Croup in children: symptoms, treatment
Croup is a rather dangerous disease of the respiratory system, which occurs as a complication of acute infectious and inflammatory processes in the respiratory system. Due to some anatomical and physiological features of the child's organism, young children are most likely to develop this ailment.
The main danger of the croup for the health of the patient consists in the increasing frustration of breathing, which appears due to the narrowing of the larynx and the upper parts of the trachea.Therefore, this disease has another name - stenosing( that is accompanied by a persistent narrowing of the lumen of the organ) laryngitis or laryngotracheitis.Table of contents: Cereal varieties Causes of cereals Why do children develop cereals most often?What happens with croup in the airway?Symptoms of groin Diagnosis of cereals First aid for croup Cure for groats Prevention
There are two types of groats:
- True.It develops only with diphtheria.At the heart of the pathology is a specific fibrinous inflammation with the formation of films on the mucous membrane of the larynx( in the region of vocal folds).The human breathing path is blocked by these films, and choking occurs.
- False.It is a complication of other infectious-inflammatory diseases of the respiratory system.Obstruction of the respiratory tract with this variety of croup arises mainly because of the edema of the walls of the larynx( and the same vocal folds).
False groats are more common, so it will focus on this article.
Depending on the prevailing pathological changes, the false cereal can occur in various forms:
- in the edematic, in which the severe condition of the patient is caused by edema of the respiratory tract;
- in a hypersecretory, characterized by abundant formation of viscous sputum, overlapping the laryngeal lumen;
- in spasmodic, respiratory spasm;
- in a mixed, in which there are several pathological manifestations at once( edema and hypersecretion, edema and spasm, etc.).
Causes of groats
Croup in a child can occur against the background of the following infectious diseases:
- Influenza and parainfluenza are in most cases.
- Diseases caused by the respiratory syncytial virus and adenovirus.
- Inflammatory diseases of the respiratory system of bacterial nature.
Why do children develop cereals most often?
Children from 6 months are most susceptible to development of a false groin.Up to 3 years, in a more adult age this syndrome is much less common. This pattern is explained by some of the anatomical and physiological features of the child's airways:
- In young children, the larynx has a funnel shape and the trachea is a narrow lumen, so that even a small mucosal edema can lead to almost complete overlap of these organs.
- Tendency of tissues to the development of edema.
- Hyperexcitability of the muscular apparatus of the respiratory system.
What happens when the croup is in the airway?
Acute inflammatory process in the larynx is usually accompanied by mucosal edema and mucus formation.If this swelling is severe( especially in the narrowest place of the larynx - in the area of the vocal folds and underneath them), the lumen is partially blocked at first, and with the increase in pathological changes to a critical level, so the patient can not breathe normally - suffocates.This is the croup.Contributes to the violation of airway patency in this disease, a significant accumulation of sputum and spasm of the muscles of the larynx.And it is very important that the child's anxiety, crying and crying only increase the spasm of the respiratory system.
The probability of croup development at night is especially high. This is explained by the following physiological phenomena: when the child lays for a long time, the outflow of blood and lymph from the tissues is somewhat different( therefore, the puffiness increases), the drainage activity of the respiratory tract decreases( mucus accumulates in them).If the room is still dry and warm air, drying the mucous membranes, the risk of respiratory disorders increases many times.
Symptoms of groats
For the croup is characterized by a triad of symptoms:
- barking paroxysmal cough;
- stridor( noisy breathing), especially when the child cries or worries;
- hoarseness of voice.
In addition, there are secondary signs of ailment - severe anxiety, rapid breathing and palpitations, nausea, hyperthermia.
With the increase in respiratory failure, all symptoms are aggravated, the child's skin becomes gray or bluish, salivation increases, wheezing becomes audible already in peace, and confusion is replaced by restlessness.
Diagnosis of croup
Diagnosis of cereal in a child by a characteristic clinical picture and the presence of symptoms of an infectious and inflammatory disease of the respiratory organs.There is simply no time to conduct any additional studies in such situations, since the patient's help should be provided immediately.
Similar to cerebral symptoms may have other pathological conditions: aspiration of a foreign body( for example, falling into the respiratory organs of parts of toys), allergic edema of the respiratory tract, larynx injury, sudden laryngospasm, epiglottitis and others.The approach to treatment of these ailments is somewhat different, therefore it is impossible to independently treat a child who has manifestations of airway obstruction.
First aid for croup
The first thing parents should do when a child develops symptoms of croup is to call an ambulance.Then do the following( before the arrival of doctors, you can try to ease the condition of the baby):
- Take the baby in your arms and calm down.As already mentioned above, fear and anxiety lead to an increased spasm of the respiratory tract.
- Cover the patient in a blanket and bring it to an open window or take it out to a balcony( he needs access to cold air).You can also bring the child to the bathroom, which includes a tap with cool water( not hot!).
- If there is a nebulizer in the house, let the child breathe saline or mineral water.
Important! Any steam inhalation, rubbing and other similar procedures with cereals are contraindicated.
Treatment of groats
Children with cerebral symptoms are shown hospitalization .The first thing that physicians should do is to restore the airway patency.For this, it is necessary to reduce the swelling and spasm of the larynx, and also to release its lumen from the accumulated mucus. Therefore, in the prehospital phase, and then in a hospital setting, the patient is treated as follows:
- Glucocorticoids are introduced to reduce the laryngeal edema.Recently, pediatricians prefer the inhalation of such drugs( through a nebulizer).
- Assigning funds that remove the spasm of the respiratory tract( Salbutamol, Atrovent, as well as such antispasmodics as Baralgin), with expressed spasm in addition also sedatives.
- Inhalation of Ambroxol or other drugs that facilitate sputum discharge.
- If necessary, antihistamines are administered.
If the conservative therapy is ineffective, intubation of the trachea or tracheotomy with subsequent artificial ventilation is performed.
Since false cereals most often occurs in children against the background of ARVI, its development can be prevented by preventing "cold" diseases. In addition, the correct behavior of parents in influenza and other similar ailments in the child plays an important role in preventing the occurrence of stenosing laryngitis.It is the implementation of the doctor's recommendations, the creation of comfortable conditions in the patient's room( clean, moist, cool air), copious drinking, regular nose washing, and not advertised medicines, can reduce the severity of pathological changes in the respiratory system.
In addition, in ARD it is not advisable to do the following: put mustard, rub the patient with means with essential oils, give the baby citrus, honey and other potential allergens.All this can cause a reflex spasm of the muscles of the larynx and provoke the development of croup.
Important: parents of children who had had cereal before, should always consult their pediatrician about how to behave if the child has the first menacing symptoms of respiratory distress and what emergency medicines must necessarily be in the home medicine chest.
Zubkova Olga Sergeevna, medical reviewer, epidemiologist-doctor