Bronchial asthma in children

Bronchial asthma in children is allergic disease, although the specific Allergy occurs only rarely. Sick children often certain properties of the organism, often hereditary. Direct heredity is not often; more often a family history revealed allergic, metabolic diseases, endocrinopathies, etc., of particular importance is the presence of these diseases in the mother during pregnancy. The influence of such a family history causes the number of functional disorders, for example the tendency of capillaries to the rapid expansion at insignificant (inadequate) irritation, increased vascular permeability and other barriers. These features are characteristic of exudative diathesis (see), celebrated in more than half of patients with bronchial asthma, facilitate the possibility of sensitization, which in early childhood can occur through the gastrointestinal tract food allergens. When an existing food allergies layering of respiratory diseases may be a "permissive factor" and to cause allergic reactions in the form of bronchial asthma attacks. In further attacks can occur under the influence of other stimuli. So usually develops purely allergic asthma.
Infectious-allergic form B. A. results of repeated inflammatory processes in the respiratory organs; bacterial or viral antigens with autoallergy formed by inflammation, sencibilisiruet the body. In the occurrence of further attacks great importance conditioned reflex mechanism.
Pathological anatomy and B.. in children is not different from that of adults. Death can occur from asphyxia at full obstruction of the bronchi viscous sputum during the attack.
Clinical presentation and course of bronchial asthma in children have some differences due to the structural and functional features of the child's body. Narrowing of the bronchi clearance in children was primarily due to the swelling of the mucous membrane of the bronchi and increased mucus secretion and to a lesser extent with spasm still poorly developed bronchial muscles. For children uncharacteristically sudden, rapid onset of attack B. A.; it is usually preceded by an upper respiratory catarrh, often vasomotor rhinitis. The younger the child, the easier it occurs oxygen starvation, so early childhood attack occurs with increased frequency of breathing and shortness of breath mixed type, although the prevalence of expiry.
For bronchial asthma attack, the pathognomonic dry wheezing on the expiratory phase, but often you can hear and mixed moist rales in the phase of breath that occurs in children of early age or while exacerbation of chronic pneumonia at any age. Many patients from the beginning of the attack appears dry obsessive cough. With wet bronchial asthma, more frequent in children, duration of attack increases. When combined with chronic pneumonia attack may go a long asthmatic condition. When viral and bacterial pneumonia in young children may be asthmatic symptoms that disappear in recovery and is not repeated in the future. Great importance is the nature, duration and frequency of attacks, the combination of a and B.. chronic pneumonia complicates the course of the disease. Often bronchial asthma may result in puberty; it is very important to begin early and systematic treatment.
The diagnosis. Recognition B. A. and its shape helps carefully assembled history. Blood testing for allergic form reveals leukopenia and eosinophilia; x-ray examination of the thorax is celebrated only emphysema. Sputum children are difficult to obtain, as they usually her swallow. Specific bronchial asthma elements - the spiral of Churchman or crystals Charcot-Leyden - detected rarely, usually only occur eosinophils (up to 10% and above). The differential diagnosis B. A. children should be borne in mind sharp small pneumonia, foreign body airway and jumorazmy bronchogenic.
Treatment. Mild attack carried out by the same means and adults (in appropriate doses); but children rarely have to resort to intravenous infusions. When an asthmatic condition that occurs commonly with simultaneous aggravation of chronic pneumonia, in the face of antibiotics (penicillin!) prescribe corticosteroids (prednisone, rarely cortisone), preferably in a hospital. The most important is a comprehensive and systematic treatment of asthma in the interictal period. In allergic form by collecting a thorough medical history to determine and eliminate allergens and irritants that cause seizures. Since children only specific allergen is observed extremely seldom, perform non-specific desensitization by the same means as adults, avoiding distinct reactions observed, for example, when neopeninsula and similar tools.
With infectious-allergic form of primary importance is the identification of infectious lesion and its reorganization. Adeno - tonsillectomy in patients with bronchial asthma children should be conducted on the background of application of tranquilizers avoid psychical trauma that may lead to the attack; in the postoperative period in a few days prescribed sedatives, and antihistamines. After adenotomy necessarily trained nasal breathing. Infectious hearth even young children can be in the sinuses. In the presence of chronic pneumonia sanitation listed foci acquires special significance and is included in the stages of pneumonia. Such patients and sanatorium treatment, preferably in local health centers, and then in the forest schools, where they are not turned off from the life of children's collective, not lag behind in teaching, hardened and used systematically engage in physical exercise. Spa treatment of bronchial asthma in children less effective; it is absolutely contraindicated stay on the black sea coast of the Caucasus, where high humidity is usually arise severe attacks. Permitted southern coast of Crimea , subject to a return in the middle or Northern region is not late autumn.
The long-term appointment of corticosteroid hormones in the case of severe B. A. should simultaneously apply anabolic hormones (such as Dianabol), which is necessary for the growing organism.
A compulsory condition of the complex treatment is the improvement of the environmental situation not only in hygienically. Rational education is no less important; sometimes incorrect behavior of parents (underscore painful condition of the child) have to remove the patient from home environment to obtain long-term remission. In the complex treatment of bronchial asthma is of particular importance exercise therapy, as due to continued growth and high reparative properties of the child's body, it promotes the elimination of not only functional, but also reversible morphological changes in broncho-pulmonary system.
Prevention of bronchial asthma in children is to reduce the possibility of sensitization of the organism and the prevention of diseases of the respiratory system: proper upbringing, conditioning and physical education from early childhood, the fight against rickets, early detection of exudative diathesis, off strong food allergens, etc. In the clinic should be taken on account all "threatened" children. Vaccination is performed on the background of application of antihistamines.