Of the dangerous conditions that affect the respiratory system, broncho-obstructive syndrome deserves special attention. The pathology of biofeedback, as statistics show, has recently been found with a greater frequency than before. The phenomenon is complex, includes a number of special manifestations due to a decrease in bronchial lumens. The etiology of such processes can vary significantly from case to case.
General view
If the diagnosis of "broncho-obstructive syndrome" is formulated, you will have to responsibly treat the treatment of the disease. In this condition, inside the thoracic parts of the respiratory system, the pressure necessary for exhalation rises significantly, and this leads to a negative effect on the large bronchi, provoking vibration. Exhaling, a person makes a whistling sound, which can be used to suspect an illness and consult a doctor.
If diagnosedformulated accurately, you will have to strictly follow the medical recommendations. The clinical picture of broncho-obstructive syndrome manifests itself quite clearly, the exhalation becomes longer, the patient sometimes suffers from suffocation, and often coughs, which does not bring significant relief. During a visual examination, the doctor notes that auxiliary muscles take an active part in the act of breathing. If obstruction develops, over time, the respiratory rate increases, which leads to noticeable fatigue of the muscles responsible for the operation of this system. At the same time, partial blood oxygen pressure decreases. This condition sooner or later leads to serious consequences if timely therapeutic measures are not taken.
Risk group
As can be seen from medical statistics, the incidence of broncho-obstructive syndrome in children is much higher. Clinical recommendations to alleviate the child's condition can only be given by a doctor at the reception. The doctor prescribes specialized examinations, on the basis of which he formulates a conclusion on a particular case. It is known that the problem is more likely to occur in three-year-old babies and even younger children. In some cases, the doctor decides not to mention biofeedback when formulating the final diagnosis. Such cases are not analyzed in the statistical distribution.
Often, help is needed for broncho-obstructive syndrome if the child has had an infection of the respiratory system that has affected the lower tracts. Estimates of how highchance of developing biofeedback, differ significantly. Some experts talk about the risk within five percent, while others mention 40%. The likelihood of encountering BOS is increased if there are allergies among close relatives. For such a group, biofeedback is automatically estimated at 40% or more. Also at risk are babies suffering from infection of the respiratory system six times a year or more.
About statistics
As shown by specific studies, broncho-obstructive syndrome in children whose age is from three months to three years old, who have had infection of the respiratory lower sections, occurs in 34%. The disease is more likely to develop if the baby has had bronchitis, but pneumonia provokes BOS in a smaller percentage of cases. Only slightly less than half of all hospitalized juvenile patients will experience a recurrence in the future. The average age of these patients is one year old and older.
Danger
Broncho-obstructive syndrome is more often diagnosed in children against the background of cell hyperplasia (glandular), due to the age of the small width of the paths for the passage of air. It is known that in young patients sputum is produced more often viscous, which also affects the likelihood of biofeedback, develops with weakness of local immunity. A significant role is played by specific individual features of the structure of the body, in particular, the diaphragm.
Higher risk of broncho-obstructive syndrome in children whose closest relatives suffer from allergic reactions, as well as in babies with rickets. BOS is possible if abnormal development is observedthymus (hyperplasia, hypotrophy). The risk is higher if genetic factors cause the likelihood of atopy. BOS threatens in the pathological state of the central nervous system, due to the period of gestation. More often, the syndrome develops in children who are early transferred to artificial nutrition.
Attention to all factors
The pathogenesis of broncho-obstructive syndrome is related to the conditions of the surrounding space. Special analytics showed that BOS is more likely to develop in children whose relatives abuse tobacco. Passive smoking is considered a risk factor for the development of numerous diseases of the respiratory system, including biofeedback. No less important is the ecology of the area where the child lives - the worse the situation, the greater the risk of obstructive processes.
Mutual influence
The development of broncho-obstructive syndrome in the form of an inflammatory chronic process associated with an allergic reaction makes it possible to diagnose bronchial asthma. Pathology is formed under the complex influence of environmental factors and the individual characteristics of the patient. Among the congenital it is customary to include heredity, atopy, increased reactivity of the respiratory tract. These features for modern doctors in their bulk are beyond control.
Features of the external environment that provoke broncho-obstructive syndrome are diverse, numerous, and in their bulk can be corrected and controlled. It is under their influence that the manifestation of asthma begins, an exacerbation is observed. The most striking impact ishand allergens, so it is important to limit the child's space from the influence of negative compounds. Viruses, infection with pathological bacteria can provoke an acute form of BOS. The presence of smokers in the daily environment of the child plays a role, the early transition to artificial nutrition.
Where did the trouble come from?
In order to formulate adequate recommendations for broncho-obstructive syndrome in children, it is necessary to understand the reason for the development of a pathological condition. Modern medicine has accumulated a lot of information about the etiogenesis of the problem. In one-year-old babies and earlier, as common causes, it is worth noting aspiration associated with an incorrect swallowing response, as well as disorders caused by abnormalities in the development of the nasopharynx (the factor is often congenital). Sometimes BOS provoke fistula of the trachea, bronchi, some forms of reflux, malformations of the airways, distress syndrome. The cause of BOS can be a lack of immunity, infection during the period of gestation by the mother of the fetus, dysplasia of the bronchi, lungs. The factors provoking the disease include cystic fibrosis.
Broncho-obstructive syndrome in the second or third year of life can be observed against the background of asthma, helminth migration, aspiration of some object, bronchiolitis. The condition can be provoked by diseases affecting the respiratory organs - genetically determined, congenital. There is a high probability of biofeedback with heart defects that provoke pulmonary hypertension.
Recommendations for broncho-obstructive syndrome forthree-year-old children and older children are based on the reason for the formation of the problem at that age. More often the disease is caused by asthma, malformations of the organs of the respiratory system. Other diseases caused by a hereditary factor, congenital can play a role.
Why is this happening?
BOS provoke reversible, irreversible mechanisms. The former include infection, swelling, increased mucus production. Irreversible are bronchial obliteration, stenosis from birth.
Quite often, doctors are forced to give recommendations for broncho-obstructive syndrome, provoked by inflammatory processes. The problem is more often caused by infection, allergies, poisoning of the body, but neurogenic, physical aspects are possible. The main mediator is interleukin, produced by phagocytes, macrophages under the influence of peculiar factors (not always of an infectious nature). Under the influence of the mediator, an immune response begins, stimulating the production of serotonin, histamine. Additionally, eicosanoids are produced, that is, the second type of mediators characteristic of inflammation at an early stage.
What to do?
Emergency care for broncho-obstructive syndrome depends on the specific situation. The parents should be the first to help the sick person. Quite often, BOS is observed suddenly, while the child is usually he althy, but an attack of asphyxia suddenly begins. This is possible when playing, eating food, due to the penetration of a foreign body into the respiratory tract. The task of parents is to call an ambulancehelp and try to extract the object that the baby choked on.
Primary treatment of broncho-obstructive syndrome in respiratory disease is entirely in the domain of qualified doctors. If asthma attacks are observed at elevated temperature, nasal congestion, symptoms of general poisoning of the body, if the child is continuously coughing, it is important to contact an ambulance in time, having already described all the signs of the condition by phone. As a rule, biofeedback manifests itself unexpectedly, and in most cases is explained by a sudden worsening of infection. If it is not possible to urgently call a doctor, you need to personally take the baby to the infectious diseases department of the hospital, where the patient is placed in the intensive care unit, constantly monitoring vital signs.
What else is possible?
Sometimes manifestations of BOS are observed when coughing - seizures, obsessive, suffocating. In such a situation, congestion and nasal discharge, it is necessary to check the temperature. If the parameter is normal or slightly above average, while the baby has asthma, it makes sense to assume an asthmatic attack. In such a situation, the treatment of broncho-obstructive syndrome consists in the use of classical methods recommended by the doctor to relieve an asthmatic attack. If the cough from dry stubbornly does not become wet, sputum does not separate, it is not possible to remove the manifestations of spasm on its own, you should call an ambulance. The doctors who arrived at the place will inject specialized drugs to stop the painful syndrome. Hospitalization is usually not required.
A special approach to the treatment of broncho-obstructive syndrome is needed if an asthma exacerbation lasts for several days and is not stopped by available home remedies. In this case, the patient is referred to a somatic hospital, placed in an intensive care unit.
What does a doctor do?
Arriving at the call, an ambulance specialist asks adults what accompanied the attack. If asphyxia is observed, the condition is serious, while the baby is usually he althy, the best measure is intubation, artificial ventilation of the respiratory system. In this option, relief of the child's condition is possible only in a hospital, so the baby is sent to the intensive care unit.
In the absence of asphyxia, a foreign body in the respiratory system, adequate therapy is possible only with an accurate diagnosis of broncho-obstructive syndrome, namely the provoking factor. The situation is especially difficult if there is no history of asthma. The task of the ambulance specialist is to understand what caused the attack. Usually this is either the influence of an allergen, or infection of the body. Having formulated the primary diagnosis, choose a measure of assistance. If an allergy is identified, the measures are similar to first aid for asthmatics, with an infection, the strategy is different. However, as can be seen from medical practice, these two conditions are very similar to each other, which leads to frequent medical errors with serious consequences for the patient.
BOS and other pathologies
As seen fromBased on the information accumulated during the observation of such cases, biofeedback often accompanies a number of diseases, mainly of the respiratory system. Inflammatory processes, infection, asthma have already been mentioned above, but this list is far from complete, there are about a hundred names in total. In addition to allergies, dysplasia, congenital malformations, tuberculosis is worth noting. There is a possibility of the syndrome and with tumor processes that disrupt the functioning of the bronchi, trachea. There is a possibility of observing the phenomenon in some diseases of the intestines, stomach, including defects, fistulas, hernia, reflux.
Differential diagnosis of broncho-obstructive syndrome should take into account the possible connection of the phenomenon with diseases of the vessels, heart, including defects, carditis, anomalies of blood vessels (large ones are especially important). CNS diseases can affect, including: paralysis, brain injury, myopathy, epilepsy. There is a possibility of biofeedback in hysteria, poliomyelitis, and some other pathologies. The hereditary factor plays its role, diseases close to rickets, insufficient production of alpha-one antitrypsin, Kartagener's disease, immune system deficiency. Sometimes biofeedback is diagnosed against the background of trauma, chemical and physical factors, intoxication, compression of the airways by external factors.
Form Features
Sometimes acute, protracted biofeedback. The first case is diagnosed if the symptoms are observed for ten days or a longer time period. Relapses, continuous relapses are possible. The latter is typical for people with dysplasia of the bronchi, lungs, bronchiolitis.
Depending on the severity of the conditiondistinguish mild cases, medium, severe, hidden. To be assigned to a specific group, it is necessary to analyze how pronounced wheezing, shortness of breath, whether cyanosis is observed, to what extent additional muscle tissues are involved in the act of breathing. The doctor takes blood for gas analysis, assesses external respiration. Consider that in any of the forms the patient coughs.
Shapes and specific differences
In a mild form, the patient breathes with wheezing, at rest they are not bothered by cyanosis, shortness of breath, and the blood test gives parameters close to normal. FVD - about 80% relative to the average. The patient's condition is normal. The next step is shortness of breath at rest, cyanosis, covering the triangle of the nose, lips. The compliant parts of the chest are retracted, and the whistle during breathing is quite loud, heard in the distance. The respiratory function is estimated at 60-80% of the norm, the quality of the blood is changing.
The severe form is accompanied by seizures, during which the patient's well-being deteriorates significantly. Breathing is noisy, difficult, additional muscle tissues are involved. Cyanosis is pronounced, blood counts deviate from the norm, respiratory function is estimated at 60% or less relative to the standard. The latent course is a specific form of biofeedback in which there are no signs of a clinical picture, but the respiratory function allows us to formulate a correct conclusion.
Formulate a conclusion
To make an accurate diagnosis, you should conduct a full clinical examination with anamnesis. Organize functionalresearch, physical. The practice of using spirography, pneumotachometry is widespread. Such approaches are more relevant if the patient is already five years old or the patient is older. At a younger age, patients cannot cope with forced exhalation. The collection of information about the patient's condition involves the analysis of the family history of the disease, including the clarification of cases of atopy. It is necessary to clarify what diseases the child had before, whether there were recurrences of obstruction.
If biofeedback is determined against the background of a cold, it proceeds in a mild form, a special research methodology is not required. In case of recurrence, blood samples should be taken for analysis, serological testing, including determination of the presence of helminths, should be performed. The patient needs to be examined by an allergist. Often, specialized studies are beneficial: PCR, bacteriological. Bronchoscopy technologies are used, sputum extraction from the lower respiratory organs, and smears are taken to analyze the flora. In some cases, it is recommended to take an x-ray. The procedure is not mandatory, but it is reasonable if the doctor suggests complications, pneumonia, foreign body, relapses. Depending on the information received, they may additionally be sent for CT scan, sweat test, scintigraphy, bronchoscopy.
How to get rid of?
The modern approach to biofeedback involves first determining the cause of the pathology, then eliminating it. To alleviate the patient's condition, they make drainage of the pulmonary system, usemeans for stopping the inflammatory process, relieving bronchospasm. Sometimes urgent help is needed. Broncho-obstructive syndrome in children can be observed in severe form, then oxygen therapy, mechanical ventilation is necessary. Normalization of the drainage of the respiratory organs includes dehydration, the use of mucolytic agents, expectorants. Some specific massage techniques, gymnastics, postural drainage are considered useful.
The use of expectorants, mucolytics allows you to effectively deal with sputum, make coughing more productive. Medicines can be used orally and with the help of a special device - an inhaler. The most popular are bromhexine, the active metabolites of this compound. In pharmacies, there is a fairly large variety of items. The action of the funds is indirect, moderate, includes the ability to stop inflammation and activate the production of surfactant. Allergic reactions to bromhexine metabolites are extremely rare. Medicines are used for colds after a meal in the form of a syrup, solution. Available in tablet form. The dosage is prescribed by the doctor, focusing on the age and weight of the patient. N-acetylcysteine is considered the most powerful of the drugs presented on the pharmacy shelves. Medicines with this compound are effective in chronic forms of the disease. This mucolytic affects the body directly, dilutes sputum, and with prolonged use reduces the generation of lysozyme, IgA, whichleads to greater reactivity of the bronchopulmonary system in a third of patients aged three years and older.
