SARS season is open. Many people have already seen this from their own experience. However, due to various reasons Not everyone pays due attention to the disease, relying on the fact that “it will go away on its own.” The result of such neglect quite often is the development of complications, the most common of which, perhaps, are bronchitis and sinusitis.

ARVI, an episode of which is experienced by more than a third of the population during the seasonal rise in incidence, with inadequate treatment and non-compliance with bed rest, can lead to the development of complications affecting both the upper and lower respiratory tract. Most often, complications appear on the 4-5th day of the disease due to the development pathogenic bacteria against the background of weakened immunity.

The most frequent complications ARVIs that specialists have to deal with are bronchitis and sinusitis.

The International Classification of Diseases includes two forms of bronchitis:

Acute bronchitis is an acute inflammatory disease of the bronchi, which is characterized by overproduction of bronchial secretions, accompanied by coughing and discharge of mucous or mucopurulent sputum;

Chronic bronchitis is a diffuse, usually progressive inflammation of the bronchi with excessive secretion of sputum in the bronchial tree, occurring with exacerbations and remissions. According to WHO definition, bronchitis is considered chronic when the patient has a cough with sputum production that lasts at least 3 months a year for 2 years or more.

In most cases, the cause of acute bronchitis is the causative agents of acute respiratory viral infections, influenza, parainfluenza, adeno-, rhinoviruses, etc. In addition, layering is common bacterial infection(pneumococci, Haemophilus influenzae, streptococci, etc.) for viral. Somewhat less frequently, bronchitis is caused by fungi, contact with allergens, or inhalation. toxic substances.

Acute bronchitis usually lasts from 10 days to 2-3 weeks. Main symptoms:

At the beginning of the disease - a feeling of tickling and irritation in the chest, lethargy, weakness;

Subsequently, a dry cough, sometimes of a paroxysmal nature, especially at night;

After 1-3 days, sputum begins to appear. A wet cough may persist for several weeks even after other symptoms have disappeared;

Body temperature is normal or slightly elevated;

Headaches;

With obstructive syndrome - shortness of breath, dry wheezing on exhalation, etc.

As for sinusitis, this term combines a number of inflammatory diseases of the mucous membrane paranasal sinuses nose The paranasal (paranasal) sinuses are located in the sections of the facial and cerebral skull and are air cavities covered with mucous membrane.

Depending on location inflammatory process secrete sinusitis (inflammation maxillary sinus), frontal sinusitis (inflammation of the frontal sinus), sphenoiditis (inflammation of the main sinus) and ethmoiditis (inflammation of the ethmoid sinus).

The inflammatory process of sinusitis can also be caused by bacterial, viral or mixed infection, allergies and a number of other factors.

As a rule, inflammatory processes in the paranasal sinuses caused by viruses lead to disruption of mucus evacuation and ventilation, which creates favorable conditions for the development of secondary bacterial infection. Opportunistic microorganisms begin to actively multiply, and slowing down the movements of the cilia of the ciliated epithelium prolongs the contact of pathogens with mucosal cells. Thus, in the paranasal sinuses it develops purulent inflammation, which, like bronchitis, can occur in acute and chronic forms.

The following general symptoms are characteristic of sinusitis:

Difficulty in nasal breathing;

Copious nasal discharge and/or mucus running down the back of the throat;

Severely exhausting headache(localized at the site of inflammation: with frontal sinusitis - in the forehead, with sinusitis - pressing pain in the paranasal region);

Possible increase in body temperature;

General malaise.

One of the main tasks in the treatment of inflammatory diseases of the mucous membranes of the respiratory tract is the rapid removal of the resulting secretion. In this case, myrtol-based products are effective. This herbal preparation effectively reduces the viscosity of mucus and facilitates its removal, stimulates the self-cleaning processes of the respiratory tract mucosa, and also prevents re-infection.

Thus, myrtol effectively fights the main elements of the pathogenesis of bronchitis and sinusitis, which is why drugs based on it should be included in complex therapy these are the most common complications of ARVI.

Expert opinion

Andrey Ivanov, therapist

Often diseases of the upper and lower respiratory tract are caused by infectious inflammation mucous membrane. Damage to the epithelium of the respiratory tract leads to disruption of the barrier function, promotes the proliferation of opportunistic microorganisms and the development of complications, usually of a bacterial nature. These diseases require careful attention and thorough treatment.

With improper treatment of bronchitis, prolonged inflammatory infiltration of all layers of the bronchial wall can lead to fibrosis of the muscular lining of the bronchi with a decrease in the lumen. The spread of the inflammatory process to the lung tissue can lead to the development of peribronchial pneumonia. Moreover, clogging of the bronchial tube with secretions causes a decline in pulmonary astration, in which certain areas of the lung tissue may undergo necrosis.

The selection of drugs for the treatment of bronchitis must be carried out taking into account the need to achieve, firstly, eradication of the causative agent of the disease, and secondly, to ensure dilution and facilitate the removal of sputum in order to avoid the development of a secondary bacterial infection.

To destroy microorganisms that cause the development of the disease, it is usually necessary to take antiviral or antibacterial drugs. The second problem can be solved by including secretolytics in the treatment regimen, which have the properties of stimulants of motor function of the respiratory tract, for example, myrtol.

A fairly common complication of ARVI is also sinusitis, or rhinosinusitis. There are acute (symptoms present for less than 4 weeks), subacute (4-12 weeks) and chronic (more than 12 weeks) rhinosinusitis. At the same time, the main sign to distinguish a relapse is acute sinusitis from an exacerbation of a chronic one, there will be a complete regression of symptoms in the interictal period with relapses of the acute form and the presence residual signs inflammation in a chronic process. Sinusitis can be unilateral or bilateral, involving one sinus or affecting all paranasal sinuses on one or both sides - the so-called pansinusitis.

The intensity of sinusitis manifestations is largely determined by the virulence of the pathogens that cause the disease. Typically, sinusitis is caused by bacteria. Moreover, it is worth noting that currently there is a tendency to change the spectrum of pathogens, as well as to increase the resistance of microorganisms to antibacterial therapy. Much less often, inflammation of the sinuses is caused by a fungal infection, which mainly develops as a result of the uncontrolled use of antibacterial agents.

In the treatment of sinusitis, drugs that improve the flow of secretions from the sinuses come to the fore. Ensuring and maintaining drainage function and the supply of sufficient oxygen is the key to successful treatment of the acute form of the disease and prevention of chronic disease. Thus, for both bronchitis and sinusitis, agents are indicated that stimulate the transport of secretions and at the same time have an antibacterial effect, in particular myrtol.

This drug of plant origin has secretolytic, mucolytic, antimicrobial, secretomotor, antioxidant, and bronchodilator effects. By reducing the viscosity of mucus, the drug based on myrtol sonova normalizes the natural mechanism of self-cleaning of the respiratory tract - mucociliary clearance, and thereby facilitates the evacuation of mucus from the respiratory tract.

The inclusion of myrtol-based drugs in the complex therapy of patients with bronchitis and/or sinusitis allows for a quick recovery and prevents the development of chronic forms of the disease.

Bronchitis is an inflammation of the bronchial mucosa, which is accompanied by such respiratory symptoms like cough and shortness of breath. With bronchitis, most often there are signs of ARVI: fever, runny nose, headache, general intoxication.

Bronchitis in children, symptoms, types and methods of treatment of this disease have been well studied in modern medicine. Inflammation of the bronchi occurs due to the entry of microbes, viruses, bacteria or allergens into the respiratory tract. During the inflammatory process, mucus is produced, which clogs the lumen of the bronchi. This, in turn, causes spasms and coughing in the bronchi. In 90% of cases, bronchitis occurs due to viral infections. Whether a child develops bronchitis during ARVI or not depends not only on immunity, but also on the type of virus. For example, influenza viruses like to settle in the bronchi. Much depends on the environment in which the sick child is located. In dry, hot air, ARVI often leads to complications in the form of tracheitis, bronchitis and pneumonia.

Types of bronchitis

Inflammation of the bronchi is classified according to different parameters. Acute and chronic bronchitis are distinguished by form and duration.

• Acute bronchitis in children. The acute form of bronchitis, as a rule, is not an isolated disease and most often occurs against the background of acute respiratory viral infection. The cough may last 2-3 weeks, after which complete recovery occurs.
• Chronic bronchitis in children. Sluggish inflammatory process in the bronchi. Characteristic difference from the acute form - large number mucus in the bronchi. If a child has been coughing for more than 3 months, has shortness of breath during physical exertion, has coughing attacks at night, there is every reason to talk about a chronic form of bronchitis or a developing one. bronchial asthma. Only a doctor can differentiate these diseases.

If during acute or chronic inflammation bronchi, symptoms of difficulty breathing are observed, such bronchitis is called obstructive. Read more about the symptoms and treatment of obstructive bronchitis in children in our other article.

According to the type of pathogen there is bronchitis:

• viral (catarrhal);
• bacterial (purulent);
• fungal;
• allergic (irritative, asthmatic).

By localization of inflammation:

• tracheobronchitis: inflammation of the trachea and large bronchi;
• bronchitis: inflammation of the medium and small bronchi;
• bronchiolitis: inflammation of the smallest bronchi - bronchioles.

Signs of bronchitis in children

Symptoms of bronchitis in children can appear in the first days of ARVI, along with a runny nose, fever, headache, malaise, and general intoxication of the body. What is characteristic of bronchitis?

• Cough. Main sign inflammation of the bronchi. At the beginning of the disease, the cough is dry and debilitating, but by about 6-7 days of illness it becomes wet.
• Cough intensity. If bronchitis is not treated or is treated incorrectly, the intensity of the cough increases. Sometimes it turns into barking cough, which may indicate the development of laryngotracheitis in children.
• Temperature. Usually does not rise above 38 °C. Often a child has bronchitis without fever or occurs with low-grade fever.

Wet cough and sputum discharge with bronchitis - good indicator. If the child begins to cough, this indicates the beginning of recovery.

How to recognize the bacterial nature of bronchitis?

• The most reliable source is sputum culture and identification of bacteria.
• Sputum is yellow or green.
• It happens that after an acute respiratory viral infection there is a rapid improvement, but then a cough appears and a high temperature rises - these signs may indicate a secondary bacterial infection that occurs against the background of a weakened immune system.
• With viral bronchitis, intoxication is not too pronounced, but with bacterial bronchitis, the child really feels bad: headache, weakness, high fever.

For a bacterial infection in a blood test leukocyte formula moves to the left, are detected elevated white blood cells, as well as high ESR (above 20 mm/h).

Drug treatment

Medicines are used to relieve inflammation, swelling, bronchospasms, as well as to liquefy and remove mucus.

When are bronchodilators used?

Bronchodilators are medications that relax the muscles of the bronchi, relieve spasms and make breathing easier. They are prescribed as an ambulance when there are signs of obstruction - obstructed passage of air in the bronchi. Bronchodilators for children come in the form of tablets, aerosols and solutions for inhalation. The most commonly used inhaler is Salbutamol; for inhalation using a nebulizer, Berodual is usually prescribed. Long-acting tablets are used strong drug- "Eufillin." Bronchodilators are not prescribed for bronchitis without signs of shortness of breath.

When antibiotics are not needed

As a rule, treatment of bronchitis in children is carried out without antibiotics. Indeed, in most cases, inflammation of the bronchi is viral nature. When treating bronchitis, mucolytic and expectorant drugs are used (usually in the form of syrups). IN in rare cases For a dry, debilitating cough, the doctor may prescribe antitussives to suppress the cough center. Self-administration of these medications is strictly prohibited. Mucolytic drugs are prescribed if a dry cough persists for a long time, the mucus in the bronchi is viscous and difficult to clear. This series of drugs includes: Ambroxol, Bromhexine, Mukobene, ACC and many other analogues. If sputum appears, but is difficult to clear, the doctor may prescribe expectorants: Bronchicum, Gerbion, Gedelix, Bronchipret, Prospan, Linkas and others.

When are antibiotics needed?

Treatment of bronchitis in children with antibiotics should be balanced and justified. It has been proven that it is unfounded antibacterial therapy leads to deterioration of the child’s condition and recurrent bronchitis. The cause of inflammation of the bronchi can be streptococci, staphylococci, pneumococci. There are also atypical pathogens of the disease - chlamydia and mycoplasma (something between a virus and a bacterium). Bacterial bronchitis is successfully treated with antibiotics from the penicillin group, macrolides, and cephalosporins. The most commonly prescribed drugs are Augmentin, Amoxicillin, Amoxiclav, Sumamed, Cephalexin and many other analogues of drugs. If the doctor has prescribed antibiotics, you must comply with all conditions for taking the medication. You cannot leave the course if your child feels much better. It is also recommended to take a course of probiotics to restore microflora.

Supportive treatments

Treating bronchitis in children at home does not mean that you can make a diagnosis yourself and begin treatment with effective methods recommended by neighbors or “experts” on forums. Any actions should be agreed with a doctor, especially if we're talking about about children under 3 years of age.

• Distraction procedures. They can be used if the child does not have a fever, bacterial infection, severe intoxication, an allergic reaction to any component and age restrictions. Distractive procedures include: mustard plasters, compresses, hot foot baths. Warming ointments for rubbing should be used with caution and only as prescribed by a doctor.
• Folk remedies. Everyone is familiar with the proven and effective method - hot milk with honey and butter. For particularly courageous patients, a pinch of soda is added to the mixture. Recommend replacement butter cocoa butter, which can be purchased at the pharmacy. Good for coughs breast training No. 1, No. 2, No. 3, No. 4. Plantain, licorice, marshmallow, calendula, coltsfoot are the most effective medicinal herbs for bronchitis. Radish juice with honey is also considered effective folk recipe with a dry cough. Read more about treating cough with folk remedies in our other article.
• Vitamins, fresh air and moderate physical activity. If the child coughs up phlegm on his own, then all distracting procedures and herbal decoctions with an expectorant effect are canceled. Walks shown fresh air- This best medicine against bronchitis for children at the recovery stage. A diet enriched with vitamins is also recommended. If there is no shortness of breath, light physical activity is acceptable. During active games, the remaining mucus will come off faster.

How to do drainage massage

Drainage massage for bronchitis in children is an effective treatment method that parents can easily master. Its function is to help the child cough up excess mucus stuck to the walls of the bronchi. Massage will be useful for babies of any age, and especially for infants who do not yet know how to cough. Moms and dads can master this procedure on their own. But it is better if the elements of drainage (percussion) massage are shown by a professional. What are the basic rules for performing this procedure?

• Massage can be used during the recovery stage, when the child has no fever or signs of intoxication.
• The movements are performed intensively, but without excessive force and pressure.
• The massage lasts from 3 to 5 minutes.
• The procedure can be performed three times a day for a week.
• You cannot force a massage, otherwise the child, in addition to bronchitis, will also have to treat his nerves (including mom and dad).

What is the technique for performing drainage massage?

1. The child should be placed on your lap so that his head is below his buttocks and his arms hang down.
2. For comfort, you can place a pillow under the baby's stomach.
3. Pat the child on the back from bottom to top.
4. Then, using the pads of your fingers or the ribs of your palms, perform tapping movements along the spine in an upward direction.
5. After the procedure, you need to sit the child down and ask him to cough.
6. The child may begin to cough up mucus already during the procedure or after the massage 10 minutes later.

Another option is drainage massage.

1. The child sits upright on the adult's lap.
2. You need to ask the baby to take a deep breath and cough.
3. When a child coughs, you need to squeeze the chest with your hands.

More about inhalations

Steam inhalation is a good old method that has been actively used to treat more than one generation of children. Breathe over the decoctions medicinal herbs, potatoes, soda solution - this was the very first remedy for cough. There is now a lot of conflicting information on the use of hot inhalations. Some pediatricians are categorically against these home procedures.

• Inhalations are not given to infants to prevent burns to the mucous membranes.
• Also hot steam can trigger a seizure in a child of any age false croup, that is, suffocation.
• For the same reason, hot baths are prohibited during bronchitis. If a piece of dried mucus in the bronchi softens and expands under the influence of steam, this can lead to sudden attack suffocation.
• It is strictly forbidden to breathe steam if there is bacterial inflammation of the bronchi.

Inhalations for bronchitis in children are safe if carried out using a nebulizer. This inhalation device is used both for prophylactic purposes to moisturize the mucous membrane of the respiratory tract, and for acute period diseases. You can breathe with sprayed saline or medications that help thin mucus, relieve swelling, inflammation, and spasms in the bronchi.

Bronchitis is a serious infectious disease. It usually doesn't go away on its own, like a runny nose. This disease should be treated by a pediatrician or pediatric pulmonologist. Any “effective” methods of self-medication can lead to serious complications. The first and most common of these is pneumonia. You should also be careful when using herbal expectorant syrups. It is strictly forbidden to use them without a doctor’s prescription.

Features of the disease in infants

ARVI and bronchitis in infants are rare, especially if the child is breastfed and receives antibodies from the mother. In addition, children of this age have limited contact with children's groups, where they can easily catch a viral infection. If the family has an older child attending kindergarten or school, the risk of developing ARVI in an infant increases significantly. What can cause bronchitis in an infant?

• Anatomical features of the bronchi. In young children, the mucous membrane of the respiratory organs is much more sensitive, and the bronchi themselves are narrow, which leads to a rapid narrowing of their lumen during inflammation.
• Malformations of the respiratory system. This is a difficult problem to diagnose and treat in pulmonology. Congenital diseases bronchopulmonary system most often require surgical intervention. Narrowing of the lumen of the bronchi, cysts of various nature and localization in the respiratory organs provoke bronchitis and pneumonia.
• Light weight. Premature and low birth weight babies have a hard time with ARVI. Viral infections in such children often result in complications in the respiratory system.
• Allergens. The mucous membrane of the respiratory tract in infants is tender and sensitive, so an allergic reaction to various stimuli: household dust, chemicals in the air, dyes on clothes, animal hair, etc.

Signs of bronchitis in children under one year old

What are the symptoms of bronchitis in a baby?

• Poor appetite and sleep, restlessness, crying, moodiness.
• Intoxication is not as severe as with pneumonia, and the temperature is usually low.
• Dry, paroxysmal cough.
• After a few days, scant sputum may appear that the child is unable to cough up.
• Signs of difficulty breathing: nasal flaring syndrome; retraction of intercostal spaces during inspiration; shallow breathing with a frequency of up to 70 breaths per minute; pale or bluish skin; shortness of breath and grunting sounds.
• At severe forms ah - suffocation, respiratory arrest (apnea).

If your baby has a runny nose along with a cough, this indicates an acute respiratory viral infection. If the nose is dry, but the child is coughing, this is a more serious symptom that may indicate a disease of a bacterial or allergic nature. It also cannot be ruled out that foreign body into the respiratory tract.

How is the treatment carried out?

Treatment of bronchitis in children under one year of age should be carried out under the close supervision of a pediatrician. Often the doctor recommends hospitalization. This is explained by the fact that infants quickly become dehydrated and rapidly develop difficulty breathing. What should parents do before the doctor arrives?

• Ensure drinking regime. It is recommended to put the baby to the breast more often and give him water and age-appropriate drinks. How to understand that the baby does not have enough fluid in the body? This can be indicated by: dry tongue, crying without tears, rare urination, lethargy, drowsiness, sunken fontanel. If these signs are detected, it is necessary to give the child glucose-saline solutions.
• Provide cool and humid indoor air. Optimal air parameters are from 18 to 20 °C, humidity - from 50 to 70%. If this condition is not met, in a hot room the delicate mucous membrane of the respiratory tract quickly dries out, the mucus thickens and sticks to the walls of the bronchi. This leads to a narrowing of the lumen of the bronchi and deterioration of ventilation. The likelihood that ARVI will end in bronchitis is very high.
• Reduce the temperature. At high temperatures, you need to give your baby antipyretic drugs based on paracetamol or ibuprofen. age dosage. It is strictly forbidden to use aspirin and analgin.
• Prevent stagnation of mucus in the bronchi. Accumulated mucus that the baby cannot cough up can cause pneumonia. Therefore, it is recommended to turn the baby from one side to the other. This promotes the movement of mucus in the bronchi and causes a reflex cough.

What can't you do?

• Rub the baby with ointments with essential oils.
• Apply mustard plasters and compresses.
• Do inhalations with hot steam.
• Use any cough medicines, including breast milk and herbal syrups, without a doctor’s prescription.

Most often, bronchiolitis develops at an early age - a severe form of bronchitis with inflammation of the bronchioles. Read more about bronchiolitis in children in our other article.

Preventive measures

Prevention of bronchitis is primarily aimed at strengthening the child’s immunity and reducing the incidence of acute respiratory viral infections. What targeted methods will help prevent or treat chronic forms of bronchitis?

• Physiotherapy. These include: electrophoresis, mud applications on the chest, ultraviolet irradiation, UHF therapy, phototherapy with the Sollux lamp and other methods. They are prescribed for recurrent, chronic forms of bronchitis. They are held no more than twice a year.
• Room hygiene. If a child has been diagnosed with asthmatic bronchitis, it is necessary to pay utmost attention to the environment in which he lives, what air he breathes, what he eats, what clothes he wears, what toys he plays with, etc. Recurrent obstructive bronchitis without signs of acute respiratory viral infection most often indicates an allergic nature. To avoid the development of bronchial asthma, it is necessary to identify the allergen and eliminate it.
• Breathing exercises. Exercises can be done in the form of a game: inflating a balloon or blowing out a candle. It is recommended to blow air through a thin tube (a pen without a rod works well for this). A special therapeutic exercises for respiratory diseases, which will give positive result when performed regularly.
• Improvement of the child. A good prevention of bronchitis of an allergic nature is the sea and mountain climate. It is useful to take your child out of town in the summer, to live for a long time in the fresh air. clean air in the village or at the dacha.
• Speleo procedures. Treatment with the healing air of salt mines is indicated for chronic allergic bronchitis and bronchial asthma.

Treatment of bronchitis in children depends on the type of pathogen. Most often, inflammation of the bronchi is viral nature, therefore, the use of antibiotics for this disease is not justified and even dangerous. Mucolytic and expectorant drugs are actively used, folk remedies and distraction procedures. Inhalation and drainage massage are effective for bronchitis.

Print

ARVI (acute respiratory viral infections) is a group of acute infectious diseases, caused by a group of viruses that infect the mucous membranes of primarily the respiratory tract and conjunctiva of the eyes. These infections rank first in frequency among all infectious diseases in the world. An adult gets ARVI on average 2–3 times a year, a child – 6–8 times. About what causes this disease, what is the mechanism of its development and the main clinical signs, you could read in the first part of our article. Right here we'll talk about possible complications of ARVI and issues of diagnosis, treatment and prevention of this disease will be considered.

Complications of ARVI

Any acute respiratory viral infection can cause complications, both viral itself and those arising from the layering of a bacterial infection. The risk of complications is higher in:

• children under 3 years of age, especially under 1 year of age;
• elderly people;
• persons with severe somatic pathology ( diabetes mellitus) And chronic disorders blood circulation;
• persons after undergoing surgery;
• persons with immunodeficiencies (HIV, congenital pathology immune system).

The most commonly diagnosed complications are:

• inflammation of the bronchi (), bronchioles () and lungs ();
• inflammation of the paranasal sinuses (sinusitis: sinusitis, sinusitis);

Complications from nervous system(polyradiculoneuritis, meningitis, meningoencephalitis, convulsive syndrome) occur less frequently, but are very difficult for patients to tolerate and often pose a threat to life.

With severe intoxication of the patient's body, cardiac dysfunction and myocarditis are possible.

Hemorrhages on the skin and mucous membranes are complications of severe forms of influenza.

Serious complication in children early age requiring emergency medical attention is, or acute stenosis larynx.

Diagnosis of ARVI

The diagnosis of ARVI usually does not cause difficulties for a doctor. It is set on the basis of the patient’s complaints, medical history (acutely ill after contact with the patient), taking into account epidemiological data.

At objective examination patient, the specialist will pay attention to the signs inflammatory phenomena in the area of ​​the conjunctival mucosa, nose, pharynx and other parts of the respiratory tract, and will also assess the severity of intoxication (heart rate, shortness of breath).

To confirm the diagnosis, the patient may be prescribed additional examination methods:

• general blood test (ESR will be increased, lymphocytosis is possible);
• general urinalysis (to exclude pathologies of the urinary system);
• examination of a fingerprint swab taken from the nasal mucosa, PCR methods and RIF (to determine the type of virus).

To diagnose possible complications, if indicated, an X-ray examination of the paranasal sinuses, lungs, as well as consultations with related specialists - an otolaryngologist, a neurologist - may be prescribed.

Principles of treatment of ARVI

Abundant, rich in vitamins drink.

Acute respiratory viral mild infections And middle degrees severe cases are treated on an outpatient basis, while severe cases are treated in a hospital setting. Treatment is carried out by a local therapist or family doctor, in a hospital - as a rule, an infectious disease specialist. If there are complications, doctors of narrow specialties - ENT, neurologist, pulmonologist - are involved in treatment...

The patient is released from work for the entire period of illness - he is issued a certificate of incapacity for work.

Volume therapeutic measures directly depends on the nature of the pathology and the severity of the disease.

Treatment of acute respiratory viral infections should be carried out comprehensively and include both non-drug and medicinal methods therapy.

The most important component of treatment is the correct microclimate in the room where the patient is located. When staying where it is hot and dry, the mucous membranes dry out and lose the ability to perform their functions. essential functions to fight infection. Therefore, the room of an ARVI patient should be cool (optimal air temperature – 18–20 °C) and humid (air humidity – 60–65%). Many people consider the recommended air temperature, to put it mildly, to be too cool, but the combination of precisely these temperature and humidity figures will improve the patient’s well-being and speed up his recovery. Of course, the patient’s home clothes should correspond to the air temperature: thin pajamas will not be enough.

Second component non-drug treatment is to drink plenty of warm water. A patient with ARVI, especially one with a fever, loses a lot of fluid with sweat, separated from the inflamed mucous membranes. It is necessary to make up for these losses. In addition, a person who drinks a lot urinates more often, and viral metabolic products and toxins come out with urine, therefore, the manifestations of intoxication are reduced. You can drink whatever you want: warm milk with honey, compotes, herbal teas, fruit and vegetable juices and fruit drinks, mineral water. Alcohol and carbonated drinks should be excluded.

Do not forget about the importance of a complete diet, rich in vitamins (A, C, group B) and microelements necessary for recovery. Difficult to digest and unhealthy foods (fried, smoked, spicy) should be excluded from the diet. Dishes consumed by the patient should be mechanically gentle and warm. If your appetite is reduced, you don’t need to force yourself to eat - after a while your appetite will normalize on its own.

Bed rest for mild and moderate forms of ARVI may not be necessary, but it is important to rest as much as possible and minimize contact with people so as not to infect them and to avoid re-infection yourself.

Drug therapy for ARVI includes etiotropic (i.e., affecting causative factor– virus), pathogenetic (detoxification) and symptomatic (alleviating the patient’s condition by reducing certain unpleasant symptoms for him) therapy.

Etiotropic antiviral therapy It is effective only in cases where it is prescribed on time, namely, when the first symptoms of the disease appear. Usually prescribed drugs are Interferon, Groprinosin, Isoprinosine (in pediatric practice), Kagocel, Arbidol, Amizon, Anaferon, Immunoflazid, Proteflazid, Oseltamivir.

The following groups of drugs can be used as symptomatic therapy:

• antipyretics (paracetamol (Panadol), ibuprofen (Nurofen)); It is worth noting that a temperature of up to 38.5 °C does not require the use of antipyretics, since it is at these numbers that the immune system actively functions, i.e. the body fights the disease; the exception is people with diseases of the central nervous system, for example, those suffering from epilepsy: even with a slight increase in temperature, they can develop a convulsive syndrome;
• antiviral and antibacterial eye drops(Albucid, Tobrex, Okulokheel) – for conjunctivitis;
• (xylometazoline, oxymetazoline) – for nasal congestion; It is important to know that these drops should not be used for more than 4-5 days in a row, as addiction may develop to them;
• (Aquamaris, Marimer, No-salt) - to thin the mucus during;
• antihistamines(cetirizine (Cetrin), loratadine (Lorano), etc.) – to eliminate the allergic component of inflammation and reduce swelling of the mucous membranes;
• anti-inflammatory and antimicrobial agents for the throat in the form of lozenges (Neo-angin, Strepsils, Aji-sept, Decatylene) and sprays (Ingalipt, Orasept, Angilex, Tera-flu);
• : expectorants (Dr. Theiss plantain syrup, Eucabal, Prospan) and mucolytics (based on ambroxol (Lazolvan, Ambrobene), acetylcysteine ​​(ACC));
• for the purpose of detoxification - sorbents (Sorbex, Atoxil); in severe cases, in a hospital setting - infusion therapy(intravenous drip administration of solutions: saline solution, rheosorbilact);
• in order to improve immunity - immunomodulators (echinacea, ginseng, lemongrass preparations);
• during the period of convalescence (recovery) - multivitamin preparations (Vitrum, Multitabs, Duovit).

Antibiotics for ARVI

Since antibiotics are drugs that act on bacteria, and acute respiratory viral infections are known to be caused by viruses, prescribing drugs of this group for acute respiratory viral infections is not advisable. However, if within 3 days (72 hours) after the onset of the disease the patient’s condition does not improve or even worsens (and subjective feelings patient, and according to a doctor’s examination), this implies a layer of bacterial flora on top of the viral infection, which requires the prescription of antibiotics.

It is necessary to take the drug wide range actions, because it is unknown what type of microbe complicated the course of the disease of a particular patient. Of course, you can conduct an examination, place the material taken from the patient on a nutrient medium, wait until the culture of microorganisms grows, and determine their sensitivity to antibacterial drugs, however, these studies will take almost a week, and the patient will not receive the treatment he needs during this time. In order not to waste time, the doctor prescribes an antibiotic immediately after establishing such a need, more often using drugs from the aminopenicillin group (Augmentin, Flemoxin Solutab, Amoxiclav) and cephalosporins (Zinnat, Cefodox, Cefix).

You should not take antibiotics irregularly or for less than the period recommended by your doctor, since the bacteria, weakened by the drug, but still living, will regain strength and will also lose sensitivity to this drug. Therefore, it is necessary to strictly adhere to the dosage and regimen of the drug prescribed by the specialist. On average, you should take the antibiotic for 3 days after the body temperature normalizes, then you can stop it.

Prevention of ARVI

About a month before the expected flu epidemic, it is advisable to vaccinate against this disease. Vaccination does not eliminate the possibility of getting sick, but it does ensure a milder course of the disease with a minimum of complications.

Methods specific prevention ARVI (vaccination) today are not effective enough - only influenza vaccination makes sense. According to the rules, it should be carried out 2–4 weeks before the outbreak of the epidemic. Vaccines such as Influvac, Vaxigrip, Grippol, etc. have proven themselves.

From non-specific preventive measures the following should be observed:

• minimize visiting crowded places during the epidemic; if this is not possible, then it is important to remember that it is better to contact people on the street than indoors (for example, prefer a market to a store) - in the fresh air the concentration of infectious agents is many times lower than in a poorly ventilated room;
• wash your hands often, do not touch your mouth or eyes with them, avoid shaking hands;
• moisturize the nasal mucosa using saline solutions or saline;
• frequently ventilate the home, carry out wet cleaning in it, maintain optimal air humidity;
• carry out hardening procedures;
• periodically use immunomodulators (licorice syrup, echinacea preparations, IRS-19, Imudon, Ribomunil, etc.);
• during epidemics, take vitamins, especially ascorbic acid.

In order not to become infected from a family member suffering from ARVI, in addition to the measures indicated above, it is necessary to provide him with individual utensils, have as little contact with the patient as possible, and if contact cannot be avoided, put a gauze bandage on him that covers both his mouth and nose. In order to disinfect the room in which the patient is located, it is advisable to regularly carry out quartz treatment in it (the room).

Forecast

In the vast majority of cases, the prognosis for ARVI is favorable - the disease ends full recovery. In case of development severe complications(pulmonary edema, meningoencephalitis, meningitis), with late diagnosis and lack of adequate treatment, the prognosis significantly worsens - the patient’s disability and even death are possible.

Medical company "Nauka", a specialist talks about the prevention and treatment of acute respiratory infections and acute respiratory viral infections:

Pediatrician E. O. Komarovsky talks about the treatment of ARVI in children:

The cold period of the year, from autumn to the end of spring, is characterized by a surge in various viral diseases. Often we try not to pay attention to a cold and suffer the disease on our feet. However, when improper treatment a complication occurs after an acute respiratory infection - bronchitis, which requires special attention And qualified treatment. Today in the article we will talk about why bronchitis develops after acute respiratory viral infection, and how to treat acute respiratory viral infection with bronchial complications.

After ARVI, complications in the bronchi may begin

Let's first figure out how ARVI and bronchitis are related, and whether it is necessary to use antibiotics for bronchitis and influenza? With bronchitis, inflammation from the upper respiratory tract spreads to the bronchi and affects their mucous membrane. When a person is healthy, purified air, free of viruses and bacteria, enters the lungs; the nasal mucosa and microcilia located on the bronchial mucosa are responsible for this. However, if viruses or bacteria enter the bronchi, the mucous membrane becomes inflamed, which is accompanied by a cough. The bronchial mucosa swells and sputum appears on the walls, which is removed by coughing.

Viruses infect the bronchi very quickly, therefore only the upper layer of the walls of the bronchi becomes inflamed and develops acute bronchitis. Feature this state the fact that after it the mucous membrane is restored as quickly as the inflammatory process proceeds. Most often, acute respiratory viral infections and acute bronchitis develop spontaneously in children, because they are more susceptible to viral infections due to the immaturity of the immune system.

How younger child, the greater the likelihood of complications in the bronchi, for example, a cough in an infant after an acute respiratory infection develops an order of magnitude faster than in a school-age child.

Children are susceptible to bronchial complications

Frequent bronchitis in children weakens the body, and the inflammatory process has a bad effect on the bronchial mucosa. Swelling occurs and grows connective tissue and obstruction develops (narrowing of the lumen in the bronchial tube). As a result, the child develops shortness of breath and breathing problems, and over time, bronchial asthma or obstruction may develop. A child's hoarse voice after an acute respiratory infection may be a symptom of laryngitis and developing bronchitis. If your voice has disappeared after an acute respiratory infection, then try to talk less, do not strain your throat and keep it warm.

The chronic form of bronchitis occurs when long-term exposure on the human body harmful factors such as tobacco smoke, indoor dust or chronic bacterial infection. In this case, the walls of the bronchi are affected much deeper than with acute form, in this case, deformation and narrowing of the bronchial tube is possible. The chronic condition is dangerous because it can trigger asthma. Treatment of influenza with bronchial asthma becomes more complicated; in most cases, acute respiratory infections and influenza provoke an exacerbation of asthma, so everything possible must be done to avoid infection.

As we have already said, bronchitis is caused by viruses, such as influenza virus, rhinoviruses, adenoviruses and bacteria, such as pneumococci and streptococci. In addition, swelling of the bronchi can develop as a result of an allergic reaction.

Antibiotics are prescribed only for bacterial bronchitis or complicated acute bronchitis, after accurate diagnosis and under the supervision of the attending physician.

Causes of the disease

ARVI and acute bronchitis are often associated, because bronchitis develops as a complication of improper treatment viral infection. Main problem Our society is that we love to self-medicate and prescribe medications to ourselves without consulting a doctor, and this leads to disastrous consequences. For colds and acute respiratory infections, it is important to follow bed rest , otherwise the likelihood of complications increases.

Bronchitis can begin due to weak immunity

Bronchitis can also be caused by weak immunity. Viruses destroy the body’s defenses, so they become more active chronic diseases and microorganisms from external environment. It turns out that during a period of illness we are completely defenseless against new danger, so you need to avoid crowded places and get proper treatment at home.

Symptoms of the disease

If an acute respiratory infection progresses to lower sections respiratory tract, this is manifested by a dry cough, hoarseness, and sometimes loss of voice. How to treat if your voice has disappeared after an acute respiratory infection? Stay home, warm, so as not to breathe cold air and treat your cold properly; most likely, your hoarseness will go away in a couple of days. The main symptom of the disease is a cough, first dry and then with sputum. It is from sputum that one can understand the characteristics of the disease:

• Green or yellow mucus indicates the development of a bacterial process
• Transparent - indicates the viral or allergic nature of the disease
• Curdled sputum with unpleasant smell characteristic of a fungal process in the bronchi.

In order to determine that bronchitis begins against the background of an acute respiratory infection, pay attention to the following symptoms:

1. For a cold, the cough goes away within a few days, but for bronchitis it can last up to three weeks.
2. If elevated temperature lasts more than 7 days against the background of a cough, this indicates that a pathological process has begun in the bronchi
3. A cough that gets worse at night, making it difficult to breathe, also indicates problems with the bronchi.

At protracted condition there is a danger of the disease progressing to such dangerous conditions such as bronchopneumonia, influenza pneumonia, pulmonary edema or pleurisy. If bronchial patency is impaired, then bronchitis becomes a chronic condition with a protracted course..

If the condition is prolonged, pulmonary edema is possible

For precise setting diagnosis and exclusion of pneumonia or asthma, in addition to an in-person examination, the doctor prescribes:

• General blood test and biochemistry
• Fluorography or x-ray of the lungs
• Sputum examination

Treatment

To treat acute bronchitis, antipyretics, bronchodilators and inhalations are used. For viral infections, antibiotics are not prescribed because viruses are not sensitive to antibacterial agents, which is why antibiotics are used only for acute bacterial bronchitis or complicated forms of viral bronchitis.

Please note that antibiotics are drugs that, if not used promptly, can cause serious side effects and resistance of certain bacteria to antibiotics. At the moment when an antibiotic is indispensable, it simply will not have an effect on the bacteria, and this is dangerous for the patient’s life.

For acute bronchitis, it is useful to drink plenty of warm liquids. mineral water, compote, herbal infusions or juice. If not high temperature, then doctors recommend walking in the fresh air - this promotes better sputum discharge. The apartment also needs to be ventilated often and maintained at a cool temperature (within 18-20 degrees). In a dry and hot room, the mucus in the bronchi dries out, which makes it difficult to remove and promotes the proliferation of viruses and bacteria.

If you have acute bronchitis, you need to drink more fluids

If you lose your voice after the flu, what should you do in this situation? Most likely, the patient develops laryngitis. In this situation, continue treatment for bronchitis, which includes antivirals, and warm your throat warm milk with honey or herbal infusions.

In order to prevent the development of chronic bronchitis or pneumonia, you must take seriously the recommendations of your doctor and strictly adhere to the given treatment regimen. You should not self-medicate or let the disease take its course. In the cold season, when viruses and bacteria are especially aggressive, you should take care of strengthening your immune system, take poly vitamin complexes and immune-boosting agents such as echinacea.

The chronic form of bronchitis requires long-term treatment . During an exacerbation, antibiotics, immunomodulators, inhalations and anti-inflammatory drugs are usually used. Also for treatment chronic form Physiotherapy and breathing exercises are used to treat bronchitis.

Breathing exercises help treat bronchitis

To prevent complications, you should adjust your daily routine, eat well and follow the rules of personal hygiene. During epidemics, the menu should include products with high content vitamins and microelements; otherwise, take vitamin complexes. Walk outside a lot, relax and humidify the air in your apartment. Healthy lifestyle and strong immunity protect as much as possible from complications of influenza and ARVI.

With the onset of the autumn-winter period, the incidence of human morbidity increases sharply colds and upper respiratory tract infections. One of the most common diseases, often complicating the course or being the next stage of a banal acute respiratory viral infection (ARVI), is acute bronchitis. During this same period, there is often an exacerbation and chronic bronchitis. According to some foreign data, acute bronchitis and exacerbations of chronic bronchitis are in the top five reasons for patients seeking treatment for medical care.

Bronchitis is an inflammation of the bronchial mucosa.

In most cases, the cause of bronchitis is viruses (influenza, parainfluenza, adeno-, rhinoviruses, etc.) and bacteria (pneumococci, Haemophilus influenzae, streptococci, etc.). Less commonly, bronchitis is caused by fungi, contact with allergens, or inhalation of toxic substances. The most common route of infection is airborne, i.e. inhalation of infected droplets of saliva upon contact with a sick person (during talking, coughing, sneezing).

Clinical manifestations

Usually the disease begins with symptoms of ARVI (runny nose, sneezing, sore throat, fever, feeling of general weakness and malaise). In some cases (but not always), there may be a picture of gradual progression of infection down the upper respiratory tract with the initial development of a picture of laryngitis (dry hacking cough, hoarseness, and sometimes total loss voices), then tracheitis (boring cough, sometimes up to painful sensations, without changes in the voice), and then bronchitis.

Main clinical symptom bronchitis is a cough. In the first days it may be dry and rough, and subsequently the formation and discharge of sputum begins.

By the nature of the sputum one can judge the cause of bronchitis and the stages of the process. Thus, green or yellow sputum indicates the presence of a bacterial infection in the bronchi; light, transparent and liquid sputum occurs with a viral infection and with allergic reactions; white, opaque, curdled sputum in the form of clots with an unpleasant odor is a sign of a fungal infection.

ABOUT speedy recovery, indicates a change in the color and consistency of sputum from green and thick to light and liquid against the background of improvement general condition patient during treatment of bronchitis.

Addition of shortness of breath, repeated increase in temperature, prolonged persistence of symptoms of intoxication (weakness, sweating, fatigue) indicates either a change in the nature of the inflammatory process (for example, the addition of a bacterial infection to a viral one) or a complication of bronchitis, for example, pneumonia.

Others characteristic features bronchitis are increased body temperature (usually up to 38 degrees C), runny or stuffy nose, sore throat, whistling when breathing, chest pain (due to severe cough), symptoms of intoxication (pain in muscles and/or joints, general weakness, fatigue, decreased performance).

Patient examination

A doctor using a stethoscope can listen hard breathing, rough buzzing and whistling dry wheezing, as well as moist coarse bubbling wheezing. These sound phenomena in the lungs are, as a rule, bilateral in nature.

When conducting x-ray examination they find only an increase in the pulmonary pattern. Often x-rays of organs chest allows you to exclude other diseases, primarily pneumonia.