Bronchial asthma - chronic illness developing on the basis of allergic inflammatory process in the child's airways. There is an acute bronchospasm and increased mucus secretion. The accumulation of mucus in the bronchi against the background of their spasm leads to bronchial obstruction (bronchial obstruction).

Bronchial asthma is a rather dangerous disease; it can develop at any, even infancy, age.

There are atopic (allergic) and non-atopic (non-allergic) forms of asthma. The atopic form predominates, it is noted in 90% of children with this disease. The disease has chronic course with alternating exacerbations and interictal periods.

Causes of bronchial asthma

Allergic diseases of a child increase the likelihood of developing bronchial asthma.

• Hereditary predisposition to the atopic form of the disease: if one of the parents suffers from bronchial asthma, the probability of developing asthma in a child is 25-30%, if both parents - up to 75-80%.
• The presence of an allergic disease in a child or members of his family (atopic dermatitis, hay fever, food or drug allergy) is a signal: bronchial asthma may develop. In 60% of children with bronchial asthma, relatives suffer allergic diseases.

In the first year of life, allergens more often enter the body through gastrointestinal tract(food allergy), and in older children hay fever predominates. Often the cause of this disease is a pathological reaction to house dust, plant pollen, drugs and food products. Allergens from pollen of grasses and trees can have a seasonal allergenic effect (from May to September).

The most pronounced ability to provoke bronchospasms is possessed by microscopic mites that live in house dust, carpets, soft toys and bedding. A high sensitizing role is also played by down and feathers of birds in blankets and pillows, mold on the walls of damp rooms. Hair and saliva of domestic animals (dogs, cats, guinea pigs, hamsters), dry food for aquarium fish, fluff and feathers of poultry also often contribute to the allergization of the child. Even after removing the animal from the premises, the concentration of allergens in the apartment decreases gradually, over several years.

• Environmental factor: inhalation with air harmful substances(exhaust fumes, soot, industrial emissions, household aerosols) - a common cause of asthma due to immune disorders in the body.

An important risk factor for developing asthma is smoking (for young children - passive smoking, or being near a smoking person). Tobacco smoke - strong allergen Therefore, if at least one of the parents smokes, the risk of asthma in a child increases significantly (tens of times!)

• Viruses and bacteria that cause damage to the respiratory organs (ARI, SARS) contribute to the penetration of allergens into the walls bronchial tree and the development of bronchial obstruction. Frequently recurring obstructive bronchitis can be a trigger for bronchial asthma. Individual hypersensitivity only to infectious allergens causes the development of non-atopic bronchial asthma.

• Factors of physical impact on the body (overheating, hypothermia, physical activity, a sharp change in weather with atmospheric pressure) can cause an asthma attack.

• Asthma can be the result of a child's psycho-emotional stress (stress, fear, constant scandals in the family, conflicts at school, etc.).

• A separate form of the disease is “aspirin” asthma: an asthma attack occurs after taking aspirin ( acetylsalicylic acid). The drug itself is not an allergen. When applied, active biological substances They cause bronchospasm.

The onset of seizures can be facilitated by the use of non-steroidal anti-inflammatory drugs and a number of other drugs, medicines in colored capsules. as well as products containing food coloring.

• Diseases can exacerbate the severity of asthma digestive tract: , . The occurrence of an asthma attack at night may be associated with the reflux of gastric contents into the esophagus (duodeno-gastric reflux).
• The cause of asthma in the first months of a baby's life can be a woman's smoking while carrying a child, her excessive consumption of allergenic foods (honey, chocolate, fish, citrus fruits, eggs, etc.), infectious diseases during pregnancy and the use of drugs.

Symptoms of bronchial asthma

The disease can begin imperceptibly, with manifestations that are difficult to treat. Bronchial asthma develops more often in children under the age of three, boys are more likely to get sick.

The following manifestations should alert parents and make them assume the development of bronchial asthma in a child:

• intermittent wheezing;
• the appearance of a cough, mainly at night;
• the appearance of coughing or wheezing after contact with the allergen;
• cough with wheezing after emotional or physical exertion;
• lack of effect from antitussive drugs and the effectiveness of anti-asthma drugs.

The main manifestation of bronchial asthma is an asthma attack. Usually such an attack appears on the background of SARS. Initially, difficulty in breathing may occur with high fever, cough (especially at night), runny nose. Then attacks of difficult wheezing become more frequent, occur without connection with colds - upon contact with an animal or during physical exertion, near plants with pungent odor or when the weather changes.

When an attack of bronchial asthma occurs in children, it is difficult to exhale. Normally, the duration of inhalation and exhalation is the same in time, and in asthma, the exhalation is twice as long as the inhalation. Respiration is rapid, wheezing, noisy, audible at a distance. The chest during an attack is somewhat swollen, the face acquires a purple hue.

The child takes a forced position: he sits, leaning slightly forward, leaning on his hands, his head is pulled in, his shoulders are raised (the so-called "coachman's position"). The breath is short, not providing enough oxygen. With a prolonged attack, pain may appear in the lower parts of the chest, the cause of which is an increased load on the diaphragm. An attack can last from several minutes to several hours. At the same time, the cough is initially dry, painful, and then thick, viscous sputum may be released.

Sometimes an atypical variety of bronchial asthma develops - a cough variant: a classic asthma attack does not occur, the symptom of the disease is agonizing cough with thick and viscous sputum, occurring mainly at night.

Older children complain of lack of air, and babies cry, show anxiety. The attack often develops very quickly, instantly after contact with the allergen. But in some children, it may be preceded by “harbingers”: nasal congestion, complaints of itchy throat, cough, skin rashes and pruritus as well as irritability, drowsiness, or restlessness.

Oxygen starvation of tissues (including the brain) contributes to the lag of a child suffering from bronchial asthma in intellectual, physical and sexual development. Such children are emotionally labile, they may develop neuroses.

Classification

According to the classification of bronchial asthma in children, there are mild, moderate and severe course of the disease, depending on the frequency of occurrence of attacks, their severity and the need for the use of anti-asthma drugs.

Light degree:

• symptoms occur sporadically;
• asthma attacks are short-lived, occur spontaneously and are stopped by taking bronchodilators;
• at night, there are no manifestations of the disease or they are rare;
• exercise stress tolerated normally or with minor disturbances;
• during the period of remission, the function of external respiration is not impaired, there are no manifestations of the disease.

Moderate degree:

• attacks occur once a week;
• attacks are moderate, the use of bronchodilators is often required;
• nocturnal symptoms are regular;
• there is a limitation of exercise tolerance;
• without basic therapy, remission is incomplete.

Severe degree:

• attacks occur several times a week (may occur daily);
• attacks are severe, protracted, daily use of bronchodilators-corticosteroids is necessary;
• night manifestations are repeated every night, even several times a night, sleep is disturbed;
• drastically reduced exercise tolerance;
• there are no periods of remission.

If the attack cannot be stopped within a few hours, this is already asthmatic status requiring immediate hospitalization of the child.

Treatment

First of all, it is necessary to identify the allergen that provokes attacks of bronchial asthma, and try to exclude or at least minimize the child's contact with it.

First you need to establish an allergen (provoking factor) and completely exclude any contact of the child with it:

• regularly carry out wet cleaning of the premises (if necessary with anti-tick means); when cleaning, use a vacuum cleaner with a water filter; use air purifiers to filter the air;
• purchase pillows and blankets for the child with hypoallergenic synthetic fillers;
• exclude games with soft toys;
• place books in glass cabinets;
• remove excess upholstered furniture, and cover the necessary with a lint-free cloth;
• in case of significant air pollution, change the place of residence;
• during the flowering period of plants provoking asthmatic attacks, minimize the child's stay on fresh air- only in the evening, after dew falls, or after rain; hang a special mesh on the windows;
• with "asthma of physical effort" significantly reduce the load, including jumping and running;
• with "aspirin" asthma, exclude the use of medications provoking an attack.

Medical treatment

Drug treatment of bronchial asthma is divided into two groups: symptomatic treatment (stopping an asthma attack) and basic therapy.

Treatment of bronchial asthma in children is very difficult process: Only a doctor can choose medication. You can not self-medicate, as improper use of drugs can aggravate the course of the disease, lead to longer and more frequent asthma attacks, and the development of respiratory failure.

Symptomatic treatment includes drugs that have a bronchodilatory effect: ventolin, berotek, salbutamol. At severe course corticosteroid drugs are also used. It is important not only the choice of the drug, but also the method of its administration.

The most commonly used method is inhalation (the medicine enters the lungs in the form of an aerosol). But it is difficult for small children to use an inhaler balloon: the child may not understand the instructions and inhale the drug incorrectly. In addition, with this method of administration, most of the drug remains on back wall pharynx (no more than 20% of the drug reaches the bronchi).

Currently, there are a number of devices that can improve the delivery of medication to the lungs. For the treatment of children, these devices are optimal: they allow the use of the drug at a lower dose, which reduces the risk of side effects.

Spacer - a special chamber, an intermediate reservoir for an aerosol. The medicine enters the chamber from a spray can, and from it the child is already inhaled. This allows you to take several breaths, 30% of the drug in the form of an aerosol enters the lungs. The spacer is not used to administer the drug in powder form.

Together with the spacer, the system " easy breath»: the inhaler turns on automatically (there is no need to press the valve on the inhaler at the moment of inhalation). At the same time, the aerosol cloud is ejected at a lower speed and the medicine does not settle in the throat, twice as much medicine penetrates into the lungs.

Cyclohaler, Diskhaler, Turbuhaler - these are the same devices as the spacer, only for the introduction of powder.

Nebulizer (inhaler) - a device that allows you to transfer the medicine into an aerosol. There are compressor (jet and pneumatic) and ultrasonic nebulizers. They allow inhalation medicinal solution for a long time.

Unfortunately, drugs symptomatic treatment have a temporary effect. Frequent, uncontrolled use of bronchodilator drugs can provoke the development of asthmatic status, when the bronchi no longer respond to the drug. Therefore, in older children who can use inhalers on their own, the dose of the drug should be clearly controlled - children, due to fear of developing an attack, can overdose a bronchodilator drug.

As basic therapy several groups of drugs are used: antihistamines(tavegil, suprastin, claritin, loratadine, etc.); drugs that stabilize the cell membrane (ketotifen, tailed, intal, etc.); antibiotics (for the rehabilitation of chronic foci of infection). can be appointed and hormonal preparations for the treatment of inflammation in the bronchi and the prevention of exacerbation of asthma. Basic therapy is also selected by the doctor individually, taking into account the characteristics of the child's body and the severity of asthma.

Leukotriene inhibitors (acolate, singular) and cromones (ketoprofen, cromoglycate, etc.) are also used. They do not affect the lumen of the bronchi and do not stop the attack. These medicines reduce the individual sensitivity of the child's body to allergens.

Parents should not cancel the prescribed maintenance therapy or basic therapy on their own. You should also not arbitrarily change the dosage of drugs, especially if prescribed. Dose reduction is carried out when there has not been a single attack for six months. If remission is observed within two years, the doctor cancels the drug completely. If an attack occurs after stopping the drug, the treatment is started again.

It is important to timely treat chronic foci of infection (, sinusitis), diseases of the digestive tract.

Non-drug treatment

Of the non-drug methods of treatment, physiotherapy, physiotherapy, massage, acupuncture, various methods breathing, hardening of the child, the use of a special microclimate of the mountains and salt caves. During the period of remission, apply Spa treatment(the season and type of the resort is agreed with the doctor) at the resorts of the Southern coast of Crimea, in Kislovodsk, Elbrus region, etc.

There is another type of fight against bronchial asthma: allergen-specific immunotherapy (ASIT). It can be received by children over the age of five. The essence of the method: a very small dose of an allergen is introduced into the body, which causes an asthma attack in a child. Gradually, the dose of the injected allergen is increased, as if “accustoming” the body to the allergen. The course of treatment lasts 3 or more months. As a result of treatment, asthma attacks stop.

Phytotherapy complements and enhances effectiveness traditional treatment medicines, contributes to a longer period of remission. Herbal teas are used from the leaves of nettle and coltsfoot, rosemary herb, licorice roots and elecampane. Fresh decoctions should be prepared daily. Take decoctions for a long time, the use and doses will be agreed with the attending physician. Parents should not try out alternative treatments on their own!

With exacerbations and attacks of bronchial asthma, you can use decoctions and infusions from plants with an expectorant effect (plantain, horsetail, chamomile, dandelion, knotweed, calendula, nettle, yarrow, St. John's wort, licorice root, coltsfoot). During the rehabilitation period, you can take an infusion of licorice root, glycyram, pertussin for a month.

For aromatherapy, you can recommend an aroma lamp for 10 minutes a day. Essential oils (lavender, tea tree, thyme) use very carefully, in microdoses. You can, for example, 5 drops essential oil add to 10 ml of massage oil and rub the child's chest.

Homeopathic treatment is also used in the treatment of bronchial asthma. A competent homeopathic doctor selects an individual treatment regimen for the child. It is impossible for parents to give drugs bought in a homeopathic pharmacy on their own!

In Russia, special asthma schools have been opened, in which both sick children and parents are taught: they teach how to properly provide assistance during an attack, explain the essence of rehabilitation, the rules of massage and exercise therapy, and talk about non-traditional methods treatment. Children are taught how to use the inhaler correctly. Psychologists work with children in such a school.

A child suffering from bronchial asthma must be provided with dietary nutrition:

Vegetable and cereal soups should be cooked on beef second broth;

Rabbit meat, lean beef are allowed boiled (or steamed);

Fats: sunflower, olive and butter;

Kashi: rice, buckwheat, oatmeal;

boiled potatoes;

Fresh fruits and green vegetables;

Sour-milk one-day products;

The bread is white.

Limit carbohydrate intake confectionery, sugar, pastries, sweets). It is recommended to exclude allergen products from the diet (honey, citrus fruits, strawberries, chocolate, raspberries, chicken eggs, fish, canned food, seafood). It is also better to do without chewing gum.

Parents can keep a food diary, where all the foods eaten by the child during the day are recorded. Comparing the food received and the occurrence of seizures, it is possible to identify the food allergens of the child.

Bronchial asthma that arose in childhood, even its severe form with frequent attacks, can adolescence disappear completely. Self-healing occurs, unfortunately, only in 30-50% of cases.

Timely diagnosed bronchial asthma in a child, accurate implementation of all medical and preventive measures- recipe for success.

Which doctor to contact

From the use of allergenic products to a child suffering from bronchial asthma, should be abandoned.

If your child has difficulty breathing, contact your pediatrician. He will refer the baby to an allergist or pulmonologist. Additionally, it would be useful to consult a nutritionist, a specialist in physiotherapy exercises, physiotherapist, immunologist, ENT doctor, dentist (to eliminate foci of chronic infection). At long-term use glucocorticosteroids, even in inhaled form, it is necessary to periodically consult an endocrinologist so as not to miss the inhibition of the function of the child's own adrenal glands. (votes - 1 , the average: 5,00 out of 5)

The appearance of a dry form of cough can be a symptom of such a chronic disease as bronchial asthma in children. It is necessary to recognize an attack of bronchial asthma in time and know how to provide first aid. With untimely treatment of attacks of the disease, negative consequences can be observed. The disease is widespread throughout the world and in the regions of Russia.

Bronchial asthma in a child

Chronic inflammation in the airways is called bronchial asthma. The disease develops in children under the influence of allergens. various etiologies. Among the characteristics of the disease, bronchial hyperreactivity to factors environment(due to bronchospasm), swelling of the walls of the bronchi and their increased secretion. Bronchial asthma in children is a common disease and affects 10% of people.

Symptoms

The disease can begin at any age, but symptoms of asthma in children are more common between the ages of 2 and 5 years. The disease does not go away on its own, and in adulthood, having become ill as a child, a person finds its manifestations in himself. The disease does not belong to the group of transmitted, so it cannot be infected from the patient. By the time of puberty in adolescents, asthma symptoms may disappear, remission occurs. Environmental changes entail the return of the disease. Symptoms of bronchial asthma in children:

• asthma attacks (may happen once a month);
• dry cough;
• noisy breathing;
• anxiety;
• wheezing.

Asthma attack

Harbingers of suffocation occur a couple of days before the attack itself. The child's condition changes for the worse: there is a fright, an excited state and there is bad dream. Among the further harbingers of the disease, the redness of the nose and a clear liquid from it, a dry cough, especially aggravated after daytime sleep secretion of mucus (phlegm). Further, an attack-like form of asthma develops, which takes place in several stages:

• during sleep or after waking up, dry cough worse;
• nasal congestion occurs;
• the baby begins to breathe through the mouth;
• the appearance of shortness of breath;
• lack of oxygen;
• chest fluctuations;
• difficulty breathing;
• breathing becomes erratic with frequent, short breaths, which are accompanied by a whistling noise in the lungs.

Causes

There are 2 most common causes of asthma in children - genetic predisposition and poor ecology in the place of residence. It has been recorded that in 70% of cases, children get the disease by inheritance and even from distant relatives. Other reasons include the gender of the disease (boys are more likely to get the disease) and the presence of excess weight (lung ventilation is impaired). Also, the causes of bronchial asthma in children can be external:

• food (honey, nuts, citrus, chocolate, fish, dairy products);
• dust;
• dampness;
• animal hair, their abundant molt;
• mold, fungi, dust mites in the apartment;
• spring, summer period (time of flowering);
• medications (antibiotics or acetylsalicylic acid).

Diagnostics

Methods for diagnosing bronchial asthma, which help to assess the degree of development of the disease, differ in 2 types: self-determination and laboratory studies. The first method is based on collecting an anamnesis about the nature of the cough, which is accompanied by wheezing and manifests itself in response to allergens. Before instrumental methods diagnosis, the doctor examines the medical history of relatives in order to identify genetic predisposition. Diagnosis of bronchial asthma in children older than 5 years is carried out by the following methods:

• spirometry;
• tests using bronchodilators, methacholine, exercise;
• determination of the gas composition of the blood;
• analysis of peripheral blood, sputum;
• skin allergy tests;
• determination of the total content of specific IgE and IgE;
• peak flowmetry (measurement of air velocity during exhalation);
• chest x-ray.

Treatment of bronchial asthma in children

To start optimal treatment of asthma in children is to identify the allergen and further elimination. Therapy of the disease includes folk methods, medication and non-drug methods treatment, preventive measures for the arrangement of the premises. Among non-drug methods they distinguish physiotherapy, massage, healing physical education, correct breathing techniques, hardening the baby, visiting salt caves and creating a therapeutic microclimate. Folk methods for treating asthma are based on the use of infusions and decoctions from the following plants:

• nettles;
• chamomile;
• dandelion;
• licorice root;
• coltsfoot;
• wild rosemary.

First aid for an attack

If a parent saw an attack of bronchial asthma, then you need to calm the baby, use an inhaler and call an ambulance. Eliminate the allergen that set the disease in motion. Having opened the window for fresh air (not cold), give the baby an antihistamine to relieve swelling respiratory tract. The upper body of the child can be freed from clothes, and the legs can be lowered into a basin with a water temperature of 45 degrees. At the end of the attack, the child will begin to cough up viscous sputum white color. For better liquefaction, it is appropriate to give the drug Ambroxol.

Medical therapy

The disease is not treated, therefore, the methods of symptomatic treatment and basic therapy are aimed at alleviating the child's condition, and act as supportive manipulations. The children's body is extremely sensitive to taking antibiotics, and if they are selected incorrectly, there is a high risk of harming the health of the baby. Inhalations (Berodual), aerosols have a positive effect, but children often do not know how to use them, as a result, only 20% of the dosage of the drug reaches the bronchi. Among other drugs for medical purposes, there are:

• bronchodilators (Salbutamol, Berotek, Ventolin);
• corticosteroid drugs;
• antibiotics;
• hormonal agents;
• drugs with a special substance to stabilize cell membranes;
• antihistamines;
• cromones (Cromoglycate, Ketoprofen);
• leukotriene inhibitors (Singulair, Akolat).

Complications

In addition to the deterioration of the child's condition, the analyzed disease causes vulnerability of internal organs, which creates favorable conditions for the development of pathologies. The most dangerous complications include status asthmaticus - respiratory pathological process, in which asthma exacerbates, suffocating attacks do not stop, sputum does not come out, and in the absence of emergency medical care and hospitalization in the clinic, the child may die. Among other consequences of asthma, diseases are distinguished:

• brain;
• of cardio-vascular system;
• metabolism;
• nervous system;
• gastrointestinal.

Prevention

Manipulations aimed at prevention can be primary and secondary. Prevention of the onset of the disease is referred to as primary prevention, which is carried out for children at risk of the disease: atopic dermatitis, hereditary predisposition, with episodes of croup and symptoms of broncho-obstructive syndrome observed in ARVI. Secondary prevention of bronchial asthma in children is carried out for those patients who previously had attacks. Preventive measures include:

Primary prevention during pregnancy and lactation	Secondary prevention
healthy lifestyle	elimination of allergens
proper nutrition	fight sinusitis, a chronic lung infection
ARVI warning	wet cleaning of premises
restriction of medication	avoid contact with animals, allergenic indoor plants
breast-feeding	do not keep aquariums with dry food
cessation of active, passive smoking	elimination of foci of mold, moisture
hardening, healing methods	eliminate contact with pollen, limit walks during flowering
good ecology	general hardening of the body
avoid contact with chemicals	breathing exercises
elimination of possible allergens in a residential area	during SARS, taking bronchodilators

Video: bronchial asthma

In most cases, asthma is caused by allergies. It manifests itself in the form of inflammation of the airways, in which acute bronchospasm is accompanied by an increase in mucus secretion.

Symptoms of the disease

Every parent should know how asthma can manifest itself. Signs in a child are usually pronounced. The baby begins bronchospasm, which doctors call bronchial obstruction. This is expressed as follows. The child begins paroxysmal dry cough. Over time, viscous sputum begins to stand out.

You can understand that obstruction has begun by breathing. If healthy child the duration of inhalation and exhalation is approximately the same, then with the development of an asthmatic attack, shortness of breath appears. It is characterized by a short inhale and a long exhale. In this case, the patient has wheezing, which is heard from afar.

There are also so-called first signs of asthma in children, which are observed even before the onset of an attack. So, the baby starts coughing, nasal congestion and itchy skin are observed.

During an attack, older children may complain of a feeling of lack of air, squeezing in the chest area. Sleep is disturbed in babies, they become whiny, irritable, lethargic.

Provoking factors

To prevent the development of the disease, you need to know what exactly can lead to problems. Experts include air pollution, changes in atmospheric pressure, flowering of allergenic plants, and even an unfavorable psychological atmosphere in the house as provoking factors.

If you have people in your family with hereditary allergic diseases, then you first need to find out how asthma can manifest itself in a child. The symptoms must be known in order not to miss the onset of problems. Also at risk are children with exudative-catarrhal diathesis.

An allergen that leads to bronchospasm can be plant pollen, certain foods, tobacco smoke, drugs, and household dust. The reaction can start from inhaling cold air or from physical exertion.

At the first contact, the body, as it were, gets acquainted with a foreign substance, but at subsequent “meetings” it already begins to react violently. The immune system produces antibodies, and they, in turn, release biologically active substances, which cause asthma in children to develop. Signs and symptoms in the form of shortness of breath, a compulsive cough, and difficulty breathing are hard to miss.

Characteristic features of the disease in infants

In all babies, before an asthma attack, the so-called At this time, deviations from the respiratory organs can be noticed. Liquid mucus begins to stand out from the nose, itching appears and the constant sneezing associated with it, dry cough. The doctor can listen to single dry rales, see swollen tonsils. These are the first signs of asthma in a child under one year old.

The disease also affects the nervous system. The baby becomes restless, irritable, his sleep deteriorates. Violations are also observed from the digestive system - constipation may begin or loose stools may appear.

Asthma develops in babies, as a rule, against the background of respiratory diseases. Only in exceptional cases, its appearance can be due to stress. In this case, the symptoms of asthma appear gradually. This is due to the fact that swelling of the bronchial mucosa and hyperemia increase at a slow pace.

The attack itself can last from several minutes to several days. It will be accompanied by wheezing, which is heard even at a considerable distance, expiratory shortness of breath.

It is worth noting that sometimes the first signs of asthma in children under one year old go unnoticed. They can appear sporadically without any regularity, at different times. At the same time, they can pass on their own, without any therapy. And in the period between attacks, parents do not notice any deviations.

Preschool children

It is also not always possible to suspect the development of the disease in older children. Signs of asthma in a child at 2 years old can be blurred. For example, they may experience rapid and irregular breathing during sleep. It also happens during physical activity.

The characteristic manifestations of the disease also include frequent sneezing, periodic coughing, restless sleep. Often children do not even notice that they are coughing in their sleep. This happens reflexively. If the child sleeps separately, then the parents may not even hear the cough. Therefore, it is necessary to observe the child, if the teacher from the kindergarten speaks, then the baby coughs during sleep.

Preschoolers cannot always describe their feelings, so parents should monitor their condition. For example, signs of asthma in a 5-year-old child may appear during active games. It is necessary to consult a doctor if, after a short run, the baby begins to cough. Active movement can cause pain in the chest, a feeling of squeezing.

Symptoms of asthma in schoolchildren

How older child, the more and more accurately he can describe his condition. Therefore, it is already a little easier to determine the disease in schoolchildren. But this can only be done if you know what signs of asthma in children may be.

As with preschoolers, children school age the disease is evidenced by coughing during sleep and after physical exertion. Patients can talk about the pressing feeling that has appeared in the chest area. In addition, having caught the connection between physical activity and emerging discomfort, children try to run as little as possible, avoiding any active games. Even in the absence of complaints, it is necessary to monitor students who refuse to attend physical education classes, try not to run, and sit quietly during breaks.

If a child has a coughing fit, it is difficult for him to sit upright. He tries to alleviate his condition, bends, humpbacks, leans forward. You may also notice excessive pallor. Preschoolers and children of primary school age may become frightened and even burst into tears during an attack.

Teenage years

As a rule, by the age of 12-14 the diagnosis is already established. At this age, it is important to teach your child to recognize when asthma starts. Signs in a child, as a rule, are always similar. He should always have with him a special inhaler prescribed by a doctor. Parents are obliged to ensure that the medicine does not run out in it, and change the used container in time.

Symptoms of the disease in children of middle and senior school age are not particularly different from those found in babies. But adolescents are already able to control the disease, which means they can prevent an exacerbation.

It is worth noting that despite the fact that many attacks begin during sports, teens with asthma need physical activity. Just before the loads, you need to take the medicine prescribed by the doctor and monitor your breathing. It should be even and rhythmic.

Attacks can cause allergens. But teenagers should already know which substances provoke the disease. If possible, they should avoid them. If seasonal plants provoke allergic attacks, then it is necessary to take medications on a regular basis that block their development.

Often at this age, the process of remission begins. All signs of asthma disappear, and parents decide that their child has simply "outgrown" the disease. But in fact, bronchial hyperreactivity persists. If a teenager encounters several provoking factors, then the disease may return. Sometimes it happens in adulthood. Quite often there are situations in which asthma disappears in adolescence and reappears in the elderly.

Diagnostics

To accurately determine whether a child has asthma, it is not enough to know the first signs and main symptoms of this disease. Shortness of breath, rapid and difficult breathing, obsessive cough can also appear with obstructive bronchitis. Therefore, without consulting doctors can not do. First of all, you need to visit a pediatrician. He will already give a direction for all the necessary tests and refer you to an allergist. If necessary, you may also need to consult a pulmonologist.

Apart from general research blood and urine, can also be taken on Asthma, it contains an increased content of eosinophils, Kurschmann spirals (mucus from the respiratory tract), Charcot-Leiden crystals (lysophospholipase released from eosinophils), Creole bodies (accumulation of epithelial cells).

To establish a diagnosis, the doctor must deal with the details of the baby's life. He needs to know how and when the seizures start. Even according to such a description, sometimes it becomes clear to a specialist what exactly is an allergen for a baby. It is also important for the doctor to know how the child reacts to bronchodilators. Asthma will be indicated by a temporary improvement in the background of their use.

Diagnosis consists in conducting special tests. One of the most common are skin allergy tests. For these purposes, potential allergens are applied to slightly scratched areas of the forearm. After 20 minutes, the doctor evaluates the results. Look at which particular areas of the skin turned red the most.

This allows you to identify the allergen, but does not make it possible to understand whether the work is broken. respiratory system. Parents themselves can determine this, knowing the signs of bronchial asthma. The cough form in children requires a more thorough diagnosis. To determine the working volume of the lungs, special examination- spirometry. With its help, the degree of impaired functioning of the respiratory system is assessed.

To do this, measure the volume of exhalation-inhalation made with an effort and the total capacity of the lungs. For the first time, these measurements are taken without any drugs. Then the examination is repeated after taking bronchodilator medications. If the lung volume increases by more than 12%, then the sample is considered positive.

Bronchial hyperreactivity after exercise is also assessed. If the forced expiratory volume decreases by 20%, this indicates that the little patient asthma. Signs in a child, however, can be so pronounced that such a detailed examination is not always prescribed.

Clinical manifestations

It should be understood that in children it is often impossible to make a diagnosis due to the fact that an obstructive syndrome occurs with bronchitis. In a few days, they develop a cough, symptoms appear that indicate respiratory disorders, and wheezing wheezes are heard. As a rule, treatment consists not only in taking bronchodilators, but also antibiotics, antihistamines. With subsequent SARS, symptoms of pulmonary obstruction may appear.

The signs of asthma in infants are quite vague, so special attention is paid to the history, asking parents about the onset of the disease, and physical examination.

The course of the disease itself can be divided into 3 conditional stages:

1. Attack immediately. Acute suffocation develops due to difficult entry. It is preceded by a pre-attack stage, which can last from several minutes to 3 days.
2. Exacerbation period. It is characterized by shortness of breath, the appearance of periodic whistles, obsessive cough and difficult expectoration. At this time, acute attacks may periodically recur.
3. Remission. The period is different in that the child can lead a normal life, he does not have any complaints. Remission can be complete, incomplete (determined by indicators of external respiration) or pharmacological (preserved when taking certain medications).

It is important to be able to recognize the first signs of asthma in children in order to prevent the development acute attack. If it was not possible to prevent it, then the parents and the immediate environment of the child should know what needs to be done. It is also important to understand that attacks are distinguished by the severity of bronchospasm.

The safest is the mild degree. With such an attack, a spasmodic cough begins, breathing is slightly difficult. General well-being while the child remains well, speech is not disturbed.

With a moderate attack, the symptoms are more pronounced. The child's health worsens, he becomes capricious and restless. The cough is paroxysmal in nature, thick viscous sputum is difficult to pass. Breathing is noisy and wheezing, shortness of breath is present. The skin at the same time turns pale, the lips become bluish. Children can only speak in single words or short phrases.

A severe attack is characterized by the appearance of shortness of breath, which is heard at a distance. The heartbeat in babies quickens, protrudes on the forehead cold sweat, there is a general cyanosis of the skin, the lips are blue. Asthma symptoms in children 6 years of age and older are characterized by the fact that the patient cannot speak, he is able to pronounce only certain short words. Babies, as a rule, cannot explain their condition, they only cry and express anxiety in all available ways.

The most severe cases are called status asthmaticus. This is a condition in which a severe attack of the disease cannot be stopped for 6 or more hours. The child develops resistance to prescribed medications.

Features of the course of the disease

It is important to know how asthma can manifest itself before an attack begins. Signs in a child may be: capriciousness, irritability, tearfulness, headache, obsessive dry cough.

In most cases, attacks begin in the evening or at night. Initially, there is a cough, noisy breathing, shortness of breath. Children are often frightened, start crying, tossing about in bed. Initial manifestations asthma in babies is often expressed in the form of broncho-obstructive syndrome with acute respiratory infections. Also, against the background of colds, an attack of asthmatic bronchitis can begin. It is characterized by shortness of breath, in which breathing is difficult, and a wet cough.

Atopic bronchial asthma is characterized by the rapid development of an attack. Timely use of bronchospasmolytics allows it to stop. But with an infectious-allergic form, attacks develop slowly, symptoms increase gradually. It is far from immediately possible to stop an attack by taking bronchospasmolytics.

After normalization of the condition, sputum begins to be coughed up, shortness of breath disappears. In some cases, the condition improves only after vomiting.

Actions of parents

Regardless of the age of a child who has been diagnosed with asthma, his relatives should be careful to prevent the development of attacks and reduce their frequency. To do this, you must strictly follow all the recommendations of doctors, drink prescribed drugs and avoid potential allergens.

IN kindergarten all educators, nurse, music worker should be aware of the situation. It is also important to give them a list of allergens that are the reason that asthma begins in a child. It is also advisable to report the symptoms of the onset of an attack to them. In this case, they will be able to send the child to health worker or call your parents.

If caregivers know what the child is allergic to, they can help avoid contact with these substances. For example, you can replace flowers in a preschool if some of them provoke the onset of an attack. Also, educators are able to monitor the nutrition of the baby. Of course, even two-year-old crumbs need to be explained that they should not eat. But not always children can control it themselves.

At school, teachers should also be aware of the child's problems. First of all, it is necessary class teacher tell the child has asthma. In children, signs and symptoms may appear gradually. For example, if there was contact with an allergen at school, then the child may sleep restlessly at night, cough during rest, his breathing may become confused. In this case, it is necessary to ask the baby in detail about what he did during the day, what he ate and in what rooms he was.

Physical education teachers should also be warned. But if the doctor sees the need for it, he will refer the child to a commission where he can be given a partial or complete release from physical activity at school.

But keep in mind: the child must be gradually accustomed to active image life. Asthma is not a hindrance to most sports. Even some Olympic champions suffered from this disease in childhood. It is important to simply teach your child to monitor their condition and be able to recognize the first signs of bronchial asthma. Children should have a good defense mechanism. You just need to explain to the child that it is important, even with a slight discomfort, to stop and restore breathing.

Treatment tactics

It is impossible to figure out on your own what to do if the first signs of asthma appear. Treatment should be prescribed by an allergist, sometimes it is required complex work and involvement of a pulmonologist. Equally important is the correct behavior of parents. There is no need to panic, but there is no need to be inactive either. It is necessary to have a conversation with the baby, to discuss possible reasons development of the disease, to tell what can be done and what cannot be done.

How to deal with a condition such as bronchial (Komarovsky, by the way, claims that it is simply necessary) is to use medication to prevent the development of an attack and put the patient into a state of remission.

You can stop the condition with the help of glucocorticosteroids. First, you need to use fast-acting inhalers. Therapy should be supportive. If it is not possible to achieve the desired effect with the help of Nedocromil or cromoglycic acid, then inhalations are made with glucocorticosteroids.

Therapy should be aimed at:

Elimination of clinical manifestations;

Improving the function of breathing;

Reduced need for bronchodilators;

Prevention of the development of life-threatening conditions.

Unfavorable environmental conditions, living in major cities, weakened immunity - all this can cause many serious chronic diseases. One of them is bronchial asthma. Most often it begins in children aged 2-5 years. In infants, this disease almost never occurs.

General description of the disease

Bronchial asthma is a chronic disease inflammation of the airways, which is accompanied by severe bronchospasm. As a result of such a spasm, a lot of sputum accumulates in the bronchi, making it difficult to breathe, causing attacks of severe suffocation.

In a healthy person, the muscles of the bronchi are constantly contracting. When exerted, they expand to let more air into the lungs. At rest, they narrow. In an asthmatic, this process is disrupted.

A strong narrowing of the bronchi can be completely unexpected, provoked by some external stimulus. If asthma is allergic in nature, then bronchospasm is accompanied by swelling of the walls of the bronchi and the release of thick mucus.

Statistically, the incidence of asthma in children is from 5 to 12% in Russia. Babies living in the northern regions are less likely to suffer from it.

Started in early age The disease may recur periodically throughout life. It is impossible to completely cure it.. But you can control, prevent seizures and lead a full active life.

Causes of occurrence, how the disease begins

There are many factors causing development pathologies:

• heredity;
• obesity;
• second hand smoke;
• allergy;
• bad ecology.

Boys at an early age suffer from asthma more often than girls. Causes - constant viral infections,. If a diagnosis of "" is made, then with repeated relapses it will end with asthma.

Most often, this disease occurs when allergens enter the body:

The risk of developing asthma increases if a child has hay fever, food allergies, and other concomitant diseases. Predisposition is noted in premature, weakened children.

Exists separate form – "aspirin" asthma. It's not about allergic reaction on the medicine, but about intolerance to its components, which can cause a strong narrowing of the bronchi. With such a disease, it is necessary to exclude the use of acetylsalicylic acid in any form, beware of using food coloring, preservatives.

If the diagnosis has already been made, triggers should be avoided. These include:

• physical overload;
• strong, pungent odors;
• traffic fumes;
• hypothermia;
• stress, fear;
• weather change;
• household chemicals;
• reflux of stomach contents back into the esophagus.

Seizures become more frequent with associated diseases of the gastrointestinal tract(dysbiosis, pancreatitis, liver disease, frequent).

The danger of bronchial asthma in children is in possible complications:

Sometimes a disease that begins in early childhood, may pass without a trace during puberty. But this rarely happens. Due to changes in hormonal status in adolescents, asthma is very difficult.

Classification

There are two types of asthma: allergenic and non-allergenic. Allergic (atopic) type occurs in 95% of patients and is caused by non-infectious causes. The non-atopic variety is the result of bacterial or viral infection. It is rarely diagnosed.

There are 2 stages of the disease: the period of exacerbation and remission. According to the severity of attacks, the disease can be divided into mild, moderate and severe.

At mild form there is a slight difficulty in breathing, a weak cough. The state of health does not cause concern.

Average degree accompanied by a heavy cough, shortness of breath, noisy breathing. The child turns pale, becomes restless, capricious.

For severe attack shortness of breath, cold sweat, rapid pulse, difficulty exhaling are characteristic. The baby's lips turn blue, he can not talk.

To prevent the development of a severe form, it is necessary to begin treatment at the first signs of the disease.

First signs

Often the symptoms of bronchial asthma are similar to signs of a cold or. Significant differences - absence high temperature and unproductive cough.

In anticipation of an asthma attack in a child there may be loss of appetite, weakness, sleep disturbances, headache. Sometimes there is excitement for no reason, euphoria, tachycardia. The attack itself is accompanied by severe difficulty in breathing, wheezing.

Specific symptoms of the disease:

Nonspecific signs:

It is not easy to recognize the onset of asthma at an early stage. But if a child has at least one of these symptoms, you should immediately consult a doctor.

How it manifests itself at different ages

Harbingers of an attack begin a few days before its onset. The attack itself can proceed in different ways, depending on age. How to identify bronchial asthma in a child, recognize the symptoms?

Children under 2 years of age are:

• hoarse, wheezing breathing;
• nasal congestion;
• apnea;
• vomiting when coughing;
• chest retraction;
• change in the frequency of inhalations and exhalations;
• feeding difficulties.

In older children, the following symptoms are added to the listed symptoms:

• dyspnea;
• irritability;
• fatigue;
• severe exhausting cough, especially after physical or emotional stress;
• difficulty exhaling;
• increased shortness of breath and cough upon contact with an allergen or hypothermia.

Uncontrolled use of bronchodilators can provoke status asthmaticus in a child. Therefore, at the beginning of an attack, it is better to call an ambulance.

Asthma is a very serious and dangerous disease. Due to frequent attacks, brain hypoxia may develop, which is fraught with a child lagging behind in mental and physical development.

Diagnostic measures

It is possible to make a conclusion about the presence of bronchial asthma in a child only after consultations. allergist and pulmonologist.

A thorough examination includes spirometry (for children over 5 years old), blood tests for antibodies to allergens, sputum examination, skin tests. In young children, the disease is diagnosed on the basis of symptoms and the general clinical picture.

More about the signs of the disease, ways to stop the attack is described in the video:

How and what to treat

Treatment of bronchial asthma in children requires an integrated approach to eliminate symptoms, prevent relapses. This is diet, drug treatment, exercise therapy, massage, elimination of allergens, physiotherapy, the use of inhalers, reflexology.

Medicines are divided into basic and symptomatic(stopping an attack). Basic, or basic, are used for long-term treatment, removing the focus of inflammation in the bronchi, reducing the frequency of attacks. These include membrane stabilizers (Intal, Kromogen, Cromohexal), antiallergic drugs (Loratadin, Kestin, Ketotifen) and glucocorticoid hormones (Prednisolone, Bekotid, Dexamethasone, Cortisone, Seretide). Hormones are used both for inhalation and for systemic treatment.

Used for symptomatic therapy fast response drugs, for example, Eufillin, Ventolin, Fenoterol, etc. Still used pocket inhalers with drugs Berotek and Salbutamol.

Often, a doctor may prescribe a so-called. immunotherapy. It is carried out at the stage of remission and consists in the use of a small amount of the allergen, which is introduced into the body to develop immunity.

Mild disease can be treated with occasional bronchodilators (Clenbuterol). The average severity of the course requires the use of inhaled glucocorticoids and anti-inflammatory drugs. In severe form, long-term hormonal therapy and inhalations with Atrovent are additionally prescribed.

Give good result ultrasound therapy, thalassotherapy, carbonic and nitrogen baths.

It is important to remove everything from the child's diet allergenic products, exclude contact with irritants (dust, wool, mold, etc.). To avoid complications, it is necessary to strictly follow all the doctor's prescriptions, take medications on time and in no case self-medicate.

About whether it is possible and how to cure asthma in a child, its manifestations and dangers, Dr. Komarovsky tells in the video:

Forecast and preventive measures

If you adhere to the basic principles of treatment, then the frequency of attacks can be reduced and the quality of life of the child can be significantly improved. Although in advanced cases Disability and strong hormonal dependence are possible. It is very important to start treatment as early as possible. so as not to lead to serious health problems.

How to prevent asthma attacks? Preventive measures include:

It is equally useful to teach the baby to breathe in advance. About simple and useful breathing exercises for children with asthma, see the video:

Don't despair if your child is diagnosed with asthma. It is necessary to surround him with attention, affection and care, to protect him from stress, to fulfill all medical appointments in a timely manner. Then there will be no reason to panic.

In contact with

Bronchial asthma in children, the symptoms of which can be easily identified, is increasingly common in childhood or even infancy. In this case, the course of the disease is chronic, accompanied by obstructions or periods of relative calm.

Scheme of the development of pathology

IN human body there are bronchi, which are part of the respiratory system. They are branched structures inside the lungs. Outside, they are covered with a layer of smooth muscles, the contraction of which causes a decrease in the lumen of the bronchi, and relaxation causes expansion. Such work of muscle fibers is natural for the human body.. The presence of muscles is necessary to increase the lumen, in cases where it is necessary to inhale more air during physical exertion.

In bronchial asthma, there is a violation normal operation muscles.

In the presence of an external irritant, which can be any allergen, excessive physical activity, emotional stress, an involuntary spasm of the bronchi occurs, which manifests itself at the wrong time.

Also, due to the course of an allergic reaction and the accompanying inflammatory process, swelling of the mucous membrane occurs, accompanied by the appearance of viscous "vitreous" sputum. This factor worsens the situation many times over.

On the left - the bronchi of a healthy person, in the center - the bronchi of a patient with bronchial asthma (BA), on the right - an attack in a patient with asthma

The diagnosis of bronchial asthma can be made after the first manifestations of the signs described in this article, but requires full examination to clarify the opinion of the doctor.

7 main reasons for the development of bronchial asthma in children

The causes of bronchial asthma in children are mostly associated with an allergic predisposition, or are a consequence of frequent colds.

Mikhailova Lyubov Igorevna, allergist, 1st city clinical Hospital, Kirov

My profile is allergies, and this is the reason children and adults are referred to me for asthma. I must say right away that the treatment of bronchial asthma in a child is a long and complicated process. Requires taking various drugs for a long time.

It is necessary to determine the allergen that causes the development of a crisis. It is difficult for a child to explain why he should not eat eggs or honey, because he does not understand what an allergy is. With a certain persistence of parents, it is possible to exclude “harmful” foods from the diet, which helps to cope with asthma with “little blood”.

To understand how to treat bronchial asthma in a child, you should know the causes. It is customary to allocate 7 main causes of this unpleasant disease:

Forms of bronchial asthma and its division into classes

When diagnosing a disease, all pulmonologists should be guided by a document published by WHO. All available varieties of bronchial asthma in this document are divided according to two criteria:

• features of the origin of the disease;
• the severity of it.

But in the light of recent scientific research, such a large division is clearly not sufficient, since new methods in the classification of asthma should take into account a large number of nuances, among which:

• the severity of the disease before the start of treatment;
• whether there is a response of the body to the treatment and how significant it is;
• whether it is possible to control the course of the disease in such a way as to prolong periods of remission and prevent the occurrence of new attacks;
• is there a relationship between the cause of the disease and the characteristics of its course;
• possible causes of complications during the course of the disease.

A clear definition of the cause of the onset of the disease can lead not only to effective therapy, but will also help in time to stop an attack of bronchial asthma. According to the causes of the appearance, the disease is divided into three large subgroups:

Bronchial asthma - an allergic form

In such a case, the causative agent of the disease is an external irritant in the form of an allergen entering the children's body respiratory route or with food, which is less common. As respiratory allergens considered:

• fungal spores;
• plant pollen;
• animal hair;
• ticks;
• tobacco smoke.

The bronchi of an asthmatic child react acutely to cigarette smoke

The initial reaction with this form always develops in the respiratory tract and manifests itself in the form of sinusitis, rhinitis,.

Against the background of the course of these concomitant diseases, atopic bronchial asthma begins to develop in children. Much less often, the cause of the development of seizures can be food. It is accompanied, along with the emergence external manifestations, in the form of a rash, redness, stool disorders, coughing or asthma attacks.

How to distinguish common cough from allergic, see.

Food allergies often cause an asthma attack in children, which can lead to a condition known as anaphylactic shock. In this case, urgent care is required for bronchial asthma in children.

infection-dependent asthma

Such a disease as bronchial asthma in children, Komarovsky also subdivides into an endogenous variety of the disease. In this case, the factors leading to a change in the lumen of the bronchi and causing coughing and seizures are microorganisms.

According to statistics, respiratory diseases and bacterial infections upper respiratory tract in childhood can provoke asthmatic attacks.

Identifying cases of this type of asthma is quite simple.: all symptoms quickly disappear during hormone therapy and in the case of the use of drugs belonging to the group of bronchodilators.

Mixed asthma

The causative agents of this type of disease are both allergens and microorganisms.. Factors that provoke the disease can be:

• poor environmental conditions;
• stressful situations;
• bad habits;
• various chemical irritants.

A separate type of bronchial asthma, not included in any category, is the cough form of the disease. Due to the lack of pronounced symptoms, it is difficult to diagnose.

A similar variety appears against the background of a constant cough, which may indicate diseases such as bronchial obstruction.

The early identification of the allergen and its complete exclusion from the life of the child will be the key to a quick recovery. Therefore, do not delay a visit to the allergist.

Symptoms that give the right to suspect the presence of asthma

Cough is a defense mechanism when the body reacts to irritation of the respiratory tract.

Timely diagnosis of any disease is a sure chance to provide competent and correct treatment. Asthma is no exception general rule. Bronchial asthma in children, the symptoms of which are known, is a disease that can be overcome. The first signs that should be " alarm bell for parents are as follows:

• systematically occurring whistling when the child breathes;
• frequent for no apparent reason;
• coughing or difficulty breathing in direct contact with the source of the allergy;
• the occurrence of whistles in the breath after exercise or emotional upheaval;
• complete lack of the desired effectiveness from the application.

At the same time, there is a division of asthma according to the severity of its manifestation:

1. Mild degree is characterized by short-term and rare manifestations of the main symptoms. Attacks are short and well eliminated with the help of appropriate drugs.. After physical activity, there is no deterioration in the child's condition. No cough at night.
2. The average degree is distinguished by the regularity of the occurrence of seizures, which occur weekly. Symptoms in the form of bouts of nocturnal cough also show a periodic character. Physical exercise available only to a limited extent.
3. The severe degree in which infectious-allergic bronchial asthma proceeds is characterized by very frequent attacks that have a long duration. Night cough can cause an asthma attack in bronchial asthma. Practically completely excluded periods of absence of symptoms. Physical activity is contraindicated.

In cases where the onset of the crisis cannot be eliminated on their own, urgent care is required for an attack of bronchial asthma, which ambulance doctors can provide.

Diagnostic measures

Holding diagnostic measures, which are based on the medical history (bronchial asthma in a child), includes whole complex measures aimed at determining the type of disease, its severity, and other related parameters.

The first stage of diagnosis is the study of anamnesis, determination external signs the presence of a disease.

The next step, if asthma is suspected, is the appointment clinical research which include a blood test. During the analysis, the immunological status of the patient is determined, and tests are also carried out to identify a group of allergens that are causally significant.

Also, during the diagnostic period, instrumental parameters are checked. They include checking respiratory function . Also at this stage, studies of all internal organs are carried out, through ECG, Ultrasound.

Bronchial asthma: medical history for therapy is the final stage of diagnosis and is a descriptive part of the anamnesis and genesis of the disease, as well as the data of the obtained research results.

In the future, the pathogenesis of bronchial asthma in children allows not only the treatment of the patient in case of crises, but also the prevention of bronchial asthma in children during periods of remission.

Bronchial asthma in children, symptoms and treatment

After the diagnosis is made and it is determined that the child suffers from this particular disease, basic therapy for bronchial asthma in children is required.

Using a nebulizer will help relieve an attack both on the road and at home.

There are several treatment options, among which are traditional medicinal methods and alternative methods, mainly consisting in herbal medicine.

Treatment of bronchial asthma in children with folk methods and the use of inhalers cannot be considered the only way to defeat the disease, but is able to have an effective effect only in combination with taking medications.

If bronchial asthma is observed in children, clinical guidelines can only be given by the attending physician based on a number of factors.

At drug treatment There are two groups of therapeutic courses:

• symptomatic, when treatment is reduced to the removal of emerging seizures;
• basic, when drugs are taken for a long time, aimed at eliminating the cause of the disease.

As drugs for symptomatic treatment, medications are used that have a vasodilating effect, allowing you to quickly increase the lumen of the bronchi and facilitate breathing.

Do not use the drug during an exacerbation more than once every 20 minutes

These include drugs:

• Bitolterol;
• Terbutaline;
• Theophylline;
• Ipratropium bromide, and a number of others.

It is possible to take medications in inhaled form, which simplifies the process of taking the drug, but reduces the effectiveness, since most active substance settles in the pharynx, and only 20% "gets" to the bronchi.

Among the existing methods, to improve the process of entry of the active substance into the bronchi during inhalation treatment, one can note the use of.

This type of inhaler is capable of transferring the medicine from liquid form into a fine aerosol, which has a positive effect on the absorption of the active substance.

Kiryanov Mikhail Vladislavovich, pulmonologist, clinic modern medicine Unimed, Vladimir

Treatment of bronchial asthma is always a rather difficult process, requiring long-term diagnosis and all kinds of assistance from the child's parents and the doctor.

For the most part, in my practice, there are cases of asthma caused by various allergens. In our clinic, it is possible to quickly take tests to determine allergens, which helps me, as a doctor, get the results and understand what course of treatment is needed.

One of the recent discoveries for me was the drug Erius, which is most effective among other antihistamines. Its use in most cases helps to prevent the onset of an attack in the event of an allergen entering the body.

The use of drugs for symptomatic treatment does not have a long-term positive effect and in most cases addiction is observed. To avoid such an effect, careful adherence to the dosage is required.

Epinephrine is a synthetic adrenaline

For basic therapy, several groups of drugs are used at once, including:

• designed to reduce allergic manifestations;
• antibiotics to get rid of existing infectious pathogens;
• preparations of the hormonal spectrum;
• contributing to the stabilization of the cell membrane.

As drugs for allergies, the most effective are:

• Tavegil;
• Suprastin;
• Zodak;
• Erius.

To stabilize cell membranes are used:

• Ketotifen;
• Tailed;
• Intal.

In some cases, the attending physician may prescribe drugs such as Accolate or Singulair, which in themselves are not intended to stop an attack or affect the lumen of the bronchi, but help the body cope with hypersensitivity to allergens.

The most commonly used drugs, their dosage and administration features are shown in the table.

Name	Daily dosage according to age	Release form
Salbutamol	2-6 years - 2 mg 3 times 6-12 years - 2 mg 4 times >12 years - 4 mg 3-4 times	Spray can
BITOLTEROL	>12 years - 2 inhalations With spasm 3 inhalations every 3 minutes	Spray can
TERBUTALIN	3-7 years - 1/4 tab. thrice 7-15 years - 1/2 tab. thrice	Tablets
THEOPHYLLINE	3-9 years 24 mg/kg body weight 9-12 years old 20 mg/kg body weight 12-16 years old 18 mg/kg body weight >16 years - 900 mg/day	Tablets
epinephrine (for relief of an attack)	in childhood 100-500 mcg	Injections
IPRATROPIUM BROMIDE	<6 лет – 0.4 мл раствора 3-4 раза 6-12 years - 1 ml of solution 3-4 times >12 years - 2 ml of solution 3-4 times	Solution for inhalation
TAVEGIL	6-12 years - 1/2 tab. 2 times >12 years - 1 tab. 2 times	Tablets
SUPRASTIN	1-12 months - 1/4 tab. 3 times 1-6 years - 1/4 tab. 3 times 6-14 years old - 1/2 tab. 3 times	Tablets
ZODAK	6-12 years - 1 tab. >12 years - 1 tab.	Tablets
ERIUS	>12 years - 1 tab. 1-5 years - 2.5 ml 6-11 years - 5 ml >12 years - 10 ml	Tablets, syrup
KETOTIFEN	>3 years - 1 mg 2 times	Tablets
TILED MINT	>2 years - 2 inhalations 2-4 times	Spray can
INTAL	>5 years 2 inhalations 6-8 times	Spray can
AKOLAT	7-11 years - 10 mg twice >12 years - 20 mg twice	Tablets
SINGULAIR	6-14 years - 5 mg >15 years - 10 mg	Tablets

Nursing process as part of planned treatment

Inhalation from the spacer should be carried out as soon as possible after spraying the aerosol.

Very important point for the treatment of asthma is nursing process with bronchial asthma in children, carried out in the conditions of moving the child to the hospital.

Nursing care for asthma in children is a way to improve general state sick, to treat an attack of bronchial asthma, to prevent complications.

There are three forms of such care:

• dependent, when therapy is carried out at the direction of a doctor;
• interdependent, when the nurse acts as part of a team;
• independent, when care is provided as part of monitoring the patient's physical condition and diet.

Nursing care for a child with asthma includes:

• initial preparation for research and testing;
• monitoring the execution of doctor's instructions;
• planning the optimal schedule for patient care;
• leisure organization. The treatment of children is a special process and requires the nurse to advise parents on the organization of the child's leisure, which includes the transfer of toys or books to the hospital.

Prevention

As a preventive measure, it is most often recommended to follow a few simple rules:

1. Regular exposure of the child to the fresh air.
2. Exclusion of the possibility of contact with potential sources of allergies.
3. Carrying out preventive measures to improve immunity.
4. Passing physical therapy courses.
5. Implementation of regular wet cleaning in the premises where the patient lives.
6. Refusal of others from smoking.
7. The use of synthetic fillers for pillows and blankets, as well as a decrease in the amount of upholstered furniture in the apartment.
8. Constant fight against rodents and domestic insects.

Frequent exposure to fresh air reduces the risk of disease. Therefore, you should often leave the city, visit the forest or the village.

Compliance with the rules will minimize the risk of bronchial asthma in a child.