False croup in a child. Features of the treatment of croup in children. How to help a child if false croup develops, Komarovsky

Laryngitis and laryngotracheitis themselves do not pose a serious danger, but in some cases they are complicated by attacks of false croup. Acute stenotic laryngotracheitis or – a disease characteristic of children from six months to two or three years. The mortality rate from this disease is still quite high. Often mothers are simply lost when their child begins an attack of stenosis, losing precious minutes, unable to either recognize the onset of the disease in time or, of course, provide necessary help.

Basic terms to make it clear:

• Stenosis and obstruction- in this case, they mean the same narrowing of the subglottic space, which is caused by swelling of the mucous membrane.
• Accessory muscles- these are the muscles that healthy condition are not involved in breathing. They begin to participate in breathing only if it becomes difficult. Accessory muscles include the wings of the nose, abdominal muscles, intercostal muscles, and muscles in the clavicle area.
• Inspiratory dyspnea- difficulty breathing.
• False croup - this is swelling of the mucous membrane below vocal cords having a viral or bacterial-viral origin.

How younger child, the more severe this disease progresses. Of course, exceptions are possible. The occurrence of laryngeal edema is facilitated by features child's body. The glottis in children is narrow, its muscles get tired easily (even after screaming), the vocal cords and mucous membrane are tender, their blood supply is very good, which determines the tendency to swelling and the occurrence of stenosis (narrowing) of the larynx.

False croup has also been described in infants and older children age group. Laryngeal edema can be either the first manifestation of the disease or a “gift” on the “tail” of the underlying disease. This condition can occur against the background of any body temperature. The attack usually occurs at night in the morning. It is possible that the attack may reoccur after treatment. There are children who experience asthma attacks with every infection. Most often, false croup can be expected from children with allergies.

The disease is usually caused by viruses and develops gradually over several days.

False croup: how to suspect?

False croup most often develops suddenly, at night. A child may go to bed outwardly quite healthy, and then suddenly wake up excited at night, with bouts of loud “barking” cough.

In addition, hoarseness and difficulty breathing are observed. Already from a distance, a whistling, difficult breath can be heard, which, in turn, causes tension in the auxiliary respiratory muscles, flaring of the nostrils, and tension in the child’s neck muscles.

During an attack of suffocation, the skin becomes bluish and the heart rate increases. Body temperature most often does not exceed 38ºC. An attack of suffocation lasts on average from 30 minutes to 2 hours and gradually passes.

Signs light form edema appear mainly by screaming and anxiety. There is a “barking” cough, an extended noisy breath, without the participation of auxiliary muscles. IN calm state shortness of breath subsides, but noisy breathing remains.

With moderate severity false croup in a child, the above symptoms are complemented by noticeable agitation, sweating, marble pattern skin. Accessory muscles take part in the act of breathing (the wings of the nose flare, the neck muscles tense).

When the glottis becomes even narrower, the so-called decompensated stenosis, the child's condition is serious. Inhalation at rest is noisy, prolonged, difficult. The skin is pale with an earthy tint, covered with cold sweat, persistent bluish color tip of the nose, lips, fingers. Excitement gives way to inhibition, and the baby periodically shudders. Very severe cases loss of consciousness and respiratory arrest are possible.

ATTENTION! If your child has an attack of barking cough and difficulty breathing, call a doctor immediately.

Urgent first aid for stenosis:

1. Try to calm the child by removing unnecessary people from the room. The groans of grandmothers will only frighten the baby, and it will be easier for you when you are left alone with the child.

2. While you are taking care of the baby, have someone call the ambulance.
(Be sure to call an ambulance for any degree of stenosis. Only a doctor can say for sure that your child has false croup and not an attack bronchial asthma, pneumonia or foreign body in the respiratory tract.)

3. Let the child breathe cool, if possible, humidified air. Be sure to ventilate the room where the child is. Cold air reduces swelling of the mucous membranes. To do this, wrap your baby up and you can go to the window or go out onto the balcony and breathe through the open window. In the summer, you can open the freezer door and try taking a few breaths. Remember, without fanaticism, sharply cold air when moving a child from a known warm room to a very cold one can, on the contrary, cause a reflex spasm of the larynx (narrowing respiratory tract) and aggravate the course of the disease.

4. Be sure to give your child any allergy medicine available at home: suprastin, fenkarol, diphenhydramine. IN emergency situation You can give your child a whole tablet, regardless of age. Give half a tablet - it won’t get worse. A one-time use of an increased dose of an allergy drug will not cause harm. Antiallergic drugs help reduce swelling and limit the area of ​​its spread.

5. If there is an inhaler in the house ( nebulizer), you can perform inhalation with a 0.05% naphthyzine solution for up to 5 minutes.

To prepare an inhalation solution, the 0.05% drug should be diluted with saline in a ratio of 1:5 (for 1 ml of the drug, 5 ml of saline) or the 0.1% drug should be diluted in a ratio of 1:10 (for 1 ml of the drug, 10 ml saline solution).

To relieve swelling, inhale 2 ml of the resulting solution once, repeat the procedure if necessary. If you do not have an inhaler at home, drip naphthyzine into your nose (2 drops in each nostril, in an age-specific dosage).

Be careful, such inhalations are fraught with an overdose of naphthyzine. This method should still be used in extreme cases.

6. Don’t impose on your child bed rest. The child himself knows what body position is in this moment will make breathing easier.

7. Give warm alkaline drink. It could be milk or mineral water. You can add it to milk baking soda on the tip of the knife. It is better not to give hot drinks because it causes additional swelling of the soft tissues of the throat and irritates the mucous membrane. The optimal temperature of the liquid is the one that is pleasant to the child. Children themselves feel the need to drink and, as a rule, do not refuse. It is better to give liquid in small portions every 5-10 minutes. A large amount of drink can provoke vomiting at the height of a coughing attack.

In any case, even if you managed to relieve an attack of false croup on your own, do not leave the child without the supervision of a doctor, call your local doctor. If you are offered hospitalization, do not refuse. Or you can safely insist on hospitalization for observation. Often, attacks of false croup tend to recur over short periods of time.

Prevention of false croup:

In the room where the sick baby is located, the air should be warm, fresh, humidified, but not damp.

Be sure to give your child antihistamines (anti-allergic) medications when he is sick. This will help, if not avoid, then reduce the risk and severity of an attack of false croup.

Preschool children often suffer from serious illnesses that can cause serious harm baby's health. One of these dangerous diseases is false croup. This disease is dangerous because it causes swelling and spasms in the child, making breathing difficult and causing suffocation.

Symptoms of false croup in children

With false croup, a narrowing of the child's larynx develops. It occurs due to swelling or spasm muscle tissue. Usually the reason similar condition considered a feature respiratory organs child. In the preschool period, children have a significant amount of blood vessels And . This makes the larynx more vulnerable. The situation is further aggravated by the funnel-shaped shape of the trachea and bronchi, which allows microbes to be localized at one point.

Most often, the attack develops unexpectedly in the evening or at night. The child begins to have a barking or croaking cough. Then the baby becomes hoarse voice or it may disappear altogether. The child begins to breathe noisily and frequently.

Such difficulty breathing inevitably affects the functioning of the heart. His work becomes more frequent, the skin becomes pale, dark shadows lie near the eyes, and blueness appears along the line of the nasolabial folds.

If the child suffers from this infectious disease, his temperature may rise. If false croup is caused by an allergy, then the child’s skin becomes covered with rashes accompanied by itching. In the future, suffocation may develop. This state of affairs cannot be allowed to happen.

Treatment of false croup in children

If a child has developed swelling and spasm of the larynx of the first or second degree, then treatment is carried out in a hospital in the infectious diseases department. With more high degree In case of stenosis, the baby is hospitalized in the intensive care unit.

The process of treating this disease consists of solving three problems - it is necessary to prevent the occurrence of new attacks, cure inflammation and eliminate swelling. Treatment must be prescribed by a doctor; independent actions can only provoke deterioration and generally lead to the most dangerous consequences.

The main measures taken are:

• There is a regular supply of fresh air, so the room needs to be ventilated periodically. If the air is too dry, it makes sense to use humidifiers.
• The child needs to be given water alkaline drinking, which significantly speeds up the process of sputum separation.
• The child should not be fed food that is too hard and irritates the surface of the throat.
• To soften the surface of the throat, give your child lozenges, use inhalers and aerosols.
• To relieve swelling, give your baby the medications prescribed by your doctor. antihistamines. This will relieve swelling faster and make it easier for the child to cough up.
• With severe laryngeal stenosis, it is necessary to give the baby glucocorticoid medications and anti-inflammatory drugs prescribed by the doctor.
• If your baby has a bacterial or fungal infection, be sure to use antifungal and antibacterial medications prescribed by your doctor.

If conservative treatment does not bring results, then tracheostomy and intubation are performed. In most cases, false croup is cured well. Respiratory blockage is rare. With this disease, the peak occurs on the second day of the disease, and within a week you can track clinical picture.

First aid for false croup

Since laryngeal edema develops in false croup, life-threatening child, it is very important to provide first aid to the baby in a timely manner.

The sequence of actions should be like this:

1. Be sure to call immediately ambulance.
2. While you wait for the specialists to arrive, reassure your child. After all, his nervous condition and crying only increase the intensity of the cough.
3. Place your baby in the bed so that his upper body is higher. To do this, place a couple of pillows under the child's head and back.
4. Prepare a warm drink - soda solution concentration 2% or warmed milk mixed with mineral water. These products help dissolve mucus and perfectly moisturize the mucous membranes of the throat.
5. Using a nebulizer, if possible, inhale with mineral water. You can use saline solution instead of mineral water.
6. In the room where it lies, open the window. The child will need moist air, so use a humidifier or hang wet towels around the room. Humidified cold air will help relieve swelling of the larynx.
7. If possible, the baby can be wrapped in a warm blanket and taken out to the balcony.
8. Can be instilled vasoconstrictor. Inhalation of this drug through a nebulizer will also work well.
9. If your child's age allows, give him an antihistamine that will reduce swelling of the larynx. To relieve spasms, it is permissible to give the child No-Spa. If your baby has a fever, give him some antipyretics.

At the same time, you need to know about those actions that you absolutely cannot do:

• Without appropriate doctor's advice, you should not give your baby cough suppressants.
• Do not rub or place mustard plasters.
• Do not inhale using home-made inhalers.
• Do not feed your child foods that can cause... These include all citrus fruits, raspberry jam and honey.

False croup is a disease that is a lesion of the walls of the larynx. In adults, false croup is extremely rare; from a statistical point of view, much more often, true croup is found in them.

The disease has another name: acute stenosing laryngotracheitis. But if we talk understandable to humans, far from the world of medicine, in language, false croup is a pathology in which a person faces a severe attack of suffocation and this can result in death.

What is false croup

The term "croup" from the Scottish language is translated as "caw", the disease got its name thanks to characteristic symptom: barking, croaking cough. However, despite the fact that this sign is indeed included in the clinical picture of patients with croup in most cases, it is not the main one.

The main symptom of croup is a violation of the breathing process, which, in case of incorrect or untimely assistance, can lead to death as a result of developing hypoxia (oxygen starvation).

Before considering what false croup is, you should know how it differs from true croup.

With true croup, films form in the human respiratory tract, which are a significant physical barrier to normal air circulation. The causative agent of true croup is diphtheria, which is why true croup is sometimes called diphtheria.

False croup is a consequence of swelling of the larynx due to an inflammatory process during a bacterial or viral infection (influenza, pharyngitis, etc.)

Both true and false croup - dangerous conditions which may cause suffocation.

Moreover, in both cases the sharp and severe attack difficulty breathing is severe stress for a person, therefore it is important to know how and why this pathology arises and develops, how to avoid it, how to treat it and how to properly provide first aid to a person with an attack.

Main causes and pathogenesis

False croup is not an independent disease; it is a pathology that accompanies a viral or bacterial infection.

The causes of false croup can be classified as follows:

In adults, bacterial infection more often occurs as the cause of the development of false croup.

Clinical picture

Symptoms of false croup begin with a strong “barking cough”, in which practically no sputum is produced. Due to damage to the vocal cords, a person develops hoarseness or even complete aphonia (lack of voice) and stridor - a pronounced whistle during the breathing process.

It is by the severity of stridor that we can tell how severely the swelling has affected the laryngeal mucosa.

Symptoms of false croup include signs of the underlying disease that provoked an attack of suffocation: heat, intoxication, sore throat, rhinitis.

Considering the fact that adult patients are more likely to experience croup due to bacterial infection, rather than viral, the signs of false croup are distinguished by a more vivid and broader clinical picture.

The development of an attack occurs in 4 stages, and they can replace each other very quickly, and the time interval from the first to last stage it will only take a few hours.

Stages of disease development

The development of an attack of false croup directly correlates with the prevalence of edema: first it narrows the lumen of the larynx, then it affects the vocal cords, then it affects other body systems (nervous, cardiovascular) that suffer from a lack of oxygen.

• The onset of an attack of false croup indicates a violation of the breathing process only when physical activity or extreme anxiety. Reflexively trying to compensate for hypoxia in the body, a person changes the depth and rhythm of breathing: his inhalation becomes longer, and his exhalation becomes shorter, with strong wheezing and whistling.
• At the second stage, suffocation begins when the person is completely at rest. If you examine his diaphragm during the breathing process, you will notice that the space between the ribs and the jugular cavity are drawn inward during inhalation. Due to the lack of oxygen, the heart begins to work faster, so by feeling the pulse, the patient can detect tachycardia. The skin around the mouth brightens and then takes on a blue tint.
• At the third stage, the difficulty of the breathing process is aggravated even more; during inhalation, the area under the diaphragm (epigastric zone) is strongly retracted, and at the exit - barking cough. Due to swelling of the larynx, the patient develops dysphonia, which is why he can only speak in a whisper. Hypoxia of the body leads to damage to the central nervous system, as a result of which an attack of strong emotional arousal is replaced by sudden lethargy and drowsiness.
• During the fourth stage of false croup, wheezing when exhaling and barking cough completely disappear. Breathing becomes weak and shallow, blood pressure and the pulse drops, confusion gradually gives way to coma. If a person is not brought out of a coma with the help of urgently taken medical measures, the likelihood of death is very high.

The sooner a person is provided with adequate health care, the lower the risk of developing severe hypoxia and associated adverse consequences.

Diagnostic methods

The first step is to carry out a differential diagnosis to exclude the presence of true croup caused by diphtheria. For this purpose the following is carried out:

• examination of the patient’s larynx in order to detect dense films there (characteristic of true croup) or swelling (characteristic of false croup);
• throat swab to determine the causative agent of the disease (including diphtheria).

In addition to diphtheria, it is important to exclude the following pathologies:

• allergic swelling;
• retropharyngeal abscess;
• bronchial asthma;
• presence of a foreign body in the respiratory tract;
• tumors in the larynx.

During the examination, the doctor listens to the patient’s lungs, collects anamnesis accompanying pathologies events preceding the attack, medications taken.

First aid

Emergency care for false croup is a set of measures that can save the patient’s life. Most often the attack occurs at night, when the patient is in horizontal position, so you need to act immediately.

First of all, you need to call an ambulance service, which will help relieve the attack quickly and effectively, and then, most likely, hospitalize the patient. But until the medical team arrives, the following measures must be taken as part of first aid for false croup:

• remove any restrictive clothing from the patient;
• ensure a flow of fresh air into the room (open a window, vent);
• humidify the air to facilitate the breathing process using a special device or containers of water placed throughout the room;
• give the patient something to drink;
• if breathing stops, press on the root of the tongue and induce vomiting;
• give an antihistamine, if the patient cannot swallow a tablet, give an injection (Prednisolone, Suprastin, Ruzam).

It is important to reassure the patient, since stress only intensifies the symptoms of the attack, to let him understand that urgent Care croup has already been treated, the attack will soon pass, there is no danger to life.

After the doctors arrive, you need to inform the team about all the drugs that were used as first aid measures.

Treatment methods

Treatment of false croup occurs in a hospital setting: this allows the use of more effective techniques treatment, and if a recurrent attack occurs, immediately provide the necessary assistance.

Treatment of false croup at home is possible if the attack was stopped by early stage, and the person feels satisfactory.

The main emphasis is on etiological therapy, that is, on the treatment of the disease that led to such serious complication as a breathing disorder. Antibiotics and antivirals are used for this.

You can select the exact drug after laboratory diagnostics(blood test, examination of a throat smear), but before the results of the research, the doctor prescribes a mutually compatible set of medications wide range actions.

To relieve and prevent attacks, it is necessary to eliminate swelling in the larynx. Glucocorticosteroids, for example, Prednisolone, are used for this with great success.

This drug has a wide spectrum side effects, but considering short course therapy, one should hardly be afraid of the development of undesirable consequences of drug treatment.

Symptomatic treatment is carried out using inhalations, which relieve inflammation from the mucous membrane of the pharynx and vocal cords, and also facilitate the breathing process.

Inhalation of cold steam using a nebulizer is considered safe. The device is filled with ordinary saline solution, alkaline mineral water or Naphthyzin.

Considering the fact that anxiety intensifies the symptoms of the disease and provokes the development of a new attack, the patient may be recommended mild sedatives.

Since attacks predominantly occur at night, a person may develop neurosis, as a result of which he will be afraid to go to bed. Properly selected sedatives will eliminate this problem.

Also appointed special diet with the necessary amount of calories, vitamins and microelements, which helps the body recover faster from illness.

Thus, the answer to the question of what to do with false croup includes both first aid and etiological treatment underlying disease, the dynamics of which will not allow the development of a life-threatening attack of suffocation.

If for an adult an acute respiratory viral infection, or as it is popularly called a “cold,” goes away in a week, without causing, in addition to snot and malaise, and maybe a cough, any special troubles, then for children it is not such a simple disease. Or rather, a group of diseases. The danger lies in the addition of complications, one of which (it is also one of the most dangerous) is false croup. More precisely, this disease is correctly called acute stenosing laryngitis (OSL) or laryngotracheitis (depending on whether only the larynx or larynx is affected, it is “larynx” and trachea in Latin), it is also sometimes called subglottic laryngotracheitis. In the future, with your permission, I will use the abbreviation OSLT. I think the decoding is already clear.

Croup (from the English Scottish croup - to croak) is an inflammation of the mucous membrane of the larynx, accompanied by wheezing, barking or croaking cough and difficulty breathing (mainly during inspiration). False croup is so named in order to distinguish it from true croup, which is observed in diphtheria and has similar symptoms. With diphtheria, the obstruction of the airways, and therefore the difficulty of air passage, is caused by specific dense films and there is no swelling, and the cause of false croup is swelling of the mucous membrane and loose tissue of the larynx and trachea.

False croup is viral disease upper respiratory tract. The infection causes inflammation, swelling and increased production of mucous discharge in the tracheal area in the subglottic space in the area of ​​the vocal cords. Usually the disease goes away on its own, however, 5 - 10% of children will still need hospitalization. Therefore, there is no need to do anything on your own; always call an ambulance. Most often, croup or OSLT develops in children of the second and third year of life, somewhat less often - in infancy(6 - 12 months) and in the fourth year of life. OSLT rarely occurs in children over 5 years of age and never in the first 4 months of life.

In the occurrence of stenotic laryngitis and laryngotracheitis, the leading role belongs to influenza viruses, parainfluenza, adenoviruses and respiratory syncytial, as well as viral-viral associations. The overwhelming factor causing inflammatory process in the larynx and trachea, which accompanies the development of croup syndrome, is the parainfluenza virus. It accounts for approximately half of all viral OSLTs. Along with viruses, OSLT plays an important role in the development of an unfavorable (severe, complicated) course. bacterial flora, activated during ARVI or added as a result of nosocomial infection.

Anatomical and physiological features of the children's larynx and trachea (because of them, croup occurs): small diameter, softness and pliability of the cartilaginous skeleton; short narrow vestibule and funnel-shaped larynx; highly located and disproportionately short vocal folds; hyperexcitability of the muscles closing the glottis; functional immaturity of reflexogenic zones and hyperparasympathicotonia. In the mucous membrane and submucosa - abundance lymphoid tissue With big amount mast cells, blood vessels and with weak development of elastic fibers. Unfavorable background factors also play a role: constitutional anomalies (exudative-catarrhal and lymphatic-hypoplastic diathesis); drug allergy; congenital stridor; paratrophy (obesity); birth injury, childbirth by caesarean section; post-vaccination period; sensitization by previous frequent acute respiratory viral infections.

When can a child “catch” the disease?

In the off-season. In winter, everything is clear to parents - it’s frosty outside, they need to dress their child warmer. And with the onset of spring, I really want to throw off my heavy clothes as soon as possible! But the first Sun rays are deceptive, the air is still cold - and the baby becomes a victim of ARVI. Where respiratory diseases, there is false croup. Or, on the contrary, the warmth has already arrived, and caring mothers are still wrapping their baby up in winter. But on a walk, children either run around like clockwork or sit in the sandbox - and it’s easy for a sweaty child to catch a cold! From this point of view, thaws in the middle of winter are also dangerous.

A virus (most often it is parainfluenza virus type 1, as well as RS virus, adenovirus, influenza viruses, measles), once on the mucous membrane of the larynx, causes its inflammation - laryngitis. Against the background of inflammation, mucus accumulates in the lumen of the larynx, swelling of the fatty tissue and reflex spasm of the glottis occurs, which leads to a narrowing of the lumen of the larynx (larynx stenosis) and, as a result, a sharp difficulty in breathing.
What does it look like? The first manifestations of croup are always sudden. As a rule, they happen at night when the child is already sleeping. And this frightens both the child and his parents even more. During the day, you might notice a slight hoarseness in your breathing, but it is so insignificant that it is barely perceptible to the ear. In the evening, the child becomes lethargic - but who doesn’t become like that after an active day, especially after a long walk? In fact, at this time the virus is already active in the body. In his sleep, the child tosses and turns, it is difficult for him to breathe (after all, swelling of the throat has already begun), he begins to cough. The cough with croup is very characteristic - dry, “barking” or “croaking”. The child breathes more often than usual, up to 50 breaths per minute (the norm at the age of 3-5 years is 25-30). This is how the body tries to make up for the lack of oxygen. The temperature may rise. Very quickly the cough becomes more and more severe, and if at this time the child does not wake up and the parents do not provide urgent help, then there is a high probability of loss of consciousness and suffocation!

OSLT disease comes in 4 degrees:

1st degree stenosis (compensated). Clinically characterized by all the signs of OSLT. With anxiety and physical exertion, there is an increase in the depth and noise of breathing, and inspiratory shortness of breath appears. There are no clinical signs of hypoxemia (excess carbon dioxide in Corvi). Through compensatory efforts of the body, the gas composition of the blood is maintained at a satisfactory level. The duration of laryngeal stenosis ranges from several hours to 1-2 days.

Stenosis of the 2nd degree (subcompensated). Strengthening everyone clinical symptoms OSLT. The characteristic stenotic breathing is clearly audible at a distance and is observed at rest. Inspiratory shortness of breath is constant. Compensation for stenosis occurs by increasing the work of the respiratory muscles by 5-10 times. Retraction of yielding areas is noted chest at rest, aggravated by tension. Children are usually excited, restless, and their sleep is disturbed. The skin is pale, perioral (around the mouth) cyanosis appears, intensifying during a coughing attack, and tachycardia. The symptoms of 2nd degree laryngeal stenosis can persist for a longer time - up to 3-5 days. They can be constant or have a paroxysmal character.

Stenosis of the 3rd degree (decompensated). It is characterized by signs of respiratory decompensation and circulatory failure, a sharp increase in the work of the respiratory muscles, which does not prevent the development of hypoxemia, hypoxia, and hypercapnia. External and tissue respiration is disrupted, the level of oxidative processes in tissues decreases, and mixed acidosis appears. General state heavy. Severe anxiety, accompanied by a feeling of fear, is replaced by lethargy and drowsiness. The voice is sharply hoarse, but complete aphonia is not observed. The cough, initially rough and loud, becomes quiet and superficial as the narrowing of the lumen of the larynx increases. Shortness of breath is constant, mixed. Breathing is noisy, frequent, with a sharp retraction of the yielding areas of the chest. In this case, you should pay attention to the severity of the retraction of the lower end of the sternum, which can appear already in the 2nd degree and sharply intensifies in the 3rd degree of laryngeal stenosis. As stenosis increases, breathing becomes arrhythmic, with uneven depth and paradoxical excursions of the chest and diaphragm. Noisy, deep breathing is replaced by quiet, shallow breathing. Expressed Clinical signs hypoxemia. Auscultation above the lungs first hears rough wheezing of a wirey nature, then a uniform weakening of breathing. Heart sounds are muffled, tachycardia, paradoxical pulse (loss of pulse wave on inspiration). Arterial hypotension may be recorded.

4th degree stenosis (asphyxia). The condition is extremely serious and is developing deep coma, there may be convulsions, body temperature drops to normal or subnormal numbers. Breathing is rapid, shallow or arrhythmic with periodic apneas. Heart sounds are muffled, bradycardia occurs, and then asystole. Hypoxemia and hypercapnia reach extreme values, and deep combined acidosis develops.
In addition to obstructive respiratory failure the severity of the condition is determined by the severity of toxicosis and the addition of complications. I wrote all this to you not to scare you with horror stories, but so that you realize that croup cannot be treated on its own, it is dangerous for the baby’s life. Call a doctor in any case, even if you think the attack has already passed. OSLT is prone to relapses (repetition of an attack), and may become more severe.

How to get ahead of an attack and what to do?

The first and most important thing is to calm down yourself and calm the child. The child's excitement and crying intensify the cough, which, in turn, intensifies the manifestations of croup, forming a “vicious circle.”
Already when the first symptoms appear (difficult wheezing, wheezing, the first hesitant cough) you need to pay attention to the climate in the room. There should always be in the house Fresh air- ventilate rooms as often as possible. False croup is a disease in which fresh air is your assistant. After all, it helps saturate the blood with oxygen.
The child must be placed in an elevated position, half sitting, with pillows or a blanket under his head and shoulders.

Free him from restrictive clothing. Unbutton all the collars of your shirt so that nothing can restrict your chest.

Give the child warm liquid to drink. With croup, a child loses fluid quite easily. Therefore, it is very important to give your child water all the time. It is better to give juices than milk. Drinking frequently thins mucus and prevents dehydration.

Don't forget about hydration. Inhalation is one of the main means in the fight against false croup, and a humid atmosphere in the apartment is a serious preventive measure. It’s good if the house already has a humidifier, but if you haven’t made this useful purchase yet, you can make do with improvised means. Wet rags on batteries and water containers in each room are suitable.

Apply mustard plasters to the area calf muscles. This will redistribute the blood to the legs and distract it from the larynx, thus preventing the swelling from getting worse.

If a child has a high temperature, give an antipyretic in an age-appropriate dose.

Call vomiting reflex if breathing stops. This reflexively excites the respiratory center, which is located next to the vomiting center.

Antihistamines (anti-allergy) drugs - to remove allergic reaction and relieve swelling.

Of course, if signs of false croup occur, you should immediately call an ambulance or take the child to the nearest hospital. Do not forget that even an attack that has passed easily can happen again and again. And its consequences are irreversible. While inhalation can still be done at home, tracheal intubation is a complex procedure that requires special conditions and constant monitoring by specialists. So if the doctor insists on hospitalization, it is better not to risk the child’s health and take him to the hospital.

Usually the attack lasts 20-30 minutes, and, gradually, the child’s condition improves. If it still hasn’t improved, then let’s hope that the ambulance you called has already arrived, and now professionals will help the child.

Medical treatment is determined by the severity of the stenosis, its duration, as well as the presence of toxicosis caused by ARVI, the age of the child, and his premorbid (pre-painful) state.
For stenosis of the 1st degree, the following is necessary: ​​wide access of air; distraction therapy - mustard plasters on calves and circular hot baths at a water temperature of up to 38-39 degrees. C, plenty of frequent warm drinks (tea, Borzhom, milk with soda), steam alkaline inhalations(4% solution of sodium bicarbonate with vitamin A, aminophylline, hydrocortisone); antispastic therapy (atropine, papaverine orally in age-related doses); sedatives and hyposensitizing agents (diphenhydramine, pipolfen, etc.), vitamins. If there is no effect, intranasal novocaine blockade is used, which helps reduce swelling of the laryngeal mucosa and relieve reflex spasm. Already at this stage of stenosis, especially in the presence of fever, it is recommended to prescribe antibiotics. It is advisable to place the child in a room where the air is humidified with steam.

For grade II stenosis, in addition to the above remedies, humidified oxygen is widely used; in order to reduce swelling of the mucous membrane of the respiratory tract - hypertonic solutions IV (20-30 ml of 20% glucose solution, 5-10 ml of 10% calcium gluconate solution); hormonal drugs: hydrocortisone, prednisolone; cardiac medications (strophanthin or corglycon intravenously or digoxin orally), diuretics; neuroleptics (aminazine, promazine, etc.).

For grade III stenosis, intravenous prednisolone (1.5-2 mg/kg), with the first dose being half the daily dose; cardiac drugs are more widely used; broad-spectrum antibiotics (ceporin, tetraolean, etc.), as well as sodium hydroxybutyrate (GHB). If there is no effect, a therapeutic laryngoscopy is performed, during which the mucus is sucked out with a polyethylene catheter, dry bloody crusts are removed, the mucous membrane is lubricated with a solution of ephedrine, hydrocortisone, peach, apricot or Vaseline oil. Sometimes direct laryngoscopy is repeated several times. For grade III stenosis, therapeutic bronchoscopy is also indicated (removal of mucus, pus, crusts, bronchial lavage, intratracheobronial administration of antibiotics), but there must be full readiness for immediate tracheostomy.

If the measures listed above are ineffective, the severity of stenosis does not decrease, there is a tendency to progression of cardiovascular failure (paradoxical pulse is noted - loss of the pulse wave, adynamia, pallor of the skin increase against the background of persistent cyanosis of the lips, limbs, etc.), intubation or tracheostomy.

The prognosis for grade III stenosis and asphyxia is serious; in grades I-II and early treatment - favorable. I also listed this so that you understand how serious this disease is.
Prevention: prevention of ARVI, especially in children with allergic diathesis.

It should be noted that difficulty breathing due to laryngeal stenosis occurs not only with viral infections. The cause of stenosis can also be diphtheria (the so-called true croup, when diphtheria films formed on the mucous membrane of the larynx sharply narrow its lumen), a foreign body, allergic edema, laryngospasm (with a decrease in the level of calcium in the blood), etc. Therefore, only a doctor can determine the real reason difficulty breathing, correctly assess the patient’s condition and determine treatment tactics.

How to prevent croup?

Unfortunately, croup is a viral disease, therefore, antibiotics do not work for it, therefore, their prescription is not justified, as with other viral infections. Try to ensure that your child does not come into contact with patients who have any viral infections, follow the basic rules of hygiene, if there is a sick person in the house, if a child has an acute respiratory viral infection, try to give him water as often as possible. Don't use aromatic oils as inhalations, because they can cause severe irritation to a child's respiratory tract. Do not smoke near your child, especially around a child who has a respiratory illness.

False croup is a disease that most often affects children, and it manifests itself with many signs that are quite easily confused with other ailments. The consequences of the disease can be quite complex, so parents should remember that a lot depends on them - timely contact with a doctor will help to begin treatment immediately. How does false croup manifest itself in children, its symptoms and treatment? dangerous disease, features and unpleasant consequences– it’s better to study everything in advance so as not to be caught off guard.

Symptoms of false croup that should prompt immediate medical attention

Questions that parents often have are what false croup is in children, the symptoms and treatment of this disease, how dangerous it is for the child and whether it will cause irreversible processes in the small body. The first thing you need to know is that this disease is quite serious, and if left untreated, it can lead to dangerous consequences for the baby’s health. This is why it is so important to start treatment as early as possible - the chances of a successful recovery increase several times.

Symptoms of the disease that parents should pay attention to:

1. night coughing attacks accompanied by shortness of breath, difficulty breathing;
2. sputum is practically not coughed up, which often leads to injuries to the respiratory tract; blood may be seen in the scanty mucus released;
3. hoarseness of voice appears;
4. often coughing attacks turn into severe vomiting;
5. the child’s skin turns pale, fingertips and lips acquire a threatening blue tint;
6. temperature rises;
7. the baby is worried about a runny nose, severe pain in the throat.

Already the first signs of the disease should be a reason to go to the doctor - it is strictly not recommended to start treatment on your own.

Treatment of false croup in children with pharmaceutical drugs

It is better to learn from a doctor about how false croup develops in children, the symptoms and treatment of the disease, and what can threaten the baby, who should be contacted at the first signs of the disease. In the presence of complications, treatment should be carried out only in medical institution, under the supervision of specialists. Usually a complex effect on the disease is prescribed - a combination of several drugs.

Treatment of false croup in children is carried out with the following formulations:

1. Suprastin, Tavegil (antihistamines);
2. inhalations with naphthyzine to constrict blood vessels;
3. diuretics;
4. Pulmicort (hormonal medicine);
5. Algirem, Arbidol (antibacterial drugs).

To quickly remove mucus and reduce the intensity of cough attacks, it is likely that the doctor will prescribe antitussive drugs - Ambrobene, Lazolvan. Regardless of which particular remedy was prescribed, the dosage, duration of treatment and number of doses per day are determined only by the doctor. It is strictly not recommended to independently increase or decrease intake or replace medications with analogues.

False croup, treatment at home

If a doctor diagnoses false croup during examination, start treatment at home only with his permission, if complete absence complications. Typically used here pharmaceutical drugs or herbal compositions against cough, which is the main sign of the disease and brings the most suffering to the baby.

Can be used to treat cough pharmaceutical compositions, but you can successfully cope with the disease sparing traditional methods. For these purposes, you can use a milk-based product that actively causes expectoration. If the last dose of the composition is taken just before bedtime, the child will sleep peacefully throughout the night, without debilitating anxiety attacks.

Preparation:

1. Bring milk to a boil (200-220 ml).
2. Remove from the stove, put baking soda (15 g) and a small piece of butter (20 g) into the hot liquid.
3. Stir the product until smooth.

The baby should drink this remedy in one go. You can give it to your child at least 3 times a day; the next day, expectoration will be more active.

How to help a child if false croup develops, Komarovsky

Often, parents who are caught by surprise begin to panic, not knowing how to alleviate the baby’s condition. There are several recommendations on how to reduce the intensity of the main signs that distinguish false croup; Komarovsky advises doing this:

1. ensure an influx of fresh cool air(open the windows, take the baby out onto the balcony or street);
2. let steam into the bathroom and let the child breathe moist air;
3. hold the baby's legs and arms under warm water, allowing them to warm up;
4. place mustard plasters on the soles of the feet to allow blood to flow out of the larynx and reduce swelling;
5. drip any vasoconstrictor into the nose;
6. Give the child a little milk with alkaline mineral water or soda.

Another important rule- If nocturnal attack does not lose its intensity, immediately call emergency help.

Treatment of true croup, how it happens, what is best to use

True croup is one of the most serious diseases that most often affects children, and treatment of this disease is possible only in a hospital. In no case should you begin to treat alarming signs on your own if the doctor has determined this particular diagnosis - treatment of true croup should be carried out comprehensively, and not always by taking medications. Most often, additional therapy is used to successfully combat the disease.

Treatment of the disease occurs with the following drugs:

1. anti-diphtheria serum (injected into a vein or muscle, depending on the stage of development of the disease);
2. detoxification compounds (if the disease develops rapidly, plasmapheresis may be used);
3. antiallergic medications;
4. cardiovascular drugs.

Treatment may vary slightly; everything depends on the development of the disease and the characteristics of the small organism. If the stenosis of the larynx is too obvious, it is possible to perform an operation during which the larynx is dissected and a special tube is inserted to allow the child to breathe.

Treatment of diphtheria croup - how it happens, what is used

Diphtheria croup – serious disease which, if left untreated, can lead to fatal consequences. That is why it is so important not only to consult a doctor in a timely manner, but also not to attempt treatment on your own. diphtheria croup– the consequences of this can be too severe.

Treatment should be carried out only in a hospital - the child is contagious, so he should be isolated from others. If there are no complications, the baby is given anti-diphtheria serum, which significantly alleviates the baby’s condition. Simultaneously with the administration of the composition, it is possible to take antihistamines. The length of a child’s stay in the hospital depends on the degree of development of the disease; if treatment was undertaken on time and took place without dangerous manifestations, then a complete recovery will take a little time.