False croup What should the child do?

False croup or stenosing laryngitis in children is an acute inflammatory process of the larynx, which is characterized by all 5 signs of inflammation, such as swelling, dysfunction, pain, temperature, redness. Due to severe edema, the lumen of the larynx narrows, which makes it difficult for air to pass through. False croup most often appears in children aged 6 months to 6 years in the form of barking cough, hoarseness and severe difficulty breathing, especially when inhaling.

False croup is also called: stenosing laryngitis, acute obstructive laryngitis, subglottic laryngitis, subglottic laryngitis.

First aid for false croup in children at home consists of calling an ambulance (emergency medical care), calming the baby, providing access to a moist cool air(child on the balcony or in the bathroom, where you need to open the water tap), put vasoconstrictor drops into the nose, give antihistamines and anti-inflammatory drugs, and ensure plenty of fluids.

False croup is a narrowing of the lumen of the larynx, which in most cases is caused by acute respiratory viral or bacterial infections. It is necessary to clearly understand that, in addition to false croup, in medicine there is also such a thing as true croup. True occurs only with diphtheria, when diphtheria films close the lumen of the larynx, as a result of which the air flow is blocked.

Acute obstructive laryngitis in most cases can develop in children from 6 months to 6 years. If the child is on breastfeeding, then mother’s milk provides it with protection from viral and bacterial infections, thereby reducing to zero the possibility of stenosing laryngotracheitis. Artificial feeding increases the risk and severity of croup.

The main symptoms of false croup in children can develop instantly, within a few hours.

1. Against the background of a cold, the baby may experience hoarseness due to swelling of the larynx and vocal cords. This should already alert parents. You must understand that the lumen of the larynx in children is very small. For clarity, take your child’s hand and look at his little finger, this is approximately the clearance of his larynx. Isn't it small?
2. Barking cough. A dry, non-clearing cough that sounds a lot like a barking dog. At the same time, it hurts your child to cough; he tries to restrain himself so as not to cough and cause pain. IN foreign literature A cough with false croup is compared to the croaking of a crow. In Scots the word "croup" is translated as "to croak". When you hear such a cough, you will immediately understand that something is wrong.
3. Congested, noisy and rapid breathing. A feature of this type of breathing is difficulty in inhaling. Inhalation time increases. Moreover, at the very beginning, when swelling of the larynx is not yet very pronounced, the child can breathe normally at rest, but with any activity he experiences noisy breathing when inhaling. If you observe the baby, you can see that the breathing process involves the intercostal muscles and the wings of the nose.

It is very important to know that the condition always worsens at night, so if the baby develops hoarseness in the evening, parents should already be on alert and make the right decision.

False croup - first aid

If the symptoms of false croup develop quickly, and you see that the child does not have enough air, here is the algorithm for the first emergency care. Help that you can provide yourself at home.

1. The first thing to do is call ambulance or emergency medical assistance 03 or 103(this depends on what country you live in);
2. Calm the child. In a calm state, the body requires less oxygen, plus stress causes additional reflex spasms of the larynx, which only aggravates the situation. Remember that you won’t be able to calm your child down if you don’t calm down yourself. I understand perfectly well that this is easier said than done in this situation, but as much as possible calm state will help you complete all subsequent steps and save your baby’s life.
3. Provide the child with access to fresh, moist air. I’ll tell you right away why this is needed. Accumulates at the site of narrowing of the larynx sticky sputum, which aggravates the course of false croup. With the help of moist air, drink plenty of fluids, inhalations you will achieve the liquefaction of sputum and its expectoration. This will significantly improve the symptoms of stenosis and allow you to breathe normally. Those. it is necessary to remove sputum, which additionally blocks the airways:
   • this can be achieved by taking the child to the balcony if it is a cool time of year;
   • bring him into the bathroom by opening the taps, preferably with hot water. The air in the bathroom will become humid, this will alleviate the condition;
   • turn on the humidifier, if available, hang wet sheets or towels to additionally humidify the room;
   • inhalation through a nebulizer, if available. You can inhale as alkaline solutions (mineral water Borjomi), and ordinary saline solution;
   • Drink plenty of warm drinks. Warm liquid is absorbed into the body faster;
   • To expectorate sputum, you can call reflex vomiting in the baby, pressing with a spoon or spatula on the root of the tongue or touching the tongue.

Emergency first aid for false croup using drugs from a home medicine cabinet

1. Apply liberally vasoconstrictor drops into the nose (naphthyzin, galazolin, rhinazolin, nok-spray, Nazivin, etc.). Adrenergic agonists, which are part of these drops, cause vasoconstriction, which in turn leads to a reduction in swelling.
2. Antihistamines (tavegil, diazols, loratodine, etc.). By giving your child a pill to take, you will remove the allergic component of the swelling.
3. Anti-inflammatory or antipyretic drugs - NSAIDs (ibuprofen, nurofen, paracetamol). NSAIDs - non-steroidal anti-inflammatory drugs - have, in addition to antipyretic, anti-inflammatory and anti-edematous effects.

By completing all the steps, you will alleviate the child’s condition until the doctor or ambulance arrives.

Further treatment of the resulting disease depends on the severity and cause of its occurrence. The answer to this question will be given to you by a doctor (pediatrician, ENT specialist or infectious diseases specialist) after an objective examination, tests, instrumental methods research.

Most often, with the correct response and implementation of the above steps, treatment of false croup ends in the hospital emergency department, where, after examination, the doctor diagnoses stenosing laryngitis viral etiology(about 90%), and your child is allowed to breathe by inhalation with a glucocorticosteroid (pulmicort is widely used for false croup in children). After inhalation of GCS (pulmicort), the swelling disappears and the child is sent for outpatient treatment.

To help the baby in an emergency situation against the background of acute respiratory infections, you need to know about false croup in children, its symptoms and treatment. This will help make the little patient feel better and wait for medical help. Our article will tell you what to do if a child develops false croup.

Basic Concepts

False croup in children and its symptoms occur when the laryngeal mucosa is involved in the inflammatory process. Doctors call it subglottic laryngitis or stenosis.

The essence of the pathology lies in the suddenly developing narrowing of the lumen of the larynx. Develops as a complication of the underlying disease. The causes are considered to be acute respiratory infections:

• parainfluenza;
• measles;
• chicken pox;
• acute rhinitis;
• tonsillitis.

Also, in the development of pathology, weakening plays a role defensive reactions. They arise in situations:
Let your baby drink liquids as much as he wants, in small sips.

• chronic inflammatory diseases respiratory organs;
• birth trauma;
• allergic dermatitis;
• oxygen starvation fetus;
• food allergy;
• hypovitaminosis;
• artificial feeding;
• increased nervous excitability;
• immunodeficiency syndrome.

Children under 6 months of age do not develop false croup due to transmission specific immunity from mother. When breastfeeding, the percentage of development of pathology is minimal.

As the baby grows older, he loses his immunity, which leads to the development of false croup at the age of 1-5 years. Over 6 years of age, this condition develops extremely rarely..

Gorokhova V.A., infectious disease specialist, 15 years of experience

False croup syndrome complicates acute viral infections. It is important not only to stop the attack, but also to cure the underlying disease.

3 main forms of pathology

Among doctors there is clinical classification. It is based on pathomorphological changes in the mucous membrane, age and symptoms. There are 3 forms of false croup in children:

1. The edematous variant develops in children under the age of 1.5-2 years. This is due anatomical features.
2. The infiltrative form occurs when the subglottic space in the larynx thickens. Changes are formed without providing medical assistance for the edematous variant. Typical for children under 2 years of age.
3. The obstructive form has a severe course. In this case, complete blockage of the lumen of the larynx and asphyxia occur. Develops in children over 2 years of age. A severe form is observed with the addition of a secondary infection and the development of descending obstructive laryngotracheobronchitis. Such cases lead to death.

The picture on the left shows signs of false croup, on the right – true croup

Laryngeal stenosis includes 2 components layered on top of each other. It is mechanical and reflexive. Therefore, with a small degree of narrowing of the lumen, severe symptoms in children with increased nervous excitability. This mechanism of development of laryngeal stenosis determines multicomponent treatment of an emergency situation.

4 degrees of laryngeal stenosis

False croup in children is divided according to its nature clinical manifestations with varying degrees of narrowing of the lumen respiratory tract. This classification includes 4 degrees of laryngeal stenosis:

1. Compensated (I), when the main symptoms arise during violent emotions or stress.
2. Subcompensated (II) is characterized by increased shortness of breath. She worries a little patient during physical activity and at peace. Has an inspiratory nature ( difficulty breathing).
3. Decompensated (III) degree corresponds to severe shortness of breath at rest. Inhalation and exhalation are difficult.
4. Terminal (IV) stenosis is characterized by suffocation. Severe degree of subglottic laryngitis, leading to the death of the child. Rarely develops with false croup.

Main complaints

In children, false croup develops at night or in the early morning hours. The child notes:

• difficulty breathing and noisy breathing;
• change in voice - hoarseness;
• fear and anxiety;
• weakness;
• “barking” cough with scanty mucous sputum (if it persists, streaks of fresh blood may be released due to vascular injury);
• signs of the underlying disease - sore throat, runny nose.

The baby is tossing around in bed, he is excited. Eyes open. Skin pale and damp. The lips and fingertips on the hands and feet take on a bluish tint. These symptoms are characteristic of the pre-asphyxial stage. They are short-lived. Such attacks of suffocation tend to increase clinical manifestations.

If emergency assistance is not provided at this stage, the pathology progresses to the stage of asphyxia. The child becomes lethargic and lethargic. Breathing is shallow. The skin is pale with a bluish tint.

Against the background of emotional arousal, laryngospasm may intensify in the child. It's important to calm him down

For severe forms of stenosis and the addition of a secondary bacterial infection, the following symptoms are characteristic:

• fever;
• severe shortness of breath;
• sputum is thick, viscous, forms dry crusts;
• development of cardiovascular failure.

False croup occurs most severely in children under 2 years of age on days 3-5 of the underlying disease. Against the background of the development of necrotic lesions of the larynx deaths are registered in most cases.

In the absence of complications and the addition of a bacterial infection, the symptoms of false croup disappear after 2-3 days. However, with the next acute respiratory infection, a second attack is possible.

How to suspect the development of pathology

False croup in children is diagnosed quickly and easily. The main stages are:

• complaints of a small patient;
• medical history;
• general examination;
• differential diagnosis.

Specific additional methods there is no survey. Their implementation is dictated by the severity of the pathology, clinical symptoms and suspected complications of the underlying disease.

Objective examination

During general examination The doctor pays attention to the following indicators:

Differential diagnosis with true croup is important when determining the tactics for managing a child. True and false croup have main differences.

When hospitalized in a hospital, blood tests, serological tests, and radiographic examination methods are prescribed. Decoding general analysis blood can be seen.

First aid

False croup occurs in a child at home when health care is not within walking distance. Parents must not allow the baby’s condition to worsen.

First aid for false croup in children is not therapeutic. Her main task is to wait for the arrival of the medical team. The activities are of a general nature:

• give an antipyretic (Nurofen, Panadol) at a temperature above 38˚C; ( more information about antipyretics for children);
• provide a flow of cool fresh air from maximum level humidity: turn on the humidifier, hang wet towels, place basins of water by the bed;
• calm the child down;
• for nasal congestion - vasoconstrictor drops (Nazivin, Otrivin, Vibrocil); (read how to choose drops for a child);
• abundant warm alkaline drink : milk with soda or Borjomi, juices, linden or raspberry tea;
• inducing a cough and gag reflex by irritating the root of the tongue or back wall pharynx - this will help improve the permeability of the lumen of the larynx by draining the thick secretion accumulated in it;
• Inhalation with saline solution through a nebulizer is not contraindicated - it promotes the removal of sputum and improves well-being; (what a nebulizer is and which one will be better will be answered for you).

Krestova A.A., resuscitator, 5 years of experience

Stenosing laryngitis in ARVI rarely leads to severe consequences. Most children admitted to the department intensive care, a secondary infection was diagnosed.

Parents of such patients learned how to treat false croup in children on the Internet. Self-therapy in this case leads to sad consequences.

When false croup develops, first aid is immediate!

If a child is choking, it is prohibited to use rubbing ointments with a strong odor, antibiotics, or traditional medicine.

In case of a recurrent course, manipulations are agreed upon with a specialist. It is safe to offer infusions to a child from traditional medicine medicinal herbs in the absence of allergies to them. The recipes are given below:

1. An infusion of sage or plantain leaves is prepared at the rate of 1 tbsp. l. for 250 g of boiling water. Leave for 15 minutes, strain.
2. It is more convenient to make chamomile tea from filter bags. For a glass of boiling water – 2 pcs. Drink in small sips.

The above-described manipulations are sufficient if the attack of false croup was mild. In moderate and severe cases, hospitalization in an infectious diseases department with intensive care units is indicated.

If laryngotracheitis develops, there is no need to force the child to drink large volumes of liquid. This only makes you feel worse. Give your baby food often and in small portions.

Drug therapy

If the attack has not been stopped, then upon arrival of doctors, immediate assistance is provided. When false croup occurs in children, emergency care includes the following:

• inhalation with humidified oxygen - oxygen therapy;
• injection administration of antihistamines - Pipolfen, Tavegil, Suprastin, Diphenhydramine; (which others exist antihistamines we'll tell you);
• at nervous excitement– sedative medications (Seduxen);
• inhalation through a nebulizer of Naphthyzine (5 ml of 0.05% per 5 ml of water for injection), Adrenaline, Pulmicort;
• intramuscular or intravenous administration hormonal drugs - Prednisolone, Hydrocortisone, Dexamethasone;
• to reduce swelling in severe cases - diuretics (Lasix).

Tishkina I.A., local pediatrician, 10 years of experience

Inhalations for false croup in a child - the main thing component healing process.

At the first symptoms, you can use a nebulizer to breathe in a simple saline solution and Naphthyzin. This will reduce the severity of laryngitis.

Emergency care for false croup is aimed at preventing complications and transporting the child to the department.

In addition to the above medications in the hospital, the following are prescribed for routine use:

• antiviral drugs (Algirem, Arbidol, Genferon Light or Viferon suppositories); (how to choose inexpensive and effective antiviral drugs);
• sputum thinners and expectorants: Lazolvan (in the form of syrup and solution for inhalation), Flavamed, Ambrohexal, Gedelix, Bronhobos, Ambrobene, Bromhexine;
• anti-inflammatory syrup – Erespal;
• vitamins.

• plenty of warm drinks;
• bed rest;
• Ventilate the room every 2-3 hours, humidify the air;
• food is warm and ground.

When bacterial complications occur, antimicrobial drugs are added to therapy. Treatment that is effective for false croup is prescribed by a doctor!

Since laryngeal stenosis is prone to recurrence, parents should have necessary medications. Some of them are presented in the table.

Medicine	Release form and dosage	From what age is it used?	Contraindications	average cost
(based on glococorticoid hormone)	Suspension for nebulizer: 2 mg/day per inhalation	From 6 months	Individual intolerance	From 920 rub.
	Syrup For body weight less than 10 kg: 10-20 ml per day More than 10 kg: 30-60 ml Teenagers – up to 90 ml	From 2 years	Allergic reactions	From 256 rub.
Lazolvan	Solution for oral administration and inhalation When taken orally: Children under 2 years: 25 drops 2-6 years: 25 drops 6-12 years: 50 drops Over 12 years: 100 drops Inhalation: Up to 6 years: 2ml Over 6 years: 2-3 ml Dilute with saline solution 1:1	Approved for use in children of the first year of life	Hypersensitivity to the drug	From 150 rub.
Adrenaline hydrochloride	Solution for injection is used for inhalation with a nebulizer 1-5 years: up to 0.5 ml per 4 ml sodium chloride solution Over 5 years: 1 ml	From 1 year	Heart defects High blood pressure Fever	From 75 rub.

It is advisable to have the above drugs in the medicine cabinet for recurrent false croup in children for its treatment.

Don't be afraid to apply hormonal drugs at emergency situations. Pulmicort for false croup in children is effective and safe. When inhaled, its absorption into the systemic circulation is minimal, but the effect is maximum.

Doctor Komarovsky's opinion

• reduce the air temperature as much as possible and humidify it;
• apply vasoconstrictor drops;
• call an ambulance.

Komarovsky believes that there should be no independent treatment when false croup occurs! This will make the situation worse.

Parents ask questions about how to treat, and that’s exactly what we’ll talk about.

What reasons could there be if your child coughs at night? with treatment and what is contraindicated for the baby.

What symptoms indicate that a child has allergic cough and how to treat it, see.

Prevention

Preventing the development of false croup is to avoid acute respiratory infections. For these purposes it is shown:

• routine vaccination;
• quarantine measures for influenza in the family, preschool and school institutions;
• hardening of the body;
• proper clothing appropriate to the weather conditions;
• inclusion of fresh fruits and vegetables in the diet;
• use of local antiviral drugs(Grippferon, Viferon ointment) during the ARVI epidemic.

If a child develops a disease - strict adherence doctor's orders. These measures do not eliminate the risk of developing laryngitis, but reduce it. For more information about the treatment of laryngitis, see.

conclusions

Knowing about false croup, its symptoms and treatment, if it occurs, you will be able to provide competent first aid. However, only the doctor selects adequate treatment, avoiding undesirable consequences.

Disease of the respiratory tract, which results in laryngeal stenosis, in medical science called croup. This disease is accompanied by the following symptoms: noisy difficulty breathing, hoarseness, “barking” cough, shortness of breath. Croup in a child is not a rare occurrence. As a rule, it occurs against the background of various infectious diseases. In this article we will consider in detail the main issues relating to such a problem as croup in children.

Causes

Very often, the mentioned disease develops with various infectious diseases, such as measles, influenza, chicken pox, tuberculosis, typhoid fever, syphilis. Even a banal acute respiratory infection can provoke this pathology. Croup often occurs as a complication of diphtheria. In some cases, the disease can be caused by simple herpes. In this case, along with swelling of the laryngeal mucosa and hyperemia, a rash may appear. At first these will be pinpoint papules, and then erosions covered with a yellow-white thin film. You should not discount factors such as unfavorable ecology, weather dependence, and weather conditions. Most often, the disease is diagnosed in children living in industrial (polluted) areas, as well as near polluted highways. Changes in reactivity play a major role in the occurrence of pathology. child's body. The reason for this is various kinds of para- and malnutrition, encephalopathy, rickets, thymic-lymphatic status, pneumonia and neurological pathologies. Some children with croup have a history of drug or food allergies, sensitization, or bronchial asthma.

Who is at risk?

Viral croup is most often diagnosed in children under three years of age. This is explained by the anatomical and physiological structure of babies. In children mentioned age group the lumen of the larynx is much narrower, and the cartilage tissue is more pliable and softer than in an adult. Vocal cords short. The submucosal layer consists of a rather loose connective tissue. That is why, when certain parts of the respiratory tract are inflamed, swelling often occurs, leading to a narrowing of the lumen of the larynx.

Pathogenesis

The larynx in a child’s body performs voice-forming, respiratory and protective functions. Any narrowing of it can cause obstruction of the upper respiratory tract, as well as oxygen starvation. important organs(heart, brain, kidneys, etc.). Croup in a child is the result of inflammatory phenomena. Ulcers, swelling, necrosis, superficial erosions, damaging the mucous membrane, cause a reflex spasm of the laryngeal muscles. With stenosis, oxygen deficiency often develops and air ventilation is disrupted. upper sections respiratory tract. Then metabolic and respiratory acidosis, hypoxemia, and cerebral edema occur. Disorders of this kind complicate the course of stenosis.

Croup in children: symptoms

The first signs of the disease appear at night. Their appearance is due to anatomical and physiological factors: at this time there is a high tone of the parasympathetic nervous system, V horizontal position, as a rule, the drainage of the lungs worsens. Typically, croup in a child begins with an increase in temperature (up to 39 degrees).

A runny nose also appears. Within twelve to forty-eight hours, a “barking” rough cough appears, reminiscent of spitting. It is often accompanied by increased breathing, retraction of the intercostal spaces, and stridor. Moreover, while crying, the cough only gets worse. Upon examination, the doctor notes a narrowing of the larynx and trachea. This causes the appearance of so-called noisy breathing, in which it is quite difficult for the baby to take a breath, as well as hoarseness and hoarseness. When exposed to cold and humid air, the symptoms are alleviated.

Signs of diphtheria croup

The main symptom is a gradual increase in stenosis, leading to a steady progression of the severity of the condition. Characteristic features There is also a “toxic” pallor of the skin, a hoarse and then silent cough. From the nose, due to paresis soft palate, liquid may leak. Croup in children, the symptoms of which are very unpleasant, is characterized by the formation of a gray-dirty coating on the tonsils. In this case, as a rule, it comes from the mouth putrid smell. It should be noted that at night a rapid deterioration of the condition is possible, leading to extremely severe, even fatal outcome. Therefore, upon detection anxiety symptoms you should call an ambulance immediately.

Diagnostics

It is possible to identify an illness, the main cause of which is viral diseases, in children endoscopic methods. When examining the larynx, the mucous membrane looks swollen, hyperemic, and easily wounded. At the same time, edematous ridges are noticeable in the subglottic space. The contours of the bronchial and tracheal rings are smoothed. Mucopurulent exudate in some cases is scanty and liquid, but most often it is thick and viscous. Fibrous-necrotic deposits often form. After removal of plaque and casts, the lumen of the trachea becomes wide. However, its walls are a continuous bleeding wound. Inflammatory swelling of the mucous membrane leads to the fact that the mouths of the bronchi become slit-like, and sputum (purulent) appears from the depths.

Analyzes

Today great importance acquired the method serological diagnostics cereal. It is based on the use of sets of antibodies to certain viruses and bacteria. The PCR (polymerase) method is also widely used chain reaction). However this method will be effective only if biomaterial is taken early from the oropharynx (in acute period). A blood test can detect nonspecific inflammatory changes. So, with bacterial croup, leukocytosis is observed, with viral croup - leukopenia. For a more accurate diagnosis, as well as if complications are suspected, X-ray methods are used (images cervical region, paranasal sinuses, chest etc.). Another method is differential diagnosis. Here the main role is played clinical picture illness. The presence of previous diseases that can cause this complication is also taken into account.

Features of therapy

It is recommended to show the child to the doctor as soon as possible. Treatment of croup in children should primarily be aimed at relieving swelling of the airways. Today, hormonal drugs are used for these purposes. It is recommended to feed or water the baby as often as possible to avoid dehydration. You can reduce the temperature and relieve pain with ibuprofen or paracetamol. In this case, you must carefully read the instructions regarding dosage or consult your doctor about this. You can also use antispasmodics, such as “Baralgin”, “Maxigan”, “Snazgan”, etc. In this case, it is recommended to give 1/3 of the tablet to babies under one year old, and 1/2 to older children. Decongestants will not help cure croup in a child, but will significantly alleviate the baby’s condition. These are the first steps that can be taken before the doctor arrives. You should also ensure that cool, fresh air enters the room.

Treatment in hospital

At the resuscitation stage, the main focus is on restoring airway patency and combating toxicosis caused by an infectious disease. For these purposes, the method of nasotracheal intubation is used. Indications for its use are cardiovascular and respiratory failure, caused by laryngeal stenosis of degrees 2, 3 and 4, as well as increasing hypoxia and hypercapnia.

Intubation is carried out under general anesthesia. However this method It also has its downsides. First of all, these are post-intubation chondroperichondritis of the trachea and larynx, leading to cicatricial stenosis. To prevent such complications, it is recommended to use special thermoplastic tubes. In addition, treatment of croup in children is unthinkable without adequate antibacterial therapy, which is prescribed by the doctor, based on individual characteristics baby. For this disease, as a rule, hormonal drugs are prescribed to help quickly relieve stenosis caused by sudden swelling of the laryngeal mucosa. In some cases, patients are given glucocorticoids medicines. If their effectiveness is not detected in the first two hours after taking hormones, further use of these drugs is not advisable. Used in the fight against toxicosis

Treatment of recurrent croup

For this disease, bronchodilators, mucolytics, etiotropic and anti-inflammatory drugs are used. Metered dose inhalers are effective. Particular attention should be paid to eliminating swelling that causes spasms. Mucolytic drugs will help restore normal work respiratory system. Secretolytics (Ambroxol and Bromhexine) help thin mucus and stimulate the formation of surfactant in the lungs. As

anti-inflammatory drugs, as a rule, cromoglycate preparations are used. After cupping acute manifestations croup, in order to prevent hypersensitivity of the bronchi and larynx, it is necessary to carry out long-term (about two months) therapy with H1 receptor blockers (the drug "Cetirizine"). During the period of convalescence, immunostimulating drugs are prescribed. Their choice depends on the age of the child, the presence of an etiotropic pathogen, the prevalence inflammatory process. These drugs include Bronchomunal and interferon preparations. In this case, the duration of treatment after discharge from the hospital should be at least one month.

Prevention of croup

The main attention should be paid to hardening the child. You should take your baby for walks more often fresh air. This will help improve the functioning of the upper respiratory tract and strengthen the immune system. You can also try hardening your throat. To do this, you should rinse it every day. cool water, gradually reducing the temperature of the liquid. However, there is no need to rush in this matter. The habituation process should take at least two months. In the final version, the water temperature is about 14-15 degrees. For older children, ice resorption can be used as hardening. It is best to freeze water in a form with small cells, having first mixed it with lemon juice. You can give your child one cube per day.

Prevention of viral diseases in children consists of following the principles proper nutrition and the use of vitamins. This will help strengthen the body's defenses and contribute to the correct and healthy development of the baby. Very healthy to eat fresh vegetables and fruits to drink herbal teas and decoctions. They will not only strengthen the immune system, but also help in the fight against emerging early infections and viruses. It is recommended to give your child foods rich in vitamins C and A. Fermented milk products, especially live kefir, are very healthy.

It is important that the air in the apartment is warm and fresh. At the same time, a certain humidity must be maintained. Don't forget about the rules of hygiene. And smoking near a child is strictly prohibited. It is also not recommended to use aromatic oils, candles, etc. in the room where the baby is located. They can cause serious irritation of the respiratory tract.

False croup (acute laryngeal stenosis, laryngotracheitis) – special condition, which develops mainly against the background of acute respiratory infections. It is called false in order to differentiate it from true croup, which develops with diphtheria and has similar symptoms (difficulty breathing, barking cough, hoarseness). Most often, children 1-5 years old are affected by laryngotracheitis.

The disease can be life-threatening for the child, so at the first sign of it, urgent qualified help is needed.

Reasons for appearance

In most cases, the development of false croup is facilitated by viral infections:

• flu;
• adenovirus;
• herpes.

Laryngotracheitis of a bacterial nature is less common, but it occurs in children in more complex forms than the viral one. Bacteria that can cause false croup:

• hemophilus influenzae;
• staphylococci;
• streptococci;
• pneumococci.

The disease can occur as a complication:

• tonsillitis;
• rhinitis;
• adenoiditis;
• after vaccination.

A special risk group includes children who are overweight and have a tendency to allergic reactions. False croup often develops in children who have had:

• birth injury;
• hypoxia;

The peak incidence of laryngotracheitis in children under 5 years of age is due to the anatomical features of the structure of their respiratory organs. According to statistics, girls suffer from false croup less often than boys. After 6-8 years, children “outgrow”, false cereals disappear.

Classification and types of disease

By its nature, acute laryngeal stenosis can be viral or bacterial. According to the flow - complicated and uncomplicated.

There are 4 degrees of false croup:

• compensated (1st degree)- characterized by difficulty inhaling when physical activity or experiences;
• subcompensated (2nd degree)– difficulty breathing is observed even in a calm state;
• decompensated (3rd degree)– characterized by heavy paradoxical breathing, severe shortness of breath;
• terminal (4th degree)– a severe attack with hypoxia, which can be fatal.

Symptoms

Mostly, acute laryngeal stenosis occurs against the background of acute respiratory infections. Signs of the disease appear a few days after the onset of acute respiratory infections. This usually happens in the evening. IN daytime The child may have a fever or runny nose. In the evening the breathing pattern changes. It becomes bubbling, whistling and labored (stridor), making it difficult for the child to breathe and lacking oxygen.

How more swelling larynx, the louder the noise becomes when inhaling and exhaling. In many cases, a harbinger of stridor is a dry, barking cough. Hoarseness can be considered a symptom of laryngotracheitis if it is accompanied by stridor. In other cases, it is considered a sign of laryngitis, which occurs without significant swelling of the larynx.

In addition, symptoms characteristic of colds are observed:

• general weakness;
• joint pain;
• enlarged cervical lymph nodes;
• increased body temperature;
• lethargy.

With degree 4 stenosis, the symptoms are as follows:

• stopping barking cough;
• disappearance of breathing noise;
• decrease in pressure;
• arrhythmia and weakness of breathing;
• There are convulsions and bradycardia.

The child's consciousness becomes confused and he may faint. Without timely emergency measures, asphyxia is possible.

Acute laryngeal stenosis must be differentiated from bronchial asthma. With false croup, inhalation is very difficult, and the noise when exhaling is almost inaudible. Asthma attacks, on the contrary, are accompanied by free inhalation and difficult wheezing exhalation.

Diagnostics

To identify false croup and start promptly correct treatment, ENT or pediatrician prescribes a thorough examination of the patient. He examines the child’s larynx and listens to the airways.

Conducted:

• microlaryngoscopy;
• bacterial seeding of material from the throat;
• otoscopy;
• X-ray of the lungs and sinuses;
• rhinoscopy;
• pharyngoscopy;
• blood tests (PCR and ELISA, gas composition).

Treatment methods

It is advisable to carry out treatment in a hospital; attacks of false croup are very dangerous. Be prepared to provide first aid to your child.

Important! At the first symptoms of acute laryngeal stenosis, it is necessary to call ambulance. Swelling of the larynx can be life-threatening for the child.

On our website you can learn about other diseases of the ENT organs in children. Read about sinusitis; written about catarrhal sore throat; Find out the articles about what to do if your child has ear pain. There is a page written about tracheitis; We have an article on treating a runny nose with folk remedies.

First aid during an attack

Before rendering qualified assistance According to doctors, parents should take measures to alleviate the baby’s condition:

• Calm the child and put him on the bed. Top part the body should be on a hill. A regular pillow will do.
• Open the window, humidify the air in the room (with a humidifier or using wet towels);
• Free the child from constrictive clothing that constricts the chest.
• Give the child a warm alkaline liquid (2% soda solution or Borjomi). This will help moisturize the mucous membranes and make phlegm thinner.
• Inhale with mineral water. It's good to use a nebulizer. (Read the article for more information about inhalation with a nebulizer).
• Place vasoconstrictor drops into the nose.
• To relieve swelling, you can give an antihistamine (Erespal, Fenistil).
• In case of temperature and fever, give an antipyretic (Nurofen, Paracetamol).
• If breathing stops, induce vomiting. This will stimulate the respiratory center.

Drug therapy

After the ambulance arrives, the doctor will assess the severity of the child’s condition and determine his treatment regimen. In case of severe attacks, you cannot risk the child’s health and hospitalize him in a hospital.

Therapeutic measures for stage 1 false croup:

• good air supply;
• drinking plenty of warm water frequently;
• mustard plasters on the calf muscles;
• inhalations with sodium bicarbonate solution, vitamin A, hydrocortisone, aminophylline;
• taking antispastic drugs (Papaverine, Atropine);
• taking hyposensitizing and sedative drugs (Pipolfen, Diphenhydramine);
• vitamin therapy.

If there is no effect from such treatment, a novocaine blockade is performed in the nose. It reduces swelling of the mucous membranes and relieves reflex spasm. For fever at stage 1 of laryngotracheitis, antibiotics are prescribed.

False croup grade 2 is treated in the same way as grade 1. Additionally used:

• humidified oxygen;
• administered intravenously hypertonic solutions glucose, calcium gluconate to relieve swelling;
• hormonal therapy (Hydrocortisone, Prednisolone);
• cardiac solutions are prescribed intravenously (Korglikon, Strophanthin);
• neuroleptic drugs (Promazine, Aminazine).

For grade 3 stenosis, Prednisolone is administered intravenously. The first dose should be ½ daily. They expand the intake of cardiac medications and give sodium oxybutyrate.

Antibiotics are administered wide range actions:

• Tetraolean;
• Tseporin.

If there is no result from treatment, laryngoscopy is performed. During the procedure, mucus and blood crusts are sucked out using a polyethylene catheter. Then the mucous membrane is lubricated with ephedrine, hydrocortisone, vaseline or peach oil. Sometimes bronchoscopy is indicated. During this procedure, the bronchi are washed, pus and mucus are removed, and antibiotics are administered intratracheobronially.

If all measures are ineffective or the child has severe progressive 4th degree stenosis, intubation or tracheostomy is indicated.

Read here about how to make a gauze diaper for a newborn with your own hands.

Prohibited actions

Laryngotracheitis is especially dangerous for children who are prone to allergies, overly excitable, and with lymphoid growths in the nasopharynx. Therefore, therapy for them must be selected with caution. Adviсe:

• In order not to increase swelling in allergy sufferers, you should not give citrus juice, honey, or raspberry jam.
• To avoid causing spasms of the laryngeal muscles, do not use essential oils, mustard plasters.
• There is no need to rush to give antitussives. Moist cough – protective function body. When you cough, phlegm containing harmful toxins is expelled.

Prevention measures

Since false croup in most cases is a consequence of colds and viral diseases, effective preventive measures that help prevent them:

• harden the child;
• strengthen immunity; (About how to increase a child’s immunity with folk remedies find out the articles);
• provide adequate nutrition;
• use natural phytoncides;
• carry out vitamin therapy during seasonal colds;
• do not overcool the child;
• observe the rules of hygiene;
• Ventilate the child’s room more often and humidify it.

False croup is a common condition in children, which is caused by anatomical structure their respiratory organs. It can occur with every manifestation of an acute respiratory infection. Therefore, parents should be prepared for an attack and provide all available means to stop it. You definitely need to call an ambulance with symptoms of false croup, since there is a risk of complications, including asphyxia.

The disease of croup in children is acute stenosing laryngotracheitis. The disease is quite serious, as it is accompanied by attacks of suffocation. Therefore it requires special attention and immediate assistance. Let's look at the causes and types of croup, symptoms and treatment methods.

Children are most susceptible this disease due to the existing structural features of the respiratory tract. How smaller child, the more complex the disease progresses.

Croup in children: symptoms and treatment

As a rule, the disease manifests itself at night in the form of a sudden barking cough. Against this background, there is a deterioration of the voice or its complete disappearance, bluish discoloration of the circumlabial folds, increased heart rate and breathing. Let's look at what other signs we can use to determine the nature of false croup.

False croup in children, symptoms

The main signs of the disease are:

• severe dry cough;
• cyanosis of the triangle around the nose, as well as the tips of the fingers;
• inhibition of actions;
• in the presence of infectious diseases, body temperature may increase;
• pale skin;
• dark circles under the eyes;
• loss of consciousness.

When parents first encounter symptoms of croup, they begin to panic. This prevents you from acting quickly and correctly.
We dealt with the question “false croup, what is it.” Now let's move on to the next and main thing - methods of combating the disease.

False croup in children, treatment

First, let's decide what we will do in the event sudden attack cough. If your baby has false croup, first aid is provided as follows:

• be calm and do not frighten the child with your fear;
• as soon as an attack of suffocation begins, immediately call an ambulance;
• take a bath hot water and pour it into it baking soda. Place your baby next to the bathtub and let him breathe over it. At the same time, give him warm baths for his hands and feet;
• give the baby something to drink warm milk with the addition of soda on the tip of a knife. If you have alkaline mineral water at home, give it warm;
• After all the thermal procedures, press the baby with a spoon on the root of the tongue. This will help release any accumulated phlegm. If vomiting occurs from this manipulation, it’s okay.

After getting rid of a coughing attack, consulting a doctor remains necessary. He must examine the child, identify the cause of the disease and prescribe appropriate treatment.
Treatment of false croup in children depends on the severity of the stenosis. It can be carried out both at home and in a clinic. If a specialist insists on hospitalization, do not argue with him.
This disease occurs in waves, and attacks of suffocation can occur suddenly and unexpectedly. There are times when it is necessary to incubate the trachea, and it is good if a specialist is nearby at this moment. If it leaks in mild degree false croup, treatment at home is supported by the doctor with antiallergic drugs that help relieve swelling of the larynx (suprastin, diazolin, etc.), drugs for relieving muscle spasms (papaverine, no-shpa), drugs for removing phlegm and sedatives.

Croup is most dangerous for children with allergies. Therefore, before taking any medications, be sure to consult your doctor.

If your baby is susceptible to allergic reactions, do not use mustard plasters and rubs, honey, raspberry jam, citrus fruits, or herbal preparations during treatment.