Bronchial asthma in translation from ancient Greek means shortness of breath, heavy breathing. These symptoms are the main ones in a series of all manifestations. Asthma in children is an insidious disease, according to WHO estimates, 10% of children suffer from it. In half of the cases, various forms of asthma develop among preschoolers, mainly children under 10 are ill.
Asthma is characterized by a change in the reactivity of the inflamed bronchi, manifestations of bronchial obstruction (the lumen of the bronchi is narrowed). It has an episodically recurring form, and therefore is called chronic. Such a diagnosis is made by a doctor to a child with a disease of a specific etiology associated with the respiratory tract. The disease is caused mainly by allergic and immunological mechanisms, tormenting attacks of suffocation.
The principles of treating bronchial asthma in children depend on the type of disease. It is classified according to several criteria.
- atopic (exogenous);
- infectious-allergic – has a viral-allergic etiology;
- non-allergic (endogenous) – among the provoking factors – endocrine disorders, infections, physical activity;
- mixed – caused by a combination of allergic and etiological factors.
In the course of the disease:
- intermittent (episodic);
- persistent (permanent).
By severity – 4 steps:
- the first is intermittent ;
- the second is mild persistent ;
- third – persistent moderate;
- the fourth is persistent, severe.
According to the phases or the period of the course, the stages of exacerbation and remission are distinguished.
It is important to learn to recognize the disease at an early stage of development. Asthma in children is expressed by a paroxysmal cough, wheezing, attacks of suffocation, and respiratory dyspnea. With primary manifestations (usually at night), it occurs after a characteristic series of coughs with sneezing, with repeated attacks, constant thirst is added against the background of a feeling of dry mouth, polyuria, mental instability, and lack of appetite.
In infants, the cough is often accompanied by vomiting. The child’s sleep is disturbed. Based on these signs, the pediatrician directs the patient to take tests.
It should be understood that asthma is not contagious and does not pose a danger to others. The best opportunity in solving the problems looming over the sick is the timely detection of the disease. If the disease is diagnosed at the inception stage, the patient is much more likely to cure or completely get rid of the disease.
In terms of the form of exacerbation, bronchial asthma is expressed by the frequency of symptoms affecting the child’s sleep and wakefulness, the frequency of drug use, and expiration indicators:
- peak speed of PSV;
- forced volume of OFI1 (for 1 min).
The variability (variability) of PSV determines the risk of progression and is an indicator of the severity of the course of the disease.
Intermittent bronchial asthma is characterized by a nonspecific frequency of attacks. Sometimes a week goes by without them. Suddenly, an attack manifests itself, and at night – less often, a couple of times during the month. Manifestations are episodic and short-lived. The cycle covers hours, sometimes days, after which the attacks suddenly disappear. In the remission stage, the lungs function normally, and sleep is not disturbed. PSV is more than 80% of the standard indicator, PSV fluctuations are less than 20%.
Mild persistent asthma is characterized by increased symptoms. They appear once a month, or even a couple of times a week. An asthmatic cough affects the patient’s activity, and nighttime symptoms (a couple of times a month) disrupt sleep. PSV is more than 80% of the standard, and PSV variability is 20-30%.
With persistent form of moderate severity with the identity of the last indicator, the level of PSV is 60-80% of the standard level. Clinical manifestations are daily, sleep and wakefulness are impaired. Nighttime attacks are less than daytime.
With severe persistent asthma, the frequency of attacks in a child increases, the symptoms are already permanent (both day and night). Physical activity is minimized, sleep is disturbed. The PSV level is less than 60% of the normative parameter, and the PSV variability is more than 30%.
Causes of the disease
Among the reasons for the development of asthma, in the first place is a predisposition due to genetics. Frequent causes in the history of patients are allergic diseases (hay fever, atopic dermatitis).
List of popular provocateurs:
- food allergens;
- chemicals and drugs;
- ticks and cockroaches;
- pollen and dust;
- wool, animal feed and excrement.
Among infants, the development of bronchial asthma is preceded by food allergy, which occurs as a result of premature separation from the breast and the transition to infant formula (recognized allergens). It is difficult to treat babies, especially during the period when teeth begin to appear. Identifying possible allergens, checking respiration rates, undergoing a full diagnosis – this is the way to prescribe a basic treatment.
To ensure a healthy unborn child, doctors advise to be outdoors more often, to do gymnastics and massage. The pediatrician will teach you how to prevent impending attacks in a timely manner.
Triggers of asthma are provoked by various kinds of infections, including ARVI, influenza, staphylococcus aureus, mycoplasma.
The culprits of this pathology are industrial emissions allergens, stress, cleaning sprays, excessive physical activity, cold air, tobacco smoke and overweight.
Allergic history – the initial stage of research. Further, spirometry and peak flowmetry are performed . Chest radiography and removal of allergy tests skin will clarify the diagnosis, to identify possible allergens. Blood gas composition, lgE and sputum index are the final studies among the diagnostic stages.
Asthma treatment in children is based on the elimination of allergens through the use of bronchodilators . Antiallergic and anti-inflammatory drugs are also prescribed, immunotherapy is carried out.
Asthma treatment involves a number of conditions:
- prevent a fatal attack;
- eliminate clinical manifestations;
- improve or normalize respiratory function;
- reduce the use of bronchodilators ;
- restore and maintain vital activity;
- prevent side effects;
- prevent disability .
The drugs of symptomatic and basic therapy are used. The first is to stop the attack, and the second allows you to influence the pathogenetic mechanism of the disease.
When choosing a treatment strategy, they are guided by the GINA document specially developed for such diseases.
With a properly selected treatment method, there is no need for the child to stay in the hospital for a long time, it will be possible to be treated at home. The closeness of parents will increase the positive dynamics of healing and exclude psychosomatics . Rehabilitation with this approach is very successful.
Untimely emergency care for a child with primary manifestations of asthma negatively affects the psyche, causing fear and nervousness. A choking attack causes panic in children. Viscous sputum accumulates in the bronchi, reducing the lumen, there is an acute shortage of air. Muscle tissue spasms , respiratory function is impaired. A reflex cough tries to clear accumulated mucus from the airways, but it doesn’t. The agitated respiratory center produces a series of increasing, incessant urges. The patient instinctively assumes a seated position and begins to gasp. These are the manifestations of an attack.
First aid is accompanied by a series of targeted actions:
- Isolate the child from possible allergens. These can include cats, dogs, fish, chemicals, fertilizers, medicines, dusty rooms, flowering plants, and highly allergenic foods. Take the child into a ventilated and clean room without carpets and feather pillows, woolen blankets and blankets.
- Provide the child with a calm state. Better to sit him down with his legs dangling. An adult should remain completely calm, because the emotional state is transmitted to the child.
- If there are any suggestions about possible food allergens, give the child a sorbent. Activated charcoal or Enterosgel is suitable (1 tablet per 10 kg of weight).
- Drink plenty of warm water. Dehydration can worsen the airway.
Performing special exercises that dilate the bronchi and foot baths with mustard will help prevent an attack that begins. To avoid repeated manifestations of asthma, it is worth removing the irritant from the environment of the child.
A number of drugs and agents are known to help stop an asthma patient’s asthma attack. Among them are all kinds of inhalers. A nebulizer has proven itself well , with the help of which inhalation with medicines is carried out. Permissible multiplicity is 5-8 times. Oral medication is also recommended. Among the effective ones are Ventolin , Alupent , Salbutamol , Fenoterol. Complex treatment. If it is impossible to stop the attack on your own, it is recommended to call a doctor.
Folk remedies for treatment, in comparison with pharmacological drugs of chemical action, affect the child’s body a little sparingly. Herbs should be applied gradually, taking breaks between them. You need to start with small doses, observing the patient’s well-being. At first, use it as an adjunct to traditional treatment.
There is a list of herbs, infusions and decoctions on the basis of which they proved to be the best in therapeutic treatment regimens:
- Ginger is a recognized muscle relaxant, relieves inflammation and dilates blood vessels. In combination with turmeric, it has an excellent healing effect, preventing relapse. Able to normalize breathing, stop seizures.
- Garlic has antiparasitic properties. Crush ten cloves of garlic with a ceramic pestle in a mortar (should rest for 20 minutes), pour a glass of warm milk, let it brew. Drink before bedtime from 1 tbsp. spoons up to 100 ml.
- Oregano. Infusion, as a sedative, drink 100 ml before bedtime.
- Chamomile, thyme, sage, plantain, coltsfoot. The broth regulates the heart rate, soothes the central nervous system. They drink 100 ml.
- May burdock combined with fir needles. Add 2 mg of baking soda to an infused glass of broth. Softens cough, relieves inflammation, cleans mucous membranes from pathogenic microflora. Take 1 tbsp. spoon 2 times a week.
Also among herbalists, recognized remedies for asthma are:
- onion broth;
- infusion of viburnum and licorice;
- lingonberry tea;
- broth of mint with milk;
- rose petal jam.
When preparing medicinal infusions, decoctions and baths, you should avoid components that cause allergies: honey, citrus fruits, essential oils.
In bronchial asthma, the prognosis is generally favorable. Patients who become ill in childhood, as they grow up, get rid of the disease completely. Those are up to 80% of the number of cases. But they have to constantly monitor their condition and undergo medical examinations.
Some patients have relapses after 10 years, but severe forms persist in 7-20% of cases. Gender characteristics of a favorable prognosis were also revealed . Boys recover more often than girls.
Cases of clinical remission are known. Death among children is rare. Respiratory arrest occurs with advanced forms, without exception, food allergens and external irritants against a background of stress.
When diagnosing asthma, there is a method for the timely prevention of relapse – checking breathing during a night’s sleep. The rate of heart rate is 145-75 from birth to 15 years old, over 80-90.
Increasing immunity is the main preventive measure. A child needs a balanced diet, feasible physical activity, adherence to sleep patterns, a normal mental atmosphere in the family, in kindergarten and school. Fresh air, sea breeze, moderate sun exposure, healthy sleep are beneficial.
Prophylactic techniques that have proven themselves among patients:
- Relaxation and visualization. Mastering the relaxation technique will help the child remain calm and avoid panic in moments of impending suffocation. At the first manifestations, free yourself from external clamps by unfastening the top button of the collar, remove the belt or belt. Covering the eyelids, imagine how slowly the body parts relax, starting from the limbs towards the heart. Breathing becomes even. Imagine a comfortable, safe environment, carefully consider every detail with your inner vision, try to enjoy the visual images to the fullest. The speaker’s speech is unhurried, with pauses. A low voice is soporific. Light relaxing music sounds in the background. A vivid figurative story, compiled in advance, will allow you to conduct a session. Organs, muscles, spasmodic airways relax. The lumen of the breath increases, the impending suffocation recedes. This practice is perceived by children as a game. I like teenagers very much. They are happy to go on a virtual journey accompanied by an adult, discovering a previously unknown world.
- Protect the child from stressful situations.
- Visit the salt caves. They have a beneficial effect on the respiratory tract, prevent the development of ENT diseases. Disinfects the mucous membranes of the respiratory tract and nasopharynx. This type of service is offered by halotherapy centers . Recommended 10-15 sessions in the spring-winter period, when exacerbations appear against the background of seasonal colds and infections.
- Antiparasitic therapy. It was revealed that helminths can be the provoking factors of asthma. Cause bronchospasm .
- More often to be in the fresh air, in a coniferous forest (phytoncides). Salty sea breeze is beneficial for health.
- Chest and sinus massage. The activated blood supply flushes out the harmful microflora.
- Teach the patient to breathe correctly, drink decoctions of herbs.
- Adhere to the treatment table prescribed by the allergist.
Among the dangerous complications of the last stages of asthma are pneumothorax, atelectasis and pulmonary emphysema, or cor pulmonale. Status asthma is a formidable enemy in a series of complications. Particular attention should be paid to concomitant diseases. With the modern level of development of medicine, the joint efforts of pediatrics, pediatric pulmonology and allergology, changes in the airways in bronchial asthma are reversible. Cases of complete cure or reaching the stage of stable remission are increasing annually among patients. It seems that the hour is not far off when this ailment will not affect any child, the disease of bronchial asthma will disappear forever. There is every reason for such predictions.