a decrease in the total surface of the alveolar-capillary membrane and the reduction of capillaries and alveoli. Under these conditions, the slightest physical load leads to an acceleration of pulmonary blood flow, whereas a corresponding increase in the diffusivity of the lungs and the volume of ventilation does not occur. As a result, PaO2 decreases, arterial hypoxemia develops, and dyspnea appears. Therefore, in patients with emphysematous type of COPD for a long time, shortness of breath appears only with physical exertion.
Progression of the disease and a further decrease in the diffusive capacity of the lungs is accompanied by the appearance of dyspnea at rest. But even in this stage of the disease there is a clear dependence of the manifestation of dyspnea on the amount of physical activity.
In accordance with this dynamics of respiratory disorders in patients with emphysematous type of COPD, relatively late a detailed picture of respiratory failure, pulmonary arterial hypertension and chronic pulmonary heart. Cough with a small sputum in these patients, usually occurs after the onset of dyspnea. According to Mitchell R.S., all the symptoms of COPD develop 5-10 years later than in the bronchial type of COPD.
The presence of dyspnoea with physical exertion, after which patients "puff" for a long time, inflating their cheeks, intuitively seeking an increase in intrapulmonary pressure, which somewhat reduces the phenomenon of early expiratory collapse of the bronchi, as well as a prolonged absence of cyanosis and signs of pulmonary heart was the reason for the fact that patients with emphysematous type COPD called "pink puffing" ("pink puffer").
The bronchitis type (type B, "blue bloater" - "cyanotic edematous") generally corresponds to the above described manifestations of chronic obstructive bronchitis in combination with centroacinar pulmonary emphysema. With this variant of the course of COPD, as a result of hypersecretion of mucus, edema of the mucosa and bronchospasm, there is a significant increase in resistance as exhalation, and inhalation, which determines the occurrence of general and alveolar hypoventilation mainly in the lower parts of the lungs, a change in the vertical gradient of ventilation and early onset violations of ventilation-perfusion relations leading to the appearance of arterial hypoxemia and dyspnea. At later stages of the disease, as a result of fatigue of the respiratory muscles and increase in functional dead space, RaCO2 increases and hypercapia occurs.
In patients with bronchitis of COPD, pulmonary arterial hypertension develops earlier than with emphysematous type, signs of decompensated chronic pulmonary heart appear.
In the lungs are revealed auscultatory signs of bronchoobstructive syndrome (dry wheezes, expiratory lengthening), more often there is cyanosis, peripheral edema and others signs of respiratory failure and chronic pulmonary heart in connection with which such patients are sometimes figuratively called "bluish edematous" bloater ").
The described two clinical variants of the disease course in pure form are rare, especially emphysematous type COPD. Practitioners often meet with a mixed version of the course of the disease.
Complications of chronic obstructive bronchitis
The most significant complications of chronic obstructive bronchitis include:
- emphysema of the lungs;
- respiratory failure (chronic, acute, acute on the background of chronic);
- secondary pulmonary arterial hypertension;
- pulmonary heart (compensated and decompensated).
It should pay attention to the high incidence of acute pneumonia in patients with chronic obstructive bronchitis. This is due to the blockage of the bronchi viscous sputum, a violation of their drainage function and a sharp decrease in the function of the local bronchopulmonary protection system. In turn, acute pneumonia, which can be severe, aggravates violations of bronchial patency.
An extremely serious complication of chronic obstructive bronchitis is acute respiratory failure with the development of acute respiratory acidosis. The development of acute respiratory failure is often due to the effect of acute viral, mycoplasmal or bacterial infection, less often - pulmonary embolism, spontaneous pneumothorax, iatrogenic factors (treatment with beta-blockers, hypnotics, sedatives, narcotics that depress the respiratory center).
One of the most common and prognostically unfavorable complications of long-term chronic obstructive bronchitis is the chronic pulmonary heart.
Current and forecast
The course of COPD is characterized by a steady progression of bronchial obstruction and respiratory failure. If normal non-smokers are healthy individuals over the age of 35-40 years, FEV1 is reduced annually to 25-30 ml, then the rate of reduction this integral index of pulmonary ventilation in patients with COPD and smoking patients is much higher. It is believed that the annual decline in FEV1 in COPD patients is at least 50 ml.
The main factors that determine the unfavorable prognosis in COPD patients are;
- age over 60 years;
- a long history of smoking and a large number of cigarettes smoked at the present time;
- frequent exacerbations of the disease;
- baseline low values and rates of decline in FEV1;
- formation of pulmonary arterial hypertension and chronic pulmonary heart;
- presence of severe concomitant diseases;
- low social status and general cultural level of COPD patients.
The most common causes of death in COPD patients are acute respiratory failure and chronic heart failure. Less often COPD patients die from severe pneumonia, pneumothorax, heart rhythm disturbances and pulmonary embolism.
It is known that approximately 2/3 of patients with severe COPD die within the first 5 years after the signs of decompensation of the blood circulation against the background of the formed chronic pulmonary heart. According to research data, 7.3% of patients with COPD with compensated and 29% of patients with decompensated pulmonary heart die within 2 years of follow-up.
The appointment of adequate therapy and the implementation of preventive measures can reduce the rate of buildup of bronchial obstruction and improve the prognosis of the disease. So, only the cessation of smoking after a few months can lead to a marked decrease in the rate of build-up of bronchial obstruction, especially if it is largely due to a reversible component of obstruction, this leads to an improvement in the prognosis of the disease.
Chronic obstructive bronchitis - causes, symptoms and treatmentBronchitis is the most common disease. It occurs in both adults and children. Chronic obstructive bronchitis is not only an inflammatory disease of the bronchi, but also the presence of damage to the bronchial mucosa. As a result, the process of proper ventilation of the bronchi is disrupted.
In this case, spasms and an obstruction to sputum are observed. It develops as an independent disease, and occurs in the form of complications after other diseases such as influenza, acute respiratory disease, acute respiratory infections, inflammation of the nasopharynx, as a result influence of harmful substances in the production (work with cement, cadmium, silicon, in coal mines, metallurgy) as well as bad habits (smoking) and genetic predisposition.
Symptoms of obstructive bronchitis:
- A strong cough is the most common symptom of any type of bronchitis. Usually cough with bronchitis delivers a strong discomfort to the patient and makes him immediately consult a doctor.
- Cough oscillations in intensity, fluctuations in body temperature.
Tachycardia and pallor.
- A long, wheezy exhalation, wheezing.
- Shortness of breath, which occurs as a symptom of bronchitis even at the lowest physical exertion.
- Severe fatigue. This symptom occurs sharply with the onset of the development of the disease. At the same time the patient's fatigue exists at the slightest physical exertion.
In the case of obstructive chronic bronchitis, participation in the act of respiration of additional musculature is observed.
- The raised temperature characterizes an acute period of disease. When the disease goes to a chronic stage, the immunity falls so much that the body does not react to the inflammation process and the temperature does not increase.
Key mechanisms of the disease:
- Inflammation of not only medium and large bronchi, but also small ones, including the alveoli.
- Development of broncho-obstructive syndrome.
- Occurrence of diffuse secondary emphysema of the lungs.
- Hypoxemia and hypercapnia, as a consequence of the violation of gas exchange and ventilation.
- Pulmonary arterial hypertension.
Diagnosis of obstructive bronchitisTo diagnose this disease, the following studies are prescribed:
- Urine and blood tests.
- LHC, which determines the presence of a common protein and protein derivatives (fibrin, creatinine, haptoglobin, etc.).
- IAK for determination of blood content and functionality of T-B-lymphocytes, immune complexes.
- X-rays of light.
- Analysis of total and bacteriological sputum.
Treatment of obstructive bronchitis
Like any other serious illness, obstructive bronchitis requires proper targeted treatment. If the patient refuses treatment, the disease can go into a chronic form and give an inflammation to the lungs, promote the development of asthma.
For correct treatment, a clear and adequate correctly diagnosed diagnosis is necessary. Modern methods of diagnosis help the doctor accurately and in the shortest possible time to diagnose the disease, namely, the absence or presence of an obstructive form of bronchitis.
The beginning of treatment is characterized by bed rest and complete rest. As the patient's condition improves, walks and ordinary household duties are allowed.
Special conditions for proper treatment:
- Elimination of a variety of aggressively influencing factors, such as cosmetics, household chemicals and polluted air.
- To give up smoking. Among smokers, about 80% of patients suffer from obstructive bronchitis.
- The correct diet, diet, which will promote a speedy recovery. You should give up fried foods, spicy, oily and salty. Best suited are sour-milk products, cereals and broths. Such products will provide the body with the right amount of calories and do not overload it.
Medications for treatment
Drugs and procedures prescribed by a doctor are aimed at alleviating the symptoms of the disease and an obligatory hindrance to its development. Usually doctors prescribe such medicines:
- Adenoreceptors (terbutaline or salbutamol). These drugs contribute to the expansion of bronchial alveoli.
- Expectorants and mucolytics, such as Ambroxol or ATSTS. Very good effect has drugs based on herbs, in particular, thyme.
- Preparations are antibacterial. The most effective macrolide preparations are Erythromycin, Azithromycin, as well as drugs from the penicillin group, such as Amoxicillin. Such drugs are prescribed in the form of tablets, very rarely in the form of injections or inhalations in order to avoid complications.
- Inhalations with medicinal herbs (peppermint, chamomile, thyme) and essential oils are a great way to treat obstructive bronchitis.
- Antibiotics are used in case of severe forms of the disease, or when there are no positive results from treatment by other methods.
Traditional methods of treatment
The main methods used in non-traditional medicine are the reception of phytopreparations and the use of various compresses. For example, apply a compress of butter and honey. In equal proportions, the heated above ingredients are applied to the chest and back in the form of a normal compress. The course of treatment is one month.
Therapeutic exercise is also used in connection with the fact that in adults it is difficult to get rid of sputum. Thanks to physical exercises, recovery is faster. Also used breathing exercises, which improve the process of ventilation.
These methods are effective, but more moderate, compared with medicines, but have the right to exist. In any case, one should be careful and do not resort to self-treatment, since a specialist is needed to diagnose a true diagnosis, He has special knowledge and is able to choose the only correct treatment for a particular disease.
Obstructive bronchitis - causes, symptoms, treatmentIf a person has bronchial inflammation, then the permeability of the respiratory tract is completely impaired and, naturally, the ability to breathe freely and independently. Classify this disease in the form of leakage - in the acute stage and in the chronic.
Most often acute children are exposed to acute bronchitis, because at the age of 14 they can take several once a year to carry colds, flu, various viral infections in the form of rhinoviruses and adenoviruses.
The chronic form of obstructive bronchitis affects adults.
Why does it arise?
There are several factors that trigger the onset of obstructive bronchitis. Among them:
- Smoking, and chronic, which lasts for several years and even decades;
- Pathology associated with a deficit in the body antitrypsin;
- Human habitation in adverse environmental conditions - increased radiation background, dirty air, humidity, dryness, frost in the region;
- Harmful professional working conditions of a person (for example, he works in a mine, at an enterprise with heavy industry, in metallurgy, and also works with silicon, cadmium, cement).
Bronchitis in most cases develops against a catarrhal disease - ARVI. In humans, the body temperature rises rapidly, it begins to shiver, there is a strong weakness, a cough. Initially, the cough is dry, rending from the inside, then comes relief when the cough turns to wet.
In obstructive bronchitis, dyspnea appears, which arises from an increased accumulation of secretions in the bronchi. Bronchi swell, and due to this, a person even at a distance can hear strong rattles in the chest and whistles.
If we talk about the chronic form of obstructive bronchitis, then the characteristic symptoms are absent.
The provoking factors of obstructive bronchitis are permanent hypothermia, acute respiratory infections, and cured colds.
Complaints to the doctor
Patients who develop obstructive bronchitis complain about:
- Shortness of breath;
- A strong tormenting rending cough;
- Abundant sputum production, in case the cough is wet;
- Pain in the chest that hurts in the morning.
Obstructive bronchitis manifests itself very slowly. Initially, a person begins to complain of shortness of breath, which occurs with even a slight physical exertion. You will be surprised, but shortness of breath may appear 5-7 years after the person started to worry about coughing.
Exacerbation of the disease (obstructive bronchitis) occurs every time a person gets cold, freezes. But, even in such cases, not all doctors can determine that purulent sputum, shortness of breath, rapid deterioration of well-being are associated with obstructive bronchitis. Only when a person begins to get sick so often that experts have suspicions of chronic disease, the patient is sent for analysis and a complete examination of the upper respiratory tract.
The fact that the disease is progressing, you can learn from such symptoms as... whistling in the lungs during breathing, shortness of breath, acute shortage of air, the emergence of respiratory failure, which manifests itself in a severe degree.
How to treat?
In obstructive bronchitis, first of all, it is necessary to provide a person with patency of the upper respiratory tract. If the disease is a small child, then in this case it is necessary to suck off the mucus constantly (until the wellbeing is improved) from the upper respiratory tract with a special canister or in a hospital - by an electric pump.
In order to sputter easier and faster, the patients are given a special vibrating massage.
General recommendations for treatment
- A plentiful warm drink - teas, compotes, herbal infusions, decoctions;
- The use of medicinal medicines, namely - infusions on the basis of althae root, thermopsis, and also plantain;
- To remove the edema of the bronchi, it is necessary to periodically carry out special aerosol inhalations (they are sold in pharmacies);
- If a person has sputum with pus, then the treatment is done exclusively with antibiotics.
It is very important to strengthen the immunity of the patient through vitamin therapy. Vitamins, again, can be purchased at any pharmacy and it will be Vitrum, vitamin C, Complivit, as well as any other complex vitamins.
The drugs that expand the bronchi include Spiriva, Atrovent, Fenoterol, Ambrobene, Bromhexine, Euphyllinum, Salbutol. After their application, sputum in the bronchi is diluted and exits the upper respiratory tract along with a cough.
In no case should not engage in self-medication, otherwise it can only worsen a person's well-being.
"... when my daughter was 6 months old, she was diagnosed with obstructive bronchitis. But, I believe that it's more my fault than the doctors.
How did bronchitis start to develop? The child coughed the first few days and then this cough stretched for several weeks. My mistake as a parent was that I did not even notice this cough, I thought that the child just coughs a little. My child was breastfed, therefore, she apparently more or less suffered this period. It was at this stage that we needed to see a doctor, but we did not.
After 3 weeks, we went to the doctor, but the doctor diagnosed not with bronchitis, but with an ordinary cough. My daughter breathed very hard. I could not stand it, I called an ambulance. The doctor diagnosed us with "obstructive bronchitis." Treatment: support the body, in particular - immunity medications Interferon, Viferon or Kipferon. The nasopharynx was cleaned every half hour. Very well help inhalation on the nibulizer with the help of a mucus, as well as saline solution. "
Causes and symptoms of obstructive bronchitis
Such a disease as obstructive bronchitis, symptoms is quite specific. Many doctors believe that this type of bronchitis is not a disease. According to these doctors, this ailment is itself a simple symptom.
The essence of the disease
In general, obstructive bronchitis is an inflammatory disease that affects the bronchi. The main difference of this type of bronchitis is the violation of air patency.
A person may undergo an acute or chronic form of the disease. The acute form in most cases appears in the childhood period. This is due to the fact that the children's organism is more susceptible to attacks of infectious diseases like parainfluenza, adenoviruses, influenza, rhinovirus, etc. However, in children, the disease always appears only against the background of other diseases.In adults, most often there is chronic obstructive bronchitis, the symptoms of which appear in the form of weakened signs of acute form. In addition, in adults, obstructive bronchitis can progress as an independent disease.
Inflammatory process with this form of bronchitis is diffuse and affects mainly small bronchi. In rare cases, bronchus of medium size can be affected.Symptoms of obstructive bronchitis are characterized by the presence of severe dyspnea, frequent cough with phlegm, severe respiratory failure and wheezing.
It is worth noting that the chronic form of obstructive bronchitis is included in the group of COPD diseases. This group includes all diseases of a chronic and obstructive nature, affecting the lungs. In addition, it should be said that this disease is associated with bronchial spasms, which often appear in sick people. If the ailment is not treated for a long time, the disease can progress to bronchial asthma.
The causes of obstructive bronchitis
There are many factors that contribute to the appearance of this type of bronchitis. Among them, we can identify the main factors, which include the following:
- The periodic impact of respiratory infections, which include diseases of the ARVI group, angina, influenza, diseases of the ARD group and other diseases that appear against the background of the weakening of the immune system. In addition, adenoviruses, mycoplasmas and rhinoviruses can contribute to the appearance of an ailment.
- Other lung diseases not associated with a viral infection.
- Production factors. This includes unfavorable conditions in the workplace, accommodation near large factories, etc. It can be noted that the chronic form the disease often appears in people who are constantly in contact with various kinds of components that negatively affect the airways. Such substances include dust, gas, smoke, chemicals, etc.
- Genetic predisposition. In general, there is no evidence that the bronchitis is transmitted by genetic means. However, cases were often noted when children of a sick person were also exposed to bronchitis.
- Often, the disease appears against the background of exposure to airborne allergens.
- Some are risk factors and smoking. Tobacco smoke adversely affects the lungs, irritating their mucous membranes.
Symptomatology of the disease
Doctors diagnose the disease in those cases where, in addition to inflammation of the bronchi, there is bronchial obstruction in the human body. The signs of obstructive bronchitis are very specific and very different from other varieties of this ailment. So, the main distinctive feature of the obstructive form of the disease is a severe difficulty in both inhalation and exhalation. This is due to the accumulation of mucus and its subsequent congestion.With abundant production of mucus, it begins to accumulate and gradually thicken. As a result, mucous plugs begin to form, which affects the reduction of vascular patency. In the future, this affects the difficulty of air movement, which is the cause of wheezing.
Cough begins to increase by morning and worries a person throughout the day. Sometimes there is an increase in the body's overall temperature, which leads to fevers. The presence of fever and fever depends on the catalyst of the disease that has fallen into the human respiratory tract. Sputum is marked, which is often yellowish in color. The cough can last for several weeks, and maybe for a month.
It can be noted that the disease is much heavier in children. However, they carry it much easier and pass it faster. When taking a general blood test, no abnormalities are detected. Slightly increased ESR. With the X-ray, pulmonary swelling, increased pulmonary pattern, and increased transparency of the lung tissue.
Symptoms of acute obstructive bronchitis
The acute form of the disease most often occurs in children under 3 years old. The disease has an acute onset and symptoms of an infectious toxicosis, as well as bronchial obstruction. Infectious toxicosis manifests itself as a general subfebrile body temperature, severe headaches, weakness and dyspeptic disorder. The main role is assigned to respiratory disorders. There is a dry cough that will become wet with time, with sputum secretion. Cough worries the patient throughout the day.The exacerbation of cough begins in the morning, gradually softening towards evening. However, at night it does not go to the end, but simply becomes weaker. In the morning, coughing again comes with full force. In addition, attention is deserved and shortness of breath, which does not leave a person for a second. There are serious problems with breathing. So, when you breathe in, the muscles work, which in normal situations should not be involved in breathing. The wings of the nasal cavity are greatly inflated, the muscles of the shoulder girdle, the abdominal press and the neck are involved in breathing.
In addition, the inhalation of the elongated areas of the chest, such as the jugular fossa, subclavian area and intercostal intermediate areas, is noted. At exhalation, whistling sounds are clearly audible, as well as dry wheezing.
In ordinary situations, the acute form of obstructive bronchitis continues for ten days or three weeks. In cases when the disease makes itself felt two or more times a year, a relapsing form of obstructive bronchitis is diagnosed. If bronchitis periodically makes itself felt for two or more years, a chronic form of the disease is noted.
It is worth remembering that the treatment of an acute form of the disease should appoint a doctor. In no case should you try to cure the disease yourself. With improperly administered treatment, there is a high probability that the acute form will rapidly degenerate into a chronic one.
Symptomatic of chronic obstructive bronchitisIn obstructive bronchitis, symptoms of chronic form are persistent cough and shortness of breath, which almost never leave the patient. The cough is slightly moist, with a small amount of sputum, which increases significantly with exacerbation. In addition, during the period of exacerbations the sputum character changes, it becomes purulent. Cough accompanied by continuous wheezing. In extremely rare cases, there may be a period of hemoptysis, which appears against the background of arterial hypertension.
In most cases, the appearance of a chronic form of the disease begins with a cough, and only then dyspnea joins it. However, there were cases when both symptoms were manifested simultaneously.
Dyspnoea can manifest itself in different ways. In some cases, lack of air appears when physical activity occurs, while others have severe respiratory failure.
In general, the severity of dyspnea depends largely on the degree of the disease itself.
Exacerbation of the disease can occur for various reasons. It can show itself at physical activity, after exposure to any allergen of air character, against the background of any infectious diseases, after taking some potent medicines, due to decompensation of diabetes, etc.
In the period of exacerbations, respiratory insufficiency, fatigue, sweating, myalgia and subfebrile condition are added to the main symptoms.
In addition, the following signs of obstructive chronic bronchitis are noted: prolonged exhalation, strong wheezing breathing and wheezing, swelling of the veins of the neck due to the work of her muscles in the respiratory process, a change in the nail form. In addition, the appearance of cyanosis can occur in cases of increased hypoxia.
Treatment of the chronic form of the disease takes a long period. The entire process of getting rid of the chronic form or alleviating the symptoms should be controlled by the attending physician.