• Chronic tonsillitis in the acute stage, tonsillitis. 10 days: Echinacea 1-2 capsules 3 times a day with meals + Colloidal Silver gargle 2-3 times a day 1 teaspoon per 1 glass of water. 10 days: PPP, Garlic 1 capsule 2 times a day with meals + Tea Tree Oil gargle 2-3 times a day, 1-2 drops per 1 glass of water. 10 days: Bee Pollen Protective formula 2-4 capsules per day with meals + PPP, Garlic 1 capsule 2 times a day with meals, inhalation and rinsing according to condition

• Pharyngitis, laryngitis, acute tracheitis, acute bronchitis, whooping cough (cough) 1st month: Bres From 2 capsules 3 times a day with meals + Black walnut E-tea PChP, Garlic 1 capsule 3 times a day with meals + CC-A 2 capsules 2 times a day with meals. 3rd month: Black walnut 1 capsule 3 times a day with meals + Morinda

• Acute pneumonia (support during convalescence) and recovery after illness 1st month: PPP, Garlic 1 capsule 3 times a day with meals + Bee Pollen 1 capsule 2 times a day with meals or Protective formula 2-4 capsules a day with meals. 2nd month: Red clover Chlorophyll liquid 1 teaspoon per 1 glass of water 2 times a day with meals. 3rd month: Liquid chlorophyll 1 teaspoon per 1 glass of water 2 times a day + Po D'Arco Colloidal minerals 1 time per day 1 teaspoon with one glass of water.

• COPD in the acute stage of pneumosclerosis, emphysema, bronchiectasis 1st month: Po D'Arco 2 capsules 2 times a day with meals + Black walnut 1 capsule 3 times a day with meals. 2nd month: Bres From 2 capsules 2 times a day with meals + Black walnut 1 capsule 3 times a day with meals. 3rd month: Black walnut 1 capsule 3 times a day with meals + Morinda 1 capsule 3 times a day with meals. For bronchospasm attacks, Complex with valerian, 1 capsule 3 times a day with meals.

• Bronchial asthma, chronic obstructive bronchitis, bronchospastic spasm 1st, 2nd and 3rd months: PPP, Garlic 1-2 capsules 2 times a day with meals + Black walnut 1 capsule 3 times a day with meals. For asthma attacks and bronchospasm, take the Complex with valerian 2 capsules at a time.

Liquorice root

Scientific name: licorice (Glycyrrhiza glabra), another name often used is licorice or licorice. It is licorice that is included in numerous pharmaceutical preparations such as mixtures, emulsions, pills, as well as infusions and tinctures.

The list of diseases for which you can resort to the help of licorice is actually very long.

Licorice glabra (legume family) is a perennial herbaceous plant 50-100 cm high. The stems are strong, erect, branched. The rhizome forms a multi-tiered underground network consisting of intertwining horizontal and vertical sections. The roots penetrate to a depth of 7-8 meters, reaching the groundwater level. You should pay attention to this! The deeper the root system penetrates, the richer the plant is, primarily in mineral composition. An analogy can be drawn with alfalfa and morinda. We are used to calling ginseng the most valuable plant of the East, but this is just a “promoted” trademark. In traditional texts, this root is given no more attention than other medicinal plants. But licorice root is found very often in ancient recipes of oriental medicine. It was licorice that was the primary medicinal drug.

The roots and rhizomes of licorice are used for medicinal purposes. Licorice roots contain a variety of biologically active substances: glucose, fructose, sucrose, maltose, starch, mannitol, polysaccharides, cellulose; organic acids, triterpene saponins, steroids, phenolcarboxylic acids (including salicylic acid), coumarins, flavonoids (glabrene, quercetin, kaempferol, apigenin, etc.). It is not yet possible to say exactly what makes licorice work. It often makes no sense to isolate any one active component from any plant material, since a combination of natural organic compounds works most effectively. Licorice root contains a unique natural compound that tastes sweet called glycyrrhizin.

Research has shown that glycyrrhizin is a potassium and calcium salt of tribasic glycyrrhizic acid (GLA), which is a saponin, i.e. a substance that can produce abundant foam. Under the influence of acids, glycyrrhizin breaks down into glucuronic and glycyrrhizic acids. When scientists deciphered the structure of GLA, it turned out that it was very similar to the structure of the molecule of hormones produced by the adrenal cortex (cortisone, etc.). Therefore, licorice has a corticosteroid-like effect, on which its anti-inflammatory effect largely depends.

• But with all the advantages of this herb, there is one property that patients with hypertension need to take into account. This is an increase in blood pressure with long-term use of large doses of licorice.
• In addition, clinicians should note that licorice, a mineralocorticoid, removes potassium from the body, and consultation with a physician is required before prescribing licorice, especially in people using diuretics.
• Licorice has a weak estrogen-like effect, so it is not recommended for pregnant women.

In general, the positive qualities of the drug manifest themselves well with short courses of treatment of up to 2-3 weeks. Its use over a longer period of time and in large doses requires medical supervision.

The main target for treatment with licorice is the bronchopulmonary system.

Licorice is a very strong expectorant. It is especially effective when the cough is just beginning.

In folk medicine, “herbalists” recommend taking licorice twice: at sunset and closer to midnight.
Licorice dramatically increases the volume of mucus secreted. And mucus in the lungs is the main evacuator of germs. Tracheobronchial secretion consists of substances produced by mucous and serous cells under the mucous glands and goblet cells. In addition to mucus, the tracheobronchial secretion includes plasma components, immunoglobulins, products of degeneration and decay of its own cells and microorganisms
An important component of the secretion is alveolocyte surfactant. There is no surfactant in translation; in English it means a surfactant. Pulmonary surfactant is a unique natural complex of phospholipids and specific proteins.

Glycyrrhizin and foam-forming substances of licorice root - saponins - help to increase the secretory function of the epithelium of the respiratory tract, change the surface-active properties of pulmonary surfactant and exhibit a stimulating effect on the function of epithelial cilia. Under the influence of licorice preparations, sputum thins and coughing becomes easier. But the means of restoring surfactant are, first of all, lecithin and Omega-3, the use of which should be recommended from the first days of the disease and continued after recovery, as well as during the period of clinical observation (several weeks). In severe forms of pulmonary pathology, which include pneumonia and chronic obstructive pulmonary diseases (COPD), such as nonspecific bronchitis, chronic bronchitis, emphysema, bronchial asthma, it is recommended to prescribe cordyceps along with licorice.

A special feature of “Licorice root” (Eicorice root) from Nature's Sunshine Products is that licorice undergoes a special enrichment method (concentrating plant extracts and enhancing their effect). It is a concentrated product, containing 4 times more active substances in 1 capsule, than in regular licorice root.

• It has anti-inflammatory properties and has a corticosteroid-like effect.
• Maintains the normal functional state of the mucous membrane of the gastrointestinal tract and bronchi, increases the production of protective mucus.
• Reduces spasm of smooth muscles of the bronchi, intestinal wall, and bile ducts.
• Has an estrogen-like effect.

In folk medicine, licorice root was used without restrictions. But theoretically, if there are heart rhythm disturbances or serious disturbances in water and electrolyte balance, you should refrain from taking licorice. Licorice does not contain hormones, although it enhances the activity of corticosteroid hormones, which have an anti-inflammatory effect. But the task of natural compounds is not just to suppress inflammation, but to mobilize all the body’s defenses. Licorice helps to mobilize and stimulate all the body's defenses.

Ingredients: 1 capsule: Licorice root concentrate (Glycyrrhiza glabra) 410 mg

Contraindications: individual intolerance to product components, pregnancy, breastfeeding, hypertension, liver cirrhosis, liver failure, potassium deficiency in the blood, water-salt metabolism disorders. Despite these limitations, the drug is very well tolerated by children, also due to its natural sweet taste.

We are talking about patients with chronic inflammatory diseases of the lungs and bronchi. Diseases united by this term (chronic obstructive pulmonary disease, chronic bronchitis, bronchiectasis, pneumonia, etc.) last a long time and require maximum attention, since they are unpleasant due to repeated exacerbations and are fraught with a gradual worsening of secondary changes in the lungs. It is about exacerbations that we will talk about. Exacerbations always turn out to be the starting point in the progression of the entire pathological process.

To some extent, the first person, not the doctor, but the patient himself, if he has been suffering from a chronic process for a long time, is called upon to determine the onset of an exacerbation, knowing the sensations from previous periods of deterioration. Typically, the signal is gradually emerging signs of intoxication (fatigue, weakness, loss of appetite, sweating), increased cough and shortness of breath (especially in obstructive conditions - with wheezing when breathing), a change in the nature of sputum (from purely mucous it turns into opaque with a yellowish or greenish shade). Unfortunately, body temperature does not always rise. You need to study yourself so that in case of an exacerbation, you begin therapy not in the morning or evening of the next day after examination by a therapist or pulmonologist, but immediately.

The regime during exacerbations is not strictly bed rest, that is, you can walk, do light household chores (if there is no excessive weakness), but it is advisable to stay close to the bed and lie down periodically. Going to work or school is strictly prohibited.

Appetite is reduced, so nutrition should be as complete as possible, containing more proteins, easily digestible fats (sour cream, vegetable oils), and vitamins. An extremely important recommendation is to drink a lot, unless there are serious contraindications to this (a sharp increase in blood or eye pressure, severe heart or kidney failure). Intensive water exchange helps remove bacterial toxins from the body and facilitates the separation of sputum.

One of the most important points in treatment is adequate sputum drainage. Sputum should be actively coughed up from different positions (“positional drainage”), especially from those that provide the best drainage. You need to stay in each new position for a while, and then try to clear your throat. First they lie on their back, then turn on their side, then on their stomach, on the other side, and so on, in a circle, making a quarter turn each time. Last position: lying on the edge of the bed, on your stomach with your shoulder lowered below the level of the bed (“as if you were reaching for a slipper”). This is done several times a day. What is coughed up should always be spat out.

Expectorants make sputum more liquid, but they should not be used indiscriminately. All expectorants have nuances in their mechanism of action, so they must be prescribed by a doctor. Everyone knows expectorant herbs (coltsfoot, thyme, thermopsis, as well as herbal preparations - bronchicum, doctor mom cough syrup etc.) act reflexively, irritating the gastric mucosa, and for chronic processes in the bronchi they have no practical significance - they should not be used, and for peptic ulcers they are contraindicated.

For obstructive bronchitis (bronchitis that occurs with a narrowing of the bronchi - popularly known as “bronchitis with an asthmatic component”), during exacerbations, doctors usually prescribe bronchodilators. These are aerosols that relieve suffocation. Necessary warning: there are old bronchodilators containing ephedrine(For example, broncholitin, solutan) - such drugs are strictly contraindicated for hypertension and heart disease.

Every patient with chronic bronchitis should have an electric compressor-type inhaler - a nebulizer (the compressor supplies a pulsating stream of air, which forms an aerosol cloud of a medicinal solution). During exacerbations, such a device is indispensable. Inhalations are carried out in the morning and in the evening (you cannot do inhalations using means not intended for this purpose, for example, mineral waters, homemade herbal decoctions; use plain boiled water to dilute solutions!). Inhalation should be followed by positional drainage, since the solutions used for inhalation effectively dilute sputum.

The problem of antibacterial therapy for chronic processes in the lungs is very complex. On the one hand, the decision to prescribe an antibiotic must be made by the doctor. On the other hand, a quick recovery can only be determined by the fastest possible start of therapy with the appropriate drug. In the interests of the patient, we have to deviate from the rules and give the following recommendation: for a patient suffering from chronic bronchitis and aware of his disease, it makes sense to have at home a package of a reliable antibacterial agent (the doctor will tell you which one) with a good shelf life and start taking it as soon as signs of exacerbation will appear. Most likely, the sick person, having taken the first antibiotic tablet, will do the right thing, since the onset of an exacerbation in itself indicates that the body has taken a step back in its resistance to microbes, and it needs help.

Indeed, the occurrence of an exacerbation is a breakdown of the body’s immune defense. The reasons can be very different, including hypothermia, stressful situations, the beginning of flowering of plants to which there is an allergy, etc. A very common option is the aggravation of a chronic process in response to a respiratory viral infection. In this regard, reasonable preventive measures will not hurt, for example, warmer clothes in the cold season, avoiding long waits for transport in the cold, having an umbrella in case of rain, a huge cup of hot tea with honey after hypothermia, etc. A viral attack can be partly prevented by limiting contact with other people (especially those already infected). During epidemics, all Japanese wear gauze masks even on the street - they reject complexes and do the very right thing: prevention is expensive. Masks are now available and can be purchased at every pharmacy. Wear a mask at least at work, and answer puzzled questions and looks that you have a slight runny nose.

There is no need to “stimulate the immune system” with medications. This is unattainable and can be harmful. It would be nice not to do any harm! Warmth can enhance protection against germs. An increase in body temperature, if it is not excessive (no more than 38.5-39 o C), is a factor that ensures the most active interaction of the elements of immunity. Even if the patient feels unwell, but does not have a painful headache, it is advisable to refrain from taking antipyretics and painkillers. The bad practice of taking cold medicine “3 times a day” increases the recovery time for a previously healthy person during a viral infection and contributes to the development of complications, and inevitably leads to an exacerbation in a patient with chronic bronchitis. Moreover, with a sluggish infection and a very weak temperature reaction, repeated, for example in the evenings, moderately hot baths or showers will contribute to recovery. Hot baths are contraindicated for older people; for those who do not tolerate them well at all or suffer from hypertension, heart disease, or cerebral atherosclerosis. You can limit yourself to a warm water procedure. After it - tea with honey or jam.

All questions regarding further measures in the treatment of a particular patient are, of course, called upon to be resolved by the doctor. After the exacerbation subsides, the problem of preventing a new one arises, and therefore it is necessary to pay more attention to your health. Hardening and regular adequate physical activity have a good effect. Preventive inhalations using a home nebulizer are very useful. They are done from time to time (especially when there is a feeling of sputum retention); It is enough to use a physiological solution of sodium chloride and cough well after inhalation. For a person suffering from chronic bronchitis, it is very important to avoid influences that irritate the mucous membrane of the bronchial tree. If possible, it is necessary to reduce the impact of air pollutants (dust, exhaust gases, chemical reagents, including household chemicals). It is recommended to wear a respirator when performing repair work, refrain from performing painting work yourself, avoid exercising near highways, standing in traffic jams, etc. It is useful to use air humidifiers at home and in the office, especially in winter and when the air conditioner is running.

We have to raise the issue of smoking. From a logical point of view, a smoking patient suffering from chronic respiratory diseases is an unnatural phenomenon, but... terribly common. Smoking, harmful to everyone, is three times dangerous for our patient, as it provokes exacerbations and accelerates the progression of secondary changes in the lungs, which inevitably lead to respiratory failure. At first, this is not obvious to a person, but when shortness of breath begins to torment even at rest, it will be too late. It is necessary to point out that you should not quit smoking during an exacerbation, as this may complicate the discharge of sputum. However, as soon as there is an improvement, quit smoking!

Respiratory allergies are common allergic diseases with predominant damage to the respiratory system.

Etiology

Allergoses develop as a result of sensitization by endogenous and exogenous allergens.

Exogenous allergens of non-infectious nature include: household - washing powders, household chemicals; epidermal - wool, skin scales of domestic animals; pollen - pollen of various plants; food – food products; herbal, medicinal. Allergens of an infectious nature include bacterial, fungal, viral, etc.

Classification

The classification is as follows.

1. Allergic rhinitis or rhinosinusitis.

2. Allergic laryngitis, pharyngitis.

3. Allergic tracheitis.

4. Allergic bronchitis.

5. Eosinophilic pulmonary infiltrate.

6. Bronchial asthma.

Symptoms and diagnosis

Allergic rhinitis and rhinosinusitis. History – the presence of allergic diseases in the parents and close relatives of the child, the connection of diseases with allergens.

Symptomatically manifested by an acute onset: the sudden onset of severe itching, burning in the nose, bouts of sneezing, copious liquid, often foamy discharge from the nose.

Upon examination, swelling of the mucous membrane of the nasal septum, inferior and middle turbinates is revealed. The mucous membrane has a pale gray color with a bluish tint, the surface is shiny with a marble pattern.

X-ray examination shows thickening of the mucous membrane of the maxillary and frontal sinuses and the ethmoidal labyrinth on photographs of the skull.

Positive skin tests with infectious and non-infectious allergens are characteristic.

Laboratory diagnosis revealed an increase in the level of immunoglobulin E in nasal secretions.

Allergic laryngitis and pharyngitis can occur in the form of laryngotracheitis.

Characterized by an acute onset, dryness of the mucous membrane, a feeling of soreness, soreness in the throat, attacks of dry cough, which later becomes “barking”, rough, hoarseness appears, up to aphonia.

With the development of stenosis, inspiratory shortness of breath appears, the participation of auxiliary muscles in the act of breathing, retraction of the pliable parts of the chest, flaring of the wings of the nose, and abdominal breathing acquires greater intensity and amplitude.

Obstruction of the bronchi develops due to edema, spasm and exudate and, as a consequence, obstructive ventilation failure.

The use of antibacterial agents does not have a positive effect, and the condition may even worsen.

Laboratory data - positive skin tests, increased levels of immunoglobulin E in the blood serum.

Allergic bronchitis occurs in the form of asthmatic bronchitis.

The anamnesis contains evidence of allergization of the body. Unlike true bronchial asthma, asthmatic bronchitis develops spasm of large and medium-caliber bronchi, so asthma attacks do not occur.

Eosinophilic pulmonary infiltrate develops with sensitization of the body.

The most common cause is ascariasis. In a general blood test, high eosinophilia (more than 10%) appears against the background of leukocytosis. Foci of infiltration appear in the lungs, homogeneous, without clear boundaries, which disappear without a trace after 1–3 weeks. Sometimes an infiltrate, having disappeared in one place, may appear in another.

2. Bronchial asthma

Bronchial asthma– an infectious-allergic or allergic disease of a chronic course with periodically recurring attacks of suffocation caused by impaired bronchial obstruction as a result of bronchospasm, swelling of the bronchial mucosa and accumulation of viscous sputum.

Bronchial asthma is a serious health problem worldwide. It affects 5 to 7% of the Russian population. There is an increase in morbidity and mortality.

Classification (A.D. Ado and P.K. Bulatova, 1969)

1) atopic;

2) infectious-allergic;

3) mixed. Type:

1) asthmatic bronchitis;

2) bronchial asthma. Gravity:

1) mild degree:

a) intermittent: attacks of bronchial asthma less than twice a week, exacerbations are short, from several hours to several days. Attacks occur rarely at night - twice or less per month;

b) persistent: attacks do not occur every day, no more than two per week.

At night, symptoms of bronchial asthma are observed more than twice a month;

2) moderate degree - manifests itself every day, requires daily use of bronchodilators. Night attacks occur more than once a week;

3) severe degree - bronchial obstruction, expressed to varying degrees constantly, physical activity is limited.

The main link in the pathogenesis of bronchial asthma is the development of sensitization of the body to a particular allergen with the occurrence of allergic inflammation in the mucous membrane of the bronchial tree.

When collecting anamnesis from a patient, it is necessary to establish the nature of the first attack, place and time of year, duration and frequency of attacks, the effectiveness of the therapy, and the patient’s condition during the non-attack period.

Pathogenesis

The main link in the pathogenesis of bronchial asthma is the development of sensitization of the body to a particular allergen and the occurrence of allergic inflammation.

Clinic

The main symptom is the presence of attacks of expiratory type suffocation with distant wheezing and paroxysmal cough. The forced position of the patient during an attack: the legs are lowered down, the patient is sitting on the bed, the body is tilted forward, and his hands are resting on the bed on either side of the body.

Symptoms of respiratory failure appear (participation of auxiliary muscles in the act of breathing, retraction of intercostal spaces, cyanosis of the nasolabial triangle, shortness of breath). The chest is emphysematously distended, barrel-shaped.

Percussion-box sound, the boundaries of the lungs shift downward. Auscultation - weakened breathing (short inhalation, long exhalation), an abundance of dry wheezing, moist rales of various sizes. From the cardiovascular system - narrowing of the boundaries of absolute cardiac dullness, tachycardia, increased blood pressure.

On the part of the nervous system, increased nervous excitability or lethargy, changes in autonomic reactions (sweating, paresthesia) appear.

Laboratory diagnostics

The general blood history includes lymphocytosis and eosinophilia. In the general analysis of sputum - eosinophilia, epithelial cells, macrophages, or Charcot-Leiden crystals, and Kurshman spirals.

Instrumental research methods. X-ray shows pulmonary emphysema (increased transparency, the borders of the lungs are shifted downwards). Spirography: decreased expiratory flow (pneumotachometry), decreased vital capacity, hyperventilation at rest.

Allergy examination. Skin testing with bacterial and non-bacterial allergens gives a positive result. Provocative tests with allergens are also positive.

Immunological indicators. In atopic bronchial asthma, the level of immunoglobulins A decreases and the content of immunoglobulins E increases; in mixed and infectious asthma, the level of immunoglobulins G and A increases.

In the atopic form, the number of T-lymphocytes decreases, in the infectious-allergic form it increases.

In the atopic form, the number of suppressors is reduced and the content of T-helper cells is increased. When sensitized by fungal agents, the level of CEC increases.

Patient examination

Interview (collection of medical history, complaints). Inspection (palpation, percussion, auscultation). General blood analysis. Microscopy and sputum culture.

X-ray of the chest organs. Study of external respiration parameters. Allergological, immunological examination.

Differential diagnosis

Differential diagnosis of bronchial asthma is carried out with diseases manifested by bronchospastic syndrome of non-allergic nature, which are called “syndromic asthma”; chronic obstructive bronchitis, diseases of the cardiovascular system with left ventricular failure (cardiac asthma), hysteroid breathing disorders (hysteroid asthma), mechanical blockage of the upper respiratory tract (obstructive asthma).

Differentiate with diseases of an allergic nature: polyposis, allergic bronchopulmonary aspergillosis with obstructive respiratory disorders.

It is necessary to take into account the presence of a combination of two or more diseases in the patient.

Unlike bronchial asthma, in chronic obstructive bronchitis, the obstructive syndrome persists and does not develop reversely even when treated with hormonal drugs, and there is no eosinophilia in the sputum analysis.

With left ventricular failure, cardiac asthma may develop, which is manifested by an attack of shortness of breath at night; the feeling of lack of air and tightness in the chest develops into suffocation.

Combined with arrhythmia and tachycardia (with bronchial asthma, bradycardia is more common). Unlike bronchial asthma, both phases of breathing are difficult. An attack of cardiac asthma can be prolonged (before the use of diuretics or neuroglycerin).

Hysteroid asthma has three forms. The first form is similar to a respiratory spasm. Breathing of a “driven dog” - inhalation and exhalation are intensified. There are no pathological signs on physical examination.

The second form of suffocation is observed in hysterical people and is caused by impaired contraction of the diaphragm. During an attack, breathing is difficult or impossible, and there is a feeling of pain in the solar plexus area.

To stop the attack, the patient is offered to inhale hot water vapor or given anesthesia.

Obstructive asthma is a symptom complex of suffocation, which is based on a violation of the patency of the upper respiratory tract.

The cause of obstruction may be tumors, foreign bodies, stenosis, or aortic aneurysm. The greatest importance in making a diagnosis belongs to tomographic examination of the chest and bronchoscopy.

The combination of symptoms of shortness of breath and suffocation also occurs in other conditions (anemic, uremic, cerebral asthma, periarthritis nodosa, carcinoid syndrome).

Hay fever, or hay fever, is an independent allergic disease in which the body becomes sensitized to plant pollen.

These diseases are characterized by: bronchospasm, rhinorrhea and conjunctivitis. Seasonality of diseases is characteristic. It begins with the flowering period of plants and decreases when it ends.

The exacerbation stage is characterized by a persistent runny nose, pain in the eyes and lacrimation, coughing until an attack of suffocation develops.

Possible fever and arthralgia. A general blood test shows eosinophilia (up to 20%). During the period of remission there is no clinical manifestation.

Allergic bronchopulmonary aspergillosis– a disease caused by sensitization of the body to Asperginel fungi. With this disease, damage to the alveoli, blood vessels of the lungs, bronchi, and other organs is possible.

The clinical sign is the symptom complex of bronchial asthma (obstructive syndrome, eosinophilia, increased immunoglobulin E).

Confirmation of the diagnosis is carried out by identifying skin sensitization to aspergillus allergens.

An example of a diagnosis. Bronchial asthma, atopic form, with frequent relapses, period of remission, uncomplicated.

Treatment

The goal of treatment is to prevent the occurrence of attacks of suffocation, shortness of breath during physical activity, cough, and nocturnal breathing difficulties. Elimination of bronchial obstruction. Maintaining normal lung function.

Objectives of the therapy:

1) stop exposing the body to the allergen - the cause of the disease. In case of pollen allergy, the patient is asked to move to another area during the flowering period of the plants. In case of occupational allergies, change the place and working conditions. For food – strict adherence to an elementary diet;

2) carry out specific desensitization followed by the production of blocking antibodies (immunoglobulins G);

3) stabilize the walls of mast cells and prevent the secretion of biologically active substances;

4) limit the impact of irritants on the respiratory tract - cold air, strong odors, tobacco smoke;

5) rehabilitation of chronic foci of infection (teeth with inflammation, sinusitis, rhinitis);

6) limit developing allergic inflammation by prescribing glucocorticoids in inhaled form;

7) prevent taking non-steroidal anti-inflammatory drugs.

Principles of treatment.

1. Elimination of the allergen (exclusion, elimination).

2. Bronchospasm therapy:

1) selective β-adrenergic agonists (Berotec, salbutalone, Ventosin, terbutamol, phenotyrol, guoetarin);

2) non-selective adrenergic agonists (adrenaline, ephedrine, asthmapent, fulprenaline, isadrin, euspiran, novodrin);

3) phosphodiesterase antagonists, xanthines (theobramines, theophylline, euphylkin);

4) anticholinergics (atropine, ipratropine).

3. Histamine H2 receptor blockers (tavegil, fenkarol, suprastin, atosinil, pipolfen, displeron).

4. Drugs that reduce bronchial reactivity (glucocorticoids, intal, betotifen).

5. Expectorants:

1) increasing the liquid phase of sputum (thermopsis, licorice root, marshmallow, potassium iodide, alkyonium chloride);

2) mucolytic drugs (acetylcysteine ​​(ACC)), ribonuclease, deoxyribonuclease);

3) drugs that combine a mucoliptic effect with an increase in the level of surfactant (bromgesin, ambrocagn, lazolvan).

6. Antibiotics.

7. Vibration massage with postural drainage.

8. Physiotherapeutic procedures, reflexology (acupuncture, oxygen therapy).

9. Bronchoscopy, intranasal tracheobronchial sanitation.

10. Rehabilitation in the gnotobiological department.

11. Sauna therapy.

3. Acute bronchitis

Bronchitis is a disease of the bronchi, accompanied by gradually developing inflammation of the mucous membrane with subsequent involvement of the deep layers of the walls of the bronchi.

Etiology

More often it develops with the activation and reproduction of the opportunistic flora of the body itself with a violation of mucocilar clearance due to ARVI.

Predisposing factors are cooling or sudden heating, polluted air, smoking.

Pathogens: viruses, bacteria, mixtures, allergens.

Classification:

1) acute bronchitis (simple);

2) acute obstructive bronchitis (with symptoms of bronchospasm);

3) acute bronchiolitis (with respiratory failure);

4) recurrent bronchitis.

Pathogenesis

Viruses, bacteria, mixtures or allergens multiply, damaging the bronchial epithelium, reducing barrier properties and causing inflammation, disruption of nerve conduction and trophism.

Narrowing of the bronchial passages occurs as a result of swelling of the mucous membrane, excess mucus in the bronchi and spasm of the smooth muscles of the bronchi.

Clinic

The current is wavy. By the end of the first week of illness, the cough becomes wet, the temperature returns to normal.

The main clinical symptom is cough with mucous or purulent sputum; low-grade fever, no symptoms of intoxication. Auscultation - dry and moist, medium-caliber wheezing sounds on exhalation, hard breathing are heard.

Wheezing is scattered and practically disappears after coughing. The general blood test revealed moderate hematological changes: increased ESR, monocytosis.

X-ray shows increased bronchovascular pattern, expansion of roots, symmetrical changes.

Acute obstructive bronchitis is characterized by shortness of breath on exertion; painful cough with scanty sputum.

Auscultation - lengthening of exhalation. With forced breathing - wheezing when exhaling. In the general blood test, hematological changes are most often leukopenia.

The X-ray shows pulmonary emphysema, increased transparency of the lung tissue, and expansion of the roots of the lungs.

Acute bronchiolitis (capillary bronchitis) is characterized by generalized obstructive damage to the bronchioles and small bronchi.

Pathogenesis is associated with the development of edema of the mucous wall of the bronchioles and papillary proliferation of their epithelium.

Clinically manifested by severe shortness of breath (up to 70–90 breaths per minute) against a background of persistent febrile temperature; increased nervous excitability associated with respiratory failure within a month after temperature normalization; perioral cyanosis; On auscultation, fine-bubbly, crepitating asymmetrical rales are heard. The cough is dry and high-pitched. The chest is distended.

In the general blood test - hematological changes: increased ESR, neutrophil shift, moderate leukocytosis.

The radiograph shows an alternation of areas of increased density with areas of normal pneumatization; low standing of the diaphragm, sometimes total darkening of the pulmonary field, atelectasis.

Recurrent bronchitis is diagnosed when there are three or more illnesses during the course of a year with a prolonged cough and auscultatory changes in bronchitis without an asthmatic component, but with a tendency to have a protracted course. This disease does not cause irreversible changes and sclerosis. The pathogenesis is due to a decrease in the barrier function of the bronchial mucosa to resist infections.

Predisposing factors: immunity defects, heredity, predisposition, polluted air, damage to the bronchial mucosa by exogenous factors, bronchial hyperreactivity. Recurrent bronchitis develops against the background of clinical signs of ARVI.

Moderate fever. The cough is initially dry, then wet, with mucous or mucopurulent sputum. Percussion-pulmonary sound with a boxy tint. Auscultation - hard breathing, dry, moist rales of medium and small caliber, scattered on both sides.

In the general blood test, hematological changes - leukocytosis or leukopenia, monocytosis.

The radiograph shows increased pulmonary pattern, expansion of the roots, atelectasis, hypoventilation. Bronchological examination - signs of bronchospasm, delayed filling of the bronchi with contrast, narrowing of the bronchi.

Survey plan

The patient's examination plan is as follows.

1. Collection of anamnesis (previous acute respiratory viral infections, premorbid background, concomitant diseases, frequency of acute respiratory viral infections, hereditary predisposition, allergies to anything, assessment of the effect of treatment).

2. Examination of the patient (assessment of cough, breathing, chest shape).

3. Palpation (presence of emphysema, atelectasis).

4. Percussion – mobility of the lungs during breathing, air filling.

5. Auscultation (vesicular, hard breathing, diffuse wheezing).

6. Blood test - increased ESR, shift in leukocyte formula.

7. General urine analysis.

8. Analysis of sputum from the nasopharyngeal mucosa with determination of sensitivity to antibiotics.

10. Study of the ventilation function of the lungs.

11. X-ray – study of the vascular and pulmonary patterns, the structure of the roots of the lungs.

12. Bronchoscopy and examination of the mucous membrane.

13. Tomography of the lungs.

14. Immunological study.

Differential diagnosis

Differential diagnosis is carried out with:

1) bronchopneumonia, which is characterized by local lung damage, intoxication, and a persistent increase in body temperature; X-ray changes characteristic of focal lesions;

2) bronchial asthma, which is accompanied by attacks of suffocation, hereditary predisposition, contact with an infectious allergen;

3) with congenital or acquired heart disease, which are characterized by congestion in the lungs. An example of a diagnosis. Acute infectious-allergic obstructive bronchitis DN 2.

Treatment

Treatment principles:

1) antibacterial therapy: antibiotics: ampicillin, tetracycline and others, sulfonamide drugs: sulfapyridazine, sulfomonolitaxin;

2) mucolytic drugs: acetylcysteine, bromhexine, trypsin, chymotrypsin;

3) expectorants: breast milk (coltsfoot, wild rosemary, marshmallow, elecampane), broncholithin;

4) bronchilitics: amupect, berotene;

5) endobroncholitin: aminophylline in aerosol;

6) vitamins B, A, C (cocarboxylase, biplex);

7) immunostimulants (immunal, timolin);

8) physiotherapy, massage, breathing exercises.

4. Respiratory failure

Respiratory failure is a pathological condition of the body, characterized by insufficient provision of blood gas composition, or it can be achieved using compensatory mechanisms of external respiration.

Etiology

There are five types of factors leading to impaired external respiration:

1) damage to the bronchi and respiratory structures of the lungs:

a) disturbance of the structure and function of the bronchial tree: increased tone of the smooth muscles of the bronchi (bronchospasm), edematous-inflammatory changes in the bronchial tree, damage to the supporting structures of the small bronchi, decreased tone of the large bronchi (hypotonic hypokinesia);

b) damage to the respiratory elements of the lung tissue (infiltration of the lung tissue, destruction of the lung tissue, dystrophy of the lung tissue, pneumosclerosis);

c) decrease in functioning lung tissue (underdeveloped lung, compression and atelectasis of the lung, absence of part of the lung tissue after surgery);

2) violation of the musculoskeletal framework of the chest and pleura (impaired mobility of the ribs and diaphragm, pleural adhesions);

3) violation of the respiratory muscles (central and peripheral paralysis of the respiratory muscles, degenerative-dystrophic changes in the respiratory muscles);

4) circulatory disorders in the pulmonary circulation (damage to the vascular bed of the lungs, spasm of the pulmonary arterioles, stagnation of blood in the pulmonary circulation);

5) violation of the control of the act of breathing (suppression of the respiratory center, respiratory neuroses, changes in local regulatory mechanisms).

Classification

1) ventilation;

2) alveolorespiratory.

Type of ventilation failure:

1) obstructive;

2) restrictive;

3) combined.

Degree of severity: DN I degree, DN II degree, DN III degree.

Obstructive ventilation failure is caused by a violation of the gas flow through the airways of the lungs as a result of a decrease in the lumen of the bronchial tree.

Restrictive ventilation failure is the result of processes that limit the compliance of lung tissue and a decrease in lung volumes. For example: pneumosclerosis, adhesions after pneumonia, lung resection, etc.

Combined ventilation failure occurs as a result of a combination of restrictive and obstructive changes.

Alveolorespiratory insufficiency develops as a result of impaired pulmonary gas exchange due to a decrease in the diffusion capacity of the lungs, uneven distribution of ventilation and ventilation-perfusion deposits of the lungs.

Main stages of diagnosis

Respiratory failure stage I. Manifested by the development of shortness of breath without the participation of auxiliary muscles, it is absent at rest.

Cyanosis of the nasolabial triangle is unstable, increases with physical activity, anxiety, and disappears when breathing 40–50% oxygen. The face is pale, puffy. Patients are restless and irritable. Blood pressure is normal or slightly elevated.

External respiration indicators: minute respiratory volume (MRV) is increased, vital capacity (VC) is decreased, respiratory reserve (RR) is decreased, respiratory volume (VR) is slightly decreased, respiratory equivalent (RE) is increased, oxygen utilization factor (O2) is decreased . The gas composition of the blood at rest remains unchanged; blood saturation with oxygen is possible. The carbon dioxide tension in the blood is within normal limits (30–40 mm Hg). Violations of the CBS are not determined.

Respiratory failure stage II. Characterized by shortness of breath at rest, retraction of yielding areas of the chest (intercostal spaces, supraclavicular fossa), possibly with a predominance of inhalation or exhalation; P/D ratio 2 – 1.5:1, tachycardia.

Cyanosis of the nasolabial triangle, face, and hands does not disappear when inhaling 40–50% oxygen. Diffuse skin pallor, hyperhidrosis, pale nail beds. Blood pressure rises.

Periods of anxiety alternate with periods of weakness and lethargy, vital capacity is reduced by more than 25–30%. AP and RP reduced to 50%. DE is increased, which occurs due to a decrease in oxygen utilization in the lungs; blood gas composition, CBS: blood oxygen saturation corresponds to 70–85%, i.e., decreases to 60 mm Hg. Art. Normocapnia or hypercapnia above 45 mm Hg. Art. Respiratory or metabolic acidosis: pH 7.34 – 7.25 (normal 7.35 – 7.45), base deficiency (BE) is increased.

Respiratory failure stage III. Clinically manifested by severe shortness of breath, respiratory rate exceeds 150% of the norm, aperiodic breathing, bradypnea periodically occurs, asynchronous, paradoxical breathing.

There is a decrease or absence of breathing sounds during inspiration.

The P/D ratio changes: cyanosis becomes diffuse, generalized pallor is possible, marbling of the skin and mucous membranes, sticky sweat, and blood pressure is reduced. Consciousness and response to pain are sharply reduced, skeletal muscle tone is reduced. Cramps.

Precoma and coma. External respiration indicators: MOD is reduced, vital capacity and OD are reduced by more than 50%, RD is 0. Blood gas composition CBS: blood oxygen saturation is less than 70% (45 mm Hg).

Decompensated mixed acidosis develops: pH less than 7.2; VE is more than 6–8, hypercapnia is more than 79 mmHg. Art., the level of bicarbonates and buffer bases is reduced.

The examination plan includes:

1) survey and inspection;

2) objective examination (palpation, percussion, auscultation);

3) determination of CBS, partial pressure of O 2 and CO 2 in the blood;

4) study of external respiration parameters.

Differential diagnosis

Differential diagnosis of respiratory failure is carried out based on a comparison of clinical symptoms and indicators of external respiration and tissue respiration. If respiratory failure develops no more than stage II, it is necessary to find the cause of its development.

For example, in case of impaired alveolar patency, signs of depression of the central nervous system, impaired neuromuscular regulation of breathing and destructive processes are differentiated.

With the development of symptoms of obstruction, it is necessary to distinguish between diseases and conditions that cause high obstruction (acute stenosing laryngitis, tracheitis, allergic laryngeal edema, foreign body) and low obstruction (bronchitis, bronchiolitis, bronchial asthma attack and status asthmaticus. Circulatory failure with symptoms of stagnation in the pulmonary circle blood circulation).

An example of a diagnosis. Bronchopneumonia, complicated by cardiorespiratory syndrome, acute respiratory failure of the second degree, ventilation obstructive form.

Treatment principle:

1) creation of a microclimate (room ventilation, humidification, aeronization);

2) maintaining free patency of the airways (suction of mucus, bronchodilators, expectorants, breathing exercises, vibration massage with postural drainage);

3) oxygen therapy (through a mask, nasopharyngeal catheter, oxygen tent, mechanical ventilation, hyperbaric oxygenation);

4) spontaneous breathing under continuous positive pressure (CPBP);

5) normalization of pulmonary blood flow (aminophylline, pentamin, benzohexonium);

6) correction of CBS;

7) to improve the utilization of oxygen by tissues - glucose-vitamin-energy complex (glucose 10–20; ascorbic acid, cocarboxylase, riboflavin, ceichrome C, calcium pantothenate, union);

8) treatment of the underlying disease and accompanying pathological conditions.

5. Acute pneumonia

Pneumonia is an infectious lesion of the alveoli, accompanied by infiltration of inflammatory cells and exudation of the parenchyma in response to the introduction and proliferation of microorganisms into the usually sterile parts of the respiratory tract. One of the most common respiratory diseases; 3–5 cases per 1,000 people.

Etiology

The etiology of pneumonia may be due to:

1) bacterial flora (pneumococcus, streptococcus, staphylococcus, E. coli, Proteus, etc.);

2) mycoplasma;

4) fungi.

1) bacterial flora (pneumococcus, streptococcus, staphylococcus, Haemophilus influenzae, Friednender's bacillus, enterobacteria, Escherichia coli, Proteus);

2) mycoplasma;

3) influenza viruses, parainfluenza, herpes, respiratory sensitial, adenoviruses, etc.;

4) fungi.

Classification

1) focal bronchopneumonia;

2) segmental pneumonia;

3) interstitial pneumonia;

4) lobar pneumonia.

1) spicy;

2) protracted.

Severity is determined by the severity of clinical manifestations or complications:

1) uncomplicated;

2) complicated (cardiorespiratory, circulatory, extrapulmonary complications).

Diagnostic criteria. Anamnestic:

1) presence of respiratory diseases in the family (tuberculosis, bronchial asthma);

2) previous ARVI infections, adenoviral infection;

3) hypothermia.

Clinic

Complaints of cough, fever, weakness, sweating.

Signs of respiratory failure: moaning, rapid breathing, the number of breaths up to 60–80 breaths per minute, flaring of the wings of the nose, retraction of the pliable parts of the chest, irregular breathing rhythm, inhalation is longer than exhalation, cyanosis of the skin, nasolabial triangle is very pronounced, especially after physical activity ; gray complexion, pallor of the facial skin as a result of hypoxemia and hypercapnia, caused by the exclusion of a more or less significant part of the alveoli from participating in normal respiratory gas exchange.

It is characterized by intoxication syndrome: fever, weakness, adynamia or agitation, sometimes accompanied by convulsions, sleep disturbances, and decreased appetite.

Disorders of the cardiovascular system: muffled heart sounds, tachycardia, expansion of the borders of the heart, pulse filling is reduced, blood pressure is sometimes increased, emphasis of the second tone on the aorta. Slowing cardiac function in severe pneumonia is an ominous symptom.

Changes in the gastrointestinal tract develop due to a decrease in secretory and enzymatic activity: nausea, vomiting, flatulence due to impaired peristalsis, abdominal pain due to irritation of the lower intercostal nerves innervating the diaphragm, abdominal muscles and abdominal skin.

Objective changes in the lungs: functional data are expressed in segmental (polysegmental) and confluent pneumonia, less pronounced in focal pneumonia and bronchopneumonia.

Minimal changes in interstitial pneumonia. Examination and palpation of the chest reveals swelling, more in the anterior sections, tension, which is a characteristic sign of pulmonary enphysema.

During percussion, the percussion sound is mottled (dullness during percussion alternates with areas of tympanic sound); dullness of percussion sound in the lower posterior parts of the lungs is characteristic of confluent pneumonia.

There may be no changes on percussion due to the small size of the inflammatory focus.

During auscultation, breathing disturbances are heard: hard, puerile, weakened, moist wheezing, small, medium and large caliber, depending on the involvement of the bronchi in the inflammatory process; wheezing can be dry, of various types (wheezing, musical). With a deep location of inflammatory foci in the lungs, there may be no percussion and auscultation changes.

Research methods

X-ray examination: in the images, emphysematous changes are combined with foci of infiltration of the lung tissue. The entire segment of the lung may be affected, including the root on the affected side.

In the general blood test, hematological changes: in the peripheral blood, neutrophilic leukocytosis with a shift to the left, increased ESR. If the body's reactivity decreases, the indicators may be within normal limits.

Examination plan:

1) general blood and urine analysis;

2) biochemical study of blood serum (protein fractions, sialic acids, seromucoid, fibrin, LDH);

3) radiography of the chest organs in two projections;

5) blood test for immunoglobulins, T- and B-lymphocytes;

6) bacteriological examination of mucus from the nasopharynx, sputum with determination of the sensitivity of the isolated flora to antibacterial drugs;

7) assessment of the main indicators of external respiration;

8) study of pH and blood gas composition;

9) radiography of the paranasal sinuses according to indications (complaints of pain when tilting the head, palpation in the projection of the sinuses, nasal discharge).

Differential diagnosis

Differential diagnosis is carried out with bronchitis, bronchiolitis, acute respiratory viral infection, acute dissimilated pulmonary tuberculosis.

An example of a diagnosis. Focal bronchopneumonia is uncomplicated, acute.

Treatment

Treatment principle:

1) the patient is prescribed bed rest, aerotherapy, and a diet corresponding to the severity of the condition;

2) antibacterial drugs, antibiotics (semi-synthetic penicillins, aminoglycosides, cephalosporins), sulfonamide drugs (sulfadimezin, sulfalopanetaxine, biseptol), nitrofuran drugs (furagin, furadonin, furazolidone);

3) treatment of respiratory failure, elimination of obstructive syndrome (removal of mucus from the upper respiratory tract, expectorants and mucolytics, bronchodilators);

4) antihistamines (diphenhydramine, fenkarol, kistin, telfast);

5) increasing the patient’s immunological activity (immunoglobulin, dibazol, pentoxin, methyluracil, immunomodulators - immunal);

6) vitamin therapy.

6. Pleurisy

Pleurisy is an inflammation of the pleura, accompanied by tension in the function and structure of the pleural layers and altering the activity of the external respiratory system.

Etiology

The development of pleurisy may be associated with an infectious agent (staphylococcus, pneumococcus, tuberculosis pathogen, viruses, fungi); non-infectious effects - a complication of the underlying disease (rheumatism, systemic lupus erythematosus, pancreatitis).

Pleurisy may be of unknown etiology (idiopathic pleurisy).

Classification

The classification is as follows:

1) dry pleurisy (fibrous);

2) effusion pleurisy: serous, serous-fibrinous, purulent, hemorrhagic (depending on the nature of the exudate).

Diagnostic criteria

History of previous infectious diseases, pneumonia, inflammation of the paranasal sinuses; frequent hypothermia of the body; the presence in the family or close relatives of tuberculosis or other respiratory diseases.

Clinical signs of pleurisy include a painful, wet cough with a small amount of mucous sputum; the patient complains of pain in the chest (one half), which intensifies with breathing.

Respiratory failure syndrome appears: shortness of breath, pale skin, perioral cyanosis, which worsens with physical activity; acrocyanosis. Characterized by intoxication syndrome: fatigue, poor appetite, lethargy, adynamia.

An objective examination reveals asymmetry of signs: forced position of the child on the affected side with fixation of the diseased half of the chest.

The side with the source of inflammation looks smaller, lags behind in the act of breathing, the shoulder is lowered.

When exudate accumulates in the pleural cavity during percussion, there is a shortening of the percussion sound with an upper border that goes from the spine upward outward and to the inner edge of the scapula (Damoiso line).

This line and the spine limit the area of ​​clear pulmonary sound (Garland's triangle). On the healthy side of the chest there is a triangular area of ​​shortening of percussion sound (Grocco-Rauchfuss triangle).

Auscultation: with exudative pleurisy, a sharp weakening of breathing is heard or there is no opportunity to listen to it, with dry pleurisy - a pleural friction noise.

Additional research methods

The x-ray shows an oblique darkening of the diseased lung (fluid level), a shift of the mediastinum to the healthy side, and infiltrates in the lung tissue.

The blood test shows changes in the form of increased ESR, neutrophilic leukocytosis.

When examining the exudate of the pleural cavity, its nature is determined (serous, purulent, hemorrhagic), the specific gravity, the nature and number of formed elements, and the level of protein are determined.

Inflammatory exudate is characterized by: density greater than 1018, amount of protein more than 3%, positive Rivalta test. In a cytological examination of the sediment, neutrophils predominate at the beginning of the development of inflammation.

During development, the number of neutrophils increases and they can be destroyed. If eosinophils predominate in the sediment, then the patient has allergic pleurisy. Transudate is characterized by a sediment with a small amount of desquamated epithelium. In case of serous and hemorrhagic pleurisy, cultures on simple media do not give results.

Tuberculous pleurisy can be diagnosed by inoculation on a special medium or infection of guinea pigs. Research is complemented by biopsy and morphological studies of altered areas of the pleura during thoracoscopy. If there is exudate in the pleural cavity, bronchoscopy is indicated.

Examination plan:

1) biochemical, general blood and urine tests;

2) blood serum examination (protein, seromucoid, sialic acids, fibrinogen);

3) bacteriological studies of mucus from the throat and nose, sputum, fluid from the pleural cavity with determination of the sensitivity of the isolated flora to antibiotics;

4) study of immunological status with determination of T- and B-lymphocytes;

5) radiography of the chest organs in two projections in a vertical position;

6) pleural puncture;

7) tuberculin diagnostics.

Differential diagnosis

Differential diagnosis is carried out between pleurisy of various etiologies (rheumatic pleurisy, with systemic lupus erythematosus, leukemia, lymphogranulomatosis, hemophilia, kidney disease, liver cirrhosis, liver amebiasis, tumors, brucellosis, syphilis, mycosis), between effusion pleurisy and atelectasis of the lower lobe, lobar pneumonia .

Diagnosis example:

1) exudative pleurisy, purulent (pleural empyema, interlobar, pneumococcal);

2) dry pleurisy (fibrinous), effusion (purulent) pleurisy.

Treatment

Treatment principle:

1) elimination of pain syndrome;

2) influence on the cause that caused pleurisy (antibiotics, anti-inflammatory therapy);

3) therapeutic pleural punctures;

4) symptomatic therapy;

5) physiotherapy, exercise therapy.

7. Chronic nonspecific lung diseases

Chronic nonspecific lung diseases are a group of diseases with different etiologies and pathogenesis, characterized by damage to the lung tissue.

The classification is as follows:

1) chronic pneumonia;

2) malformations of the bronchopulmonary system;

3) hereditary lung diseases;

4) lung damage due to hereditary pathology;

5) bronchial asthma.

Chronic pneumonia is a chronic nonspecific bronchopulmonary process, which is based on irreversible structural changes in the form of bronchial deformation, pneumosclerosis in one or more segments and is accompanied by inflammation in the lung or bronchi.

Etiology

Most often, chronic pneumonia develops as a result of recurrent or prolonged pneumonia of staphylococcal nature, with destruction of the lungs.

Chronic secondary pneumonia is based on immunodeficiency states, foreign body aspiration, and malformations of the pulmonary system.

Classification

1) with deformation of the bronchi (without their expansion);

2) with bronchiectasis. Period of illness:

1) exacerbation;

2) remission.

The severity of the disease depends on the volume and nature of the lesion, the frequency and duration of exacerbations, and the presence of complications.

Clinic

Chronic pneumonia: history of repeated pneumonia with a protracted course and destruction of the lungs. Clinically manifested by a constant wet cough, intensifying during an exacerbation.

The sputum is mucopurulent, more often in the morning. Symptoms of intoxication are clearly expressed: pale skin, cyanosis of the nasolabial triangle, decreased appetite. Chronic heart and pulmonary failure syndrome; cyanosis, shortness of breath, tachycardia, nail phalanges in the form of “watch glasses” and “drumsticks”.

The chest is deformed - flattening, asymmetry in the act of breathing; percussion – shortening of sound over the affected area. Auscultation - bronchial amphoric, weakened breathing. The wheezes are varied, wet and dry.

Polycystic lung disease is characterized by a wet cough with purulent sputum, shortness of breath, bulging and retraction of individual parts of the chest. Percussion – shortening of sound over foci of inflammation. Auscultation – amphoric breathing, moist rales.

Lung damage in primary immunodeficiency conditions. Characteristic frequent acute respiratory viral infections, sinusitis, otitis, hepatolienal syndrome. Reduction of immunoglobulins of a certain class. In the general blood test there is lymphopenia; decrease in T- and B-lymphocytes.

Primary pulmonary hypertension. Clinical manifestations: cough may be absent, patients are severely exhausted, ECG shows right ventricular hypertrophy; X-ray shows expansion of the roots of the lungs, expansion of the branches of the pulmonary artery.

Kartagener syndrome is characterized by a triad of symptoms:

1) reverse arrangement of internal organs;

2) bronchiectasis;

3) sinusitis.

Percussion – shortening of sound over the lesion; Auscultation – wet rales. On the radiograph, the lung damage is diffuse, localized mostly in the basal segments.

Idiopathic pulmonary hemosiderosis is characterized by damage to the lungs and deposition of iron and anemia.

In the sputum there are macrophages with gynosiderin. There is an increased level of indirect bilirubin in the blood. The radiograph shows small cloud-like (1–2 cm) focal shadows, often symmetrical.

Pneumonia

Bronchial asthma

Acute respiratory diseases

Respiratory diseases vary in clinical manifestations and etiology. The pathological process is mainly localized in the airways, namely in the bronchi or trachea, pleura or lungs. Often, the disease affects several parts of the respiratory tract.

Let's consider the main symptoms of diseases of the bronchopulmonary system

Despite the fact that there are a lot of respiratory diseases, there are common symptoms, the correct identification of which is extremely important for making a diagnosis. These symptoms include: sputum production, cough, hemoptysis, chest pain, shortness of breath, malaise, fever, loss of appetite.

So, cough is one of the main symptoms of the disease, but it can also occur in healthy people. This is a so-called reflex protective act, that is, if a foreign body enters the body, it reflexively tries to get rid of it by coughing. Often, the cause of a cough can be the irritating effect of a large amount of mucus, which is formed under the influence of smoke, dust or gas that accumulates on the inner surface of the bronchi and trachea.

Diseases of the bronchopulmonary system - cough It can be wet, with sputum production, insignificant and rare - coughing, frequent and strong, leads to insomnia, accompanied by chest pain.

Throughout the course of the illness, the cough may change its character. For example, at the beginning of tuberculosis, the cough is almost unnoticeable; as the disease progresses, the cough intensifies and then becomes painful. The most important thing is to determine the type of cough, this will help make the correct diagnosis.

Diseases of the bronchopulmonary system - hemoptysis is considered a very serious symptom of respiratory disease. This manifests itself in the form of sputum with blood when coughing. This symptom can be caused by the following diseases: tuberculosis, cancer, abscess, this may be a sign of pulmonary myocardial infarction. Hemoptysis can also occur as a result of rupture of blood vessels with a very strong cough.

The blood that is released along with sputum when coughing is usually scarlet. This can also occur with fungal infection of the lungs (actinomycosis).

Diseases of the bronchopulmonary system - shortness of breath, also a serious symptom that reflects a dysfunction of external respiration during pathological processes. At the same time, shortness of breath can also be observed in such cases as diseases of the cardiovascular system and anemia. It should also be remembered that even in a healthy person, in certain situations deepening and increased breathing may occur, which is perceived as shortness of breath. This can occur with rapid movements, increased stress, nervous excitement, and elevated body temperature.

Shortness of breath is characterized by: disturbance of the frequency of depth and rhythm of breathing, acceleration of the work of the respiratory muscles. Shortness of breath is usually accompanied by a lack of air. There are inspiratory shortness of breath (difficulty in inhaling) and expiratory shortness of breath (difficulty in exhaling), and mixed (difficulty in both inhaling and exhaling at the same time).

Often, mixed shortness of breath is observed. It appears in diseases accompanied by a significant decrease in the respiratory surface of the lungs. Such shortness of breath can be temporary (with pneumonia) or permanent (with emphysema). Shortness of breath initially appears only during physical activity; as the disease progresses, it intensifies and becomes more frequent. This condition can be observed in patients with advanced tuberculosis and third stage cancer.

At diseases of the bronchopulmonary system Complaints of weakness, sweating at night, increased body temperature, and decreased performance are possible. Such complaints are mainly due to the phenomenon of intoxication.

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Acute respiratory diseases of the upper respiratory tract

Acute respiratory diseases, or acute respiratory infections, as they are commonly called for short, are the most common diseases of childhood. There are practically no children who do not suffer from acute respiratory infections. Sometimes children are extremely susceptible to these diseases; they can occur several times a year or even several times a month, separating the child from the team and parents from work.

Acute respiratory diseases (ARIs) are infectious and inflammatory diseases that occur with primary damage to the mucous membranes of the upper respiratory tract, that is, the nose, nasopharynx, larynx, paranasal sinuses, etc.

A viral infection is transmitted from a sick person to a healthy person through airborne droplets during talking, coughing, sneezing, or very close contact. The infection penetrates various parts of the upper respiratory tract. With the normal functioning of the barrier protective mechanisms of the nose, pharynx, larynx and bronchi, pathogens quickly die and the disease does not develop, however, if the protective mechanisms are insufficient or disrupted, the infection penetrates into the mucous membrane of the respiratory tract, which causes its damage and the development of an infectious-inflammatory process.

Causes of the disease. The cause of acute respiratory infections is often a variety of viruses - the smallest microorganisms. They are extremely widespread in the environment and can cause both isolated cases of disease in the most weakened children and epidemics when the majority of the child population begins to get sick. The most dangerous viruses for children are influenza viruses, parainfluenza, adenoviruses, respiratory syncytial viruses, etc. Acute respiratory infections can also be caused by bacteria, especially streptococci, pneumococci, etc.
Acute respiratory infections mainly affect young children - from 1 year to 3 years. From 4-5 years, the incidence of acute respiratory infections decreases. Children with impaired immunity are especially often affected.

Factors predisposing to the development of acute respiratory infections:

Unfavorable environmental factors - atmospheric pollution, environmental pollution, air pollution inside the home, parental smoking, unfavorable sanitary conditions for the child, etc.;
overcrowding of the child population is a factor contributing to the rapid transmission of the pathogen from one child to another. This situation is typical for child care institutions, city vehicles, dormitories, that is, places where children are in close contact with each other;
impaired nasal breathing - enlarged adenoids, deviated nasal septum, etc.;
chronic or recurrent nasopharyngeal infections - adenoiditis, chronic tonsillitis, chronic rhinitis, otitis media, etc.;
allergic predisposition of the child.

Preventive measures for acute respiratory infections should include mandatory improvement of the environment, compliance with sanitary standards for keeping the child, treatment of nasopharyngeal infection and isolation of sick children in cases of acute respiratory infections in the team.

Symptoms of acute respiratory infections. Acute respiratory diseases begin in both large and small children, most often suddenly, against the background of complete health. For any viral disease, the main characteristic symptoms are:

Increased temperature (fever);
intoxication;
signs of damage to the upper respiratory tract - nose, larynx, pharynx, trachea, bronchi.

Attentive parents can determine even before the development of the disease that the child is ill, by such manifestations as poor health, malaise, lethargy, lack of appetite, chilling.

An increase in body temperature is an alarming signal for parents, indicating that the child is sick. This is the most common symptom that causes you to worry and see a doctor. We can talk about an increase in body temperature if there is a temperature above 37 degrees. Typically, body temperature rises from the first day of illness and remains elevated for 3-5 days, without posing a danger to the sick child. However, an increase in temperature to high numbers, above 39 degrees, is dangerous and requires the child to be prescribed antipyretic medications.

Along with fever, acute respiratory infections are characterized by manifestations of intoxication. Older children may complain of headaches, dizziness, pain or burning in the eyeballs, and inability to look at bright lights. Sometimes vague, intermittent, low-intensity pain in muscles or joints appears. The child may be bothered by nausea, vomiting, and loose stools.

In young children, intoxication can be suspected when anxiety appears or, conversely, lethargy, refusal to eat or a sharp decrease in appetite, regurgitation, or loose stools.

In severe forms of acute respiratory infections, coldness of the extremities, severe pallor and marbling of the skin, tilting of the head back, and convulsive twitching of the extremities may appear against the background of high temperature. In older children, hallucinations and delusions are possible. Particularly dangerous are the occurrence of convulsions and loss of consciousness. This requires emergency, immediate medical care for the child.

However, as a rule, the duration of intoxication in mild acute respiratory infections is several days (2-3 days).

Signs of respiratory tract damage during acute respiratory infections can be very diverse. They can appear from the first days of the disease, but more often appear from the second day of the disease. For acute respiratory infections, damage to the upper respiratory tract is more typical: the nose and its paranasal sinuses, pharynx, larynx. Often, simultaneously with damage to the respiratory tract, an inflammatory disease of the ears - otitis media - and the eyes - conjunctivitis occurs. Somewhat less frequently, the disease manifests itself as damage to the lower respiratory tract and is characterized by clinical signs of inflammation of the bronchial mucosa - bronchitis and even lung tissue - pneumonia.

Symptoms of upper respiratory tract damage

Rhinitis (runny nose) is characterized by itching in the nose, sneezing, and sometimes watery eyes; difficulty in nasal breathing - “nasal congestion” and mucous discharge from the nasal passages very quickly follows. The nose is red and slightly swollen. And with significant nasal discharge, redness can be observed under the nose and even above the child’s upper lip. The child breathes through his mouth, sleep is disturbed. The duration of a runny nose is usually about 7 days, but in children with a predisposition to allergies it can persist for a longer period of time.

If the paranasal sinuses are affected (sinusitis, sinusitis, frontal sinusitis), which can be suspected in older children (over 5 years), the child complains of headache, nasal congestion, and prolonged runny nose. Very often, inflammation of the paranasal sinuses accompanies rhinitis.

Pharyngitis (infection of the pharynx) is characterized by dryness, soreness, and sometimes tingling in the throat. Moreover, these symptoms may be accompanied by a dry cough or pain when swallowing. If you look into a child's throat, you can see its redness.

Laryngitis, an inflammatory lesion of the larynx, which often occurs against the background of acute respiratory infections in children aged 1-3 years, is characterized by the appearance of hoarseness. The inflammatory process spreads to the trachea, and sometimes from the first days of the illness a rough, painful, barking cough occurs. In such cases, the disease is usually called laryngotracheitis. In more severe cases, inflammatory swelling of the larynx may occur, resulting in difficulty breathing.

Inhalation is usually difficult, it becomes noisy, audible at a distance, especially when the child is restless, during a conversation or physical stress.

In severe cases, difficulty in breathing is determined both at rest and even during sleep. The appearance of difficulty breathing is often accompanied by fear, increased sweating,
retraction of compliant places of the chest - supraclavicular areas, intercostal spaces, etc. Sometimes blue discoloration appears around the mouth, rapid breathing and heartbeat. This is an alarming sign, and you should urgently call an ambulance.

The duration of uncomplicated laryngitis is usually 7-9 days.

Treatment of acute respiratory infections in a child

If signs of illness appear, the child should be isolated, since there is a danger of infecting other children, as well as the addition of another additional pathogen, which can make the course of the disease more severe.

You should create a friendly, calm environment at home for the sick child.
If the baby’s well-being is not affected, the temperature is low (up to 38 degrees), it is not necessary to put the child to bed, but it is necessary, however, to protect him from noisy games that require a lot of physical stress. If the disease occurs with high fever and severe intoxication, bed rest is necessary until the temperature normalizes.
The room where the patient is located must be frequently ventilated, since the causative agent of the disease is released into the atmosphere of the room with breathing and the child breathes it.

The air should be warm. It is very important that it is well moisturized, since with breathing the child loses moisture, and secretions of the respiratory tract often become viscous, sticky, and difficult to remove from the respiratory tract. How to achieve this? You can use special humidifiers, or you can make do with improvised means: hang wet diapers on heating devices, place basins of water in the corners of the room, and periodically spray water from a spray bottle. We should not forget about wet cleaning of the premises. This is an effective fight against the pathogen and at the same time humidifies the air.

The diet during illness should not differ from age. You should not force-feed a child if he or she has no appetite, as force-feeding may cause vomiting. Feeding should be done more often, in small portions. As a rule, as the condition improves, appetite is restored.

It is necessary to pay special attention to the child's drinking. If the body temperature is not high and health does not suffer, the child should drink the usual amount of liquid. But if the symptoms of intoxication are severe, the child has a high temperature, and his health is disturbed, then in order to reduce intoxication, it is necessary to give the child to drink more than usual, often, in small portions, evenly throughout the day. You should not drink very large volumes of liquid, as this can also lead to vomiting. It is necessary to drink between feedings. In cases where it is not possible to give the child something to drink (he does not drink or vomits after repeated attempts to give him something to drink), it is necessary to urgently seek medical help.

A sick child should drink from 800 ml to 1.5 liters of liquid per day, depending on age. It is better to give your child slightly alkaline mineral water (Essentuki, Borjomi, etc.), but you can also use slightly acidified liquids: tea with lemon, cranberry or lingonberry juice. Acidified liquids are good for relieving nausea. Decoctions of raisins, dried apricots, and rose hips are a very good drink. You should not give your child sugary drinks, as they can lead to bloating and sometimes even pain in the abdomen.

The food a child receives should not be rough, hot or spicy. It should be easily digestible, rich in vitamins and, if possible, meet the wishes of the patient.
The child's medical treatment must be determined by a doctor. The doctor takes into account the cause of the disease, the age of the child, and the characteristics of the course of the disease. However, parents can take some therapeutic measures on their own.

Medications

All medications used for acute respiratory infections can be divided into two groups: drugs aimed at eliminating the causative agent of the disease, and drugs that relieve individual symptoms of the disease.
Since acute respiratory infections are most often caused by viruses, early use of antiviral drugs is first of all necessary. Treatment should be started immediately when the first symptoms of the disease appear. What medications can be given to a sick child?

Remantadine. The drug is used in children over 3 years of age. When symptoms of acute respiratory infections appear, children aged 3 to 6 years can be given 1/2 tablet 3 times a day; children from 7 to 14 years old - 1-2 tablets 3 times a day. The medicine is given only on the first or second day of illness.
Aflubin. In the first days of the disease, it is recommended to take the drug every half hour to an hour: children under 1 year old - 1 drop, children under 12 years old - 3-5 drops; for adolescents - 8-10 drops until the condition improves, but no more than 8 times. After the condition improves, take the drug 3 times a day.

Careful toileting of the nose is necessary - removing the contents by blowing your nose. This must be done correctly - alternately from the right and left half of the nose, since when they are simultaneously blown out, purulent mucus from the nose can enter through the Eustachian tube (auditory tube) into the middle ear cavity and cause inflammation - otitis media, as well as onto the conjunctiva of the eyes and cause conjunctivitis .

If the child does not have an allergic reaction, swelling of the mucous membrane of the nose and nasopharynx can be reduced by instilling herbal infusions into the nose - chamomile, sage, linden.
How to put medicine into your nose correctly. It is necessary to lay the child on his back, place a pillow under his shoulders, and his head should be thrown back. Place 2-3 pipettes of infusion into each nostril. After 2-3 minutes, you need to blow your nose well. The procedure must be done 2-3 times a day for 7-10 days.

How to prepare a decoction of medicinal herbs. To prepare a decoction, pour 1-2 tablespoons of medicinal herbs into a thermos with boiling water and leave for several hours.

If nasal breathing is completely absent and the child breathes through the mouth, it is necessary to instill vasoconstrictor drops into the nose or inject medicine through a special nasal spray to relieve swelling and restore nasal breathing.

Vasoconstrictor medications for young children

Xymelin: children from 3 to 6 years old - 1-2 drops in the nose or 1 portion of nasal spray 3 times a day; children aged 6 years and older - 2-3 drops or 1 portion of nasal spray no more than 3 times a day.
Tizin: children aged 2 to 6 years - 0.05% solution in the nose, 2-4 drops no more than 3 times a day; children aged 6 years and older - 0.1% solution of the drug, 2-4 drops of the drug 3 times a day.

Rhinopront: medicine in syrup or capsules, which is very convenient to give to young children, and the medicine lasts 10-12 hours (all day): children from 1 to 6 years old - 1 measuring spoon of syrup 2 times a day; children from 6 to 12 years old - 2 measuring spoons of syrup 2 times a day; children aged 12 years and older - 3 scoops of syrup or 1 capsule 2 times a day.

Medicines for older children (6 years and older)

In addition to the above, you can use drugs such as afrin, pinosol, xylometazoline, naphthyzin, galazolin, sanorin: 2-3 drops in each nostril 3-4 times a day. It should be remembered that these medications should not be used for more than 5 days in a row, as prolonged use can damage the nasal mucosa.
In addition, after using these drugs, as well as for viral runny noses, lubricating the nasal mucosa with 0.25% oxolinic ointment is effective.

For inflammation of the pharynx - laryngitis - gargling with infusions of chamomile, sage, eucalyptus, raspberry leaves, aqueous solutions of garlic and onion has a good effect. The rinse solution should not be hot; rinse frequently.
In cases of laryngitis symptoms, warm inhalations with ordinary boiled water (steam inhalations) have a good effect.

What antipyretic drugs should be kept in your home medicine cabinet?

If the patient has a high temperature (over 39 degrees), antipyretic drugs are indicated and should always be on hand. These are paracetamol, Panadol, Coldrex, children's Tylenol.

It is better not to give aspirin to children. Physical cooling methods can be used at very high temperatures, but not earlier than 20 minutes after giving the medicine. To lower the temperature faster and more effectively, you can undress the child, place him near a fan for a while, wipe him with cool water, and place a vessel with ice near the child’s head. You can add a little table vinegar to the rubbing water. Rub with a soft terry towel or a special mitten until the skin appears slightly red.
Under no circumstances should you give a child with acute respiratory infections antibiotics on your own, without a doctor’s prescription. These medications do not reduce fever, do not act on viral infections, and may cause unwanted effects. Antibacterial drugs can only be prescribed by a doctor for special indications.

How to perform steam inhalations for children

Inhalation should always be carried out under adult supervision. It can be done over a pan of boiling water or over boiled potatoes in their skins.

Inhalation in adult children can be done by covering the head with a towel or sheet, but it is better to breathe through a funnel made of thick paper. In this case, you need to cover the pan with the wide end, and inhale the steam through the narrow gap.

To avoid burns to the respiratory tract in children, it is more convenient to inhale using a coffee pot or heating pad. The vessel should be filled with boiling water to 1/3 of its volume and placed on a hard, flat surface (for example, a table). Place a pacifier with the tip cut off or a rubber tube on the spout of the coffee pot through which to inhale.

In cases of signs of respiratory distress due to laryngitis (difficulty in inhaling), before the doctor arrives, a 0.05% solution of naphthyzine should be dripped into the nose, which can also be added (5-7 drops) to the water for inhalation.

How to properly perform warming procedures

The favorite procedures of all parents - warming ones, such as compresses, hot foot baths, mustard plasters on the chest or calf muscles, warming up the nose using special bags of salt or cereal, etc. - can be used, but it should be remembered that they are contraindicated in cases when a child has a high fever, or the child is allergic to mustard, or the procedure is unpleasant for him, it causes severe concern.

For pharyngitis, laryngitis and other diseases of the upper respiratory tract, compresses have a good therapeutic effect.

A compress is a specially prepared medicinal bandage. The compress dilates blood vessels, increases blood flow to the body area, and has an anti-inflammatory effect. For acute respiratory infections, compresses can be placed on the child’s neck or chest. There are dry and wet (warming, medicinal) compresses. It is better to use a damp warming compress at night, and a dry compress during the day.

How to prepare a compress? Moisten a piece of cloth or gauze folded in several layers with vodka or wine alcohol diluted in half with water, wring it out well, and place it on the neck or chest area. Place wax paper or plastic film on top of the fabric so that it extends 1-2 cm beyond the edges of the fabric, cover the top with a large layer of cotton wool and tightly bandage the compress with a bandage or scarf so that it does not move, but does not embarrass the child. Keep the warm compress for 10-12 hours.

It is rational to use a dry compress after a wet one in the daytime. Cover several layers of dry gauze with cotton wool and bandage it to the neck or chest. Such a compress can remain on the patient’s body throughout the entire waking period.

An extremely popular warming procedure is mustard plasters. Mustard plaster is a piece of paper coated with a thin layer of mustard powder. Mustard plasters have an irritating, distracting, analgesic, and anti-inflammatory effect. They can be used for inflammatory diseases of both the upper and lower respiratory tract.

Mustard plasters can be bought at the pharmacy, or you can prepare them yourself at home. To prepare homemade mustard plaster, dry mustard must be diluted in warm water until a paste-like mass is obtained. Spread the resulting mass onto a thick cloth in a layer of about 0.5 cm, and cover with the same piece of cloth on top.

For diseases of the upper respiratory tract, mustard plasters are applied to the chest (in the center of the chest) or to the calf muscles. In this case, before use, mustard plaster must be moistened in warm water, and then through a layer of gauze or directly placed on the skin, pressed, and covered with a blanket for the patient. After a few minutes, the child will feel a slight burning sensation. Usually mustard plasters are kept for 5-10 minutes until the skin turns red. After removing the mustard plasters, the remaining mustard must be washed off with warm water, gently wipe the skin; if the skin is significantly reddened, it must be lubricated with Vaseline.

How to properly prepare and take a medicinal bath

For diseases of the upper respiratory tract of a cold nature, medicinal baths can be used - general or foot baths using only water or with the addition of medicinal substances.

When taking a shared bath, the child’s entire body is immersed in water. In this case, you need to ensure that the head, neck, upper chest, including the heart area, are free of water. The child’s face should be well lit, since the reaction of the facial skin vessels can be used to judge the tolerability of the procedures. So, if the face of a child taking a bath becomes very pale or, conversely, turns sharply red, the procedure must be stopped immediately.

The bath water temperature should be 36-38 degrees for small children, 39-40 degrees for older children. The duration of the bath is 10-15 minutes. A child should take a bath in the presence of a family member to avoid an accident. After the bath, the child should be wrapped in a towel and wrapped in a blanket for 30-60 minutes.
Warm medicinal baths are best taken at night. To increase the therapeutic effect of the bath, you can add some medicinal substances to the water: pine extract (from 50 to 70 g or 1-2 tablets per 200 liters of water), bronchicum - a liquid additive to the therapeutic bath (20-30 ml per 1/3 of the bath with warm water). Essential vapors penetrate the respiratory tract, facilitate breathing and remove mucus. Such baths have a double therapeutic effect.
Mustard foot baths have a good healing effect. However, you need to remember that they should not be used in children with skin diseases and intolerance to the smell of mustard.
To prepare a mustard foot bath, you need to dilute 5-10 g of dry mustard in a small volume of water, strain through cheesecloth and pour into a bucket of water at a temperature of 38-39 degrees, mix the water with the mustard solution well. The bath is carried out in a sitting position, the child’s legs are gradually lowered into the bucket and covered with a sheet on top to protect the eyes and respiratory tract from the irritating effects of mustard.

The duration of the local bath is 10-15 minutes.

After the bath, the child’s feet should be washed with warm water, wiped dry, put on socks and put the child to bed.

After taking therapeutic baths, rest for 1-1.5 hours is necessary.

Lower respiratory tract diseases

Diseases of the lower respiratory tract are somewhat less common in children than diseases of the upper respiratory tract. Often their symptoms do not appear from the first days of the disease, but somewhat later and indicate the spread of infection from the nasopharynx to the deeper parts of the bronchopulmonary system. The most common diseases of the lower respiratory tract for children are tracheitis, bronchitis and bronchiolitis.

Tracheitis

This is an infectious and inflammatory disease of the trachea. Tracheitis can be recognized by the appearance of a particularly frequent, rough, low-pitched cough. They say about such a cough that the patient coughs “like a barrel.” The cough may be accompanied by rawness, chest pain, and sometimes discomfort when breathing. There is usually no sputum, or a small amount of very thick mucus (lumps) may be coughed up.

Tracheitis is often combined with laryngitis (laryngotracheitis). The duration of the disease is on average 7-10 days.

Bronchitis

Bronchitis is the most common disease of the lower respiratory tract.
Bronchitis is commonly called acute inflammatory damage to the bronchial mucosa.
As a result of the vital activity of the infectious agent, swelling of the bronchial mucosa occurs, which narrows the diameter of their lumen and leads to impaired bronchial obstruction.

The inflammatory process leads to dysfunction of the bronchial glands and often contributes to the production of an excess amount of thick, viscous secretion, which can be very difficult for a child to cough up.

Damage to the cilia of the bronchial epithelium under the influence of viruses, microbes, toxins, and allergic substances leads to disturbances in the self-cleaning processes of the bronchi and the accumulation of mucus in the respiratory tract.

The accumulation of secretions in the respiratory tract, as well as irritation of special cough receptors by inflammatory products, causes a cough. A cough helps cleanse the bronchi, but if the secretion is very thick and viscous, even a cough is sometimes unable to push through the mucus accumulated in the respiratory tract.

Thus, the main symptoms of bronchitis are cough and sputum.
If we look inside the bronchi during bronchitis, we can see the following picture: the mucous membrane of the bronchus is inflamed, thickened, swollen, bright red, easily vulnerable, and on the walls of the bronchi lies a cloudy, sometimes purulent-looking secretion, while the lumen of the diseased bronchus is narrowed.

Causes of bronchitis

First of all, it is a viral infection. When breathing, viruses from the nasopharynx enter the bronchi, settle on the bronchial mucosa, multiply in the cells of the mucosa and damage it. At the same time, the protective systems of the mucous membrane of the respiratory tract are affected and favorable conditions are created for the infection to penetrate deep into the body. Viral bronchitis is the most common bronchitis in children.

Bronchitis can be caused by a variety of bacteria. Bacterial bronchitis develops, as a rule, in weakened children and children with impaired immunity. Bacteria can seriously damage not only the bronchial mucosa, but also the deeper structures and tissues around the respiratory tract.

In very weakened, small, premature children, children who have received many antibiotics, bronchitis of a fungal nature may occur. This, like bacterial bronchitis, is a very serious disease with deep damage to the bronchial mucosa. Fungal bronchitis is less common than viral and bacterial ones.

In recent years, allergic bronchitis has become increasingly common, the cause of which is allergic inflammation of the bronchial mucosa in response to exposure to various antigens - dust, pollen, etc.

Toxic bronchitis, a disease associated with the action of chemicals in contaminated inhaled air, is also possible. Toxic substances can very severely and sometimes irreversibly damage the mucous membrane of the respiratory tract and lead to a chronic course of the disease.

Factors predisposing to the development of bronchitis

These factors are:
cold;
dampness;
nasopharyngeal infection;
overcrowding (dormitories, children's groups, etc.);
violation of nasal breathing;
passive or active smoking.

It should be noted that prolonged inhalation of tobacco smoke by a child is especially seriously damaging to the mucous membrane of the respiratory tract.

Tobacco smoke contains about 4,500 potent substances that have: