Algorithm of a severe course BOS therapy in children
1.
Inhalation of short-acting
β
2-agonist through a
nebulizer, 1 dose every 20 minutes. for 1 hour.
2.
IGC inhalation by nebulizer.
3. Inhalation of O2 to achieve SpO2
≥
95%.
4.
Inhalation of mucolytics are contraindicated!!!
5. Abundant alkaline drink.
Good effect:
1. Inhalation of short-acting
β
2-
agonist through a nebulizer, 1 dose
every 6-8 hours
2. Inhalation of nebulized
corticosteroids 1-2 times a day
3. Inhalation of mucolytics nebulized
4. Abundant alkaline drink
Unsatisfactory effect:
1. Inhalation of short-acting
β
2-agonist
through a nebulizer, 1 dose every 6-8
hours
2. I/v introduction of methylxanthines
(2.4% solution of aminophylline)
3. I/v introduction of GCS
4. Infusion therapy
5. Oxygen therapy
A good answer
An unsatisfactory answer:
•Transfer to the emergency
department
•
ALV
Indications for hospitalization of children
with BOS, developed against ARVI
1. The ineffectiveness of the treatment at home for 1-3 hours.
2. The expressed severity of the patient's condition.
3. Children from high-risk groups.
4. By social reasons.
5. If it is necessary to determine the nature of BOS and selection
of therapy of asthma attacks occurred for the first time .
Conclusions
• 1. Bronchial obstruction syndrome in children is common and
takes a severe course, accompanied by signs of severe
respiratory failure.
• 2. It manifests, as a rule, against a background of acute
respiratory infection, BOS may be a manifestation of many
pathological states.
• 3. The prognosis of the BOS course is serious and depends on
the form of the disease that caused the bronchial obstruction,
and timely conducting of pathogenetic schemes of therapy and
prevention.
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