Development of total obstruction of respiratory tracts
lies in basis of syndrome, which isconditioned with the expressed hypersecretion of phlegma, with the edema
and swelling of mucus ofbronchial tubes
and bronchiols and, in a less measure, bronchospasm inthe children of the first year of life on a
background of viral, more frequent respiratory-syncitial infections.
Criteria of diagnosis of bronchiolitis:
Presence of the catarrhal phenomena
Temperature of body – subfebrile, rarely 38oС.
3. Expressed signs of
respiratory insufficiency:shortness of
breathing, blowing nostrils, cyanosis of nasolabial triangle, participation of
4. Violation of the bronchial passage: thorax is emphysematosis;
horizontal position of ribs, flat position of diaphragm.
7. Cardiovascular syndrome –
tachycardia, weakening of tones.
8. X-ray- sharp swelling of lungs tissue, increased
broncho-vascular pattern, without infiltrative shades; sometimes atelectasis.
of airway obstruction lies at the basis of acute bronchiolitis, which is more
typical for children of the first six months of life. In acute bronchiolitis
body temperature is subfebrile or normal, respiratory failure progresses gradually.
Signs of intoxication are insignificant. Characteristic features are perioral
or acrocyanosis, dry cough, a large number of small moist rales on both sides -
"wet" lung and a small number of dry wheezes.
In severe cases dyspnea has predominantly
expiratory character, groaning breath, tension and swelling of nostrils,
participation in the act of breathing supporting muscles, general cyanosis of
the skin. Nonproductive cough, frequently emphysematous swelling of the chest
are present. Above the lungs percussion sounds are bandbox, throughout the
lungs a large number of small bubbling and wet crepitative wheezing. There are
tachycardia, increased liver, may be
attacks of apnea, hypoxic seizures, dehydration.
X-ray examination shows the symmetric strengthening of pulmonary pattern ofboth sides, increase of transparency of
pulmonary tissue, absence of infiltratative shades. In the blood test the appropriate changes are absent.
release from clothes.
2.To give the promoted
position of body to the child.
3.By a rubber bulb or gauze
clean thenasal cavity, mouth and
4.To provide access of fresh
5.Oxygenation with clean
moistened oxygen through a mask.
6.Euphyllini in dose of 3-5
mg/kg of mass -24 % solution intramuscular.
7.3 % solution of
Prednisoloni 1-2 mg/kg ofthe
Help onhospital stage.
release respiratory tracts from mucus and phlegma with the help
2.Oxygentherapy withmoistened warm 40 %oxygen through a nasal
mask 3-5 litres
per 1 minute.
3.Inhalation of broncholytic
mixture: Euphillini – 0,3, ephedrine – 0,2,
novocaine – 0,25, water –
50,0 ml. On inhalation 3-5 ml, before
inhalation to add 1,0 ml of5 % solution of sodium ascorbinati.
4.Inhalations of mucolytic
drugs – 2 % solution of sodium hydrocarbonatis
Acetylcysteini, Bisolvoni, Lasolvani2-3
ml on inhalation with
next aspiration of phlegma.
5.2,4 % solution of Euphyllin
3-5 mg/kg of mass on 10 % glucose solution
10 ml/kg of
mass of intravenously slowly.
6.3 % solution of
Prednisoloni 1-2 mg/kg of the masses, one dose
intravenously streamly on 10 %glucose solution 10 ml.
7.5 % solution of sodium
ascorbinati 0,2 ml/kg of the masses
of intravenously streamly on 5 ml of10 % glucose solution .
8.Cocarboxylazae 5-8 mg/kg
ofmass of intravenously streamly
on 5 ml
of10 % glucose solution .
9.Alkaline drink: 1 %
solution of sodium hydrocarbonatis10-15
of mass per
10.Vibration massage of thorax
in drainage position.
11.In default of effect and
enlargement of respiratory insufficiency –
clearing of bronchial tree
by bronchoscope,artificial ventilation.