Bronchial Obstruction in Children

Acute bronchiolitis
• is observed in children under 2 years old. Most often it is caused by RS-
infection. 
• affects small bronchi, bronchioles and alveolar passages. 
• The narrowing of the bronchi and bronchioles occurs due to edema and cell 
infiltration of the mucosa, which leads to the development of severe RF. 
• At the same time bronchoconstriction does not really matter, as is 
evidenced by the lack of effect of bronchospasmolytic means. 

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Clinical picture. 
Severe respiratory failure: perioral cyanosis, acrocyanosis, 
tachypnea (depending on age) to 60-80-100 per min., with the prevalence of an 
expiratory component, oral crepitation, retraction of malleable sites of the 
chest.
 
At percussion, over the lungs - bandbox percussion sound, at auscultation - 
many small and moist wheezing crepitating rales over all fields of the lungs on 
inhalation and exhalation, exhale is prolonged and heavy. 
Symptoms develop gradually over a few days, sometimes sharply, on the 
background of acute respiratory disease, and is accompanied by a sharp 
deterioration in the health state: 
üparoxysmal cough may occur, vomiting, restlessness; 
ütemperature reaction and symptoms of intoxication are determined by the 
course of a respiratory infection. 
ü at X-ray examination of the lungs, lungs hyperinflation, a sharp increase in 
bronchial pattern, low standing of the dome of the diaphragm, the horizontal 
position of the ribs is revealed. 
Bronchial obstruction persists long enough, at least 2-3 weeks.

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Bronchial asthma
• manifest during early childhood in the majority of patients . The initial 
symptoms are usually those of BOS character on the background of ARVI. 
• BA is often not recognized in time and patients are not treated properly. 
• The course and prognosis of BA depend to a large extent on the timely 
diagnosis and adequate treatment, so you must pay close attention to the 
early diagnosis of the disease.