What are the symptoms of false croup in children? Laryngotracheitis or false croup in children: symptoms and treatment, first aid and general recommendations Treatment for false croup

False croup in children - a syndrome characterized by a triad clinical symptoms: wheezing (wheezing), barking cough, hoarseness. The syndrome is formed in diseases accompanied by an acute inflammatory process in the mucous membrane of the larynx and trachea.

With false croup, the inflammatory process is localized on the mucous membrane of the subglottic (subglottic) area of ​​the larynx.

The development of false croup is associated with three main mechanisms:

• the inflammatory process causes swelling of the space under the vocal cords, which narrows the lumen of the larynx;
• reflex spasm of the laryngeal muscles causes obstruction;
• the secretory activity of the glands of the mucous membrane of the larynx increases, and the already narrowed lumen of the larynx becomes clogged with a viscous inflammatory secretion.

Parents of children who are prone to recurrent attacks of false croup need to ensure that the correct microclimate is maintained in the room where the child is.

False croup most often occurs in infants and preschool age. This is due to the anatomical and physiological characteristics of the children's larynx and trachea:

• small diameter of the lumen of the trachea and bronchi, short narrow vestibule, funnel-shaped (instead of cylindrical) shape of the larynx;
• relative weakness of the respiratory muscles;
• disproportionately short, high-lying vocal folds;
• hyperexcitability of the adductor muscles that close the glottis;
• functional immaturity and susceptibility of reflexogenic zones;
• abundance lymphoid tissue with weak development of elastic fibers in the mucous membrane and submucosa, prone to the development of edema.

Source: miksturka.info

Synonyms: acute stenosing laryngotracheitis, viral croup, pseudocroup.

Causes of false croup in children

The most common cause of false croup in children is viral infection. The most typical pathogens of the disease include influenza viruses, parainfluenza, herpes, measles, chickenpox, whooping cough, and adenoviruses. Prevailing etiological factor is parainfluenza virus type I. The syndrome can also occur as a complication of adenoiditis, acute pharyngitis, chronic tonsillitis, measles, rhinitis, scarlet fever, influenza, chickenpox, ARVI.

False croup of bacterial etiology is less common. As a rule, bacterial microflora (Haemophilus influenzae, streptococci, staphylococci, pneumococci) joins the viral one in case of weakened immunity.

Non-infectious causes of false croup in children include laryngeal injuries, allergic edema, kidney disease and of cardio-vascular system. Mechanical blockage lumen of the larynx can occur due to aspiration of foreign bodies.

With an uncomplicated course, false croup in children, as a rule, ends in recovery.

Contributing factors are: decreased immunity, increased excitability of the nervous system, rickets, vitamin deficiency, a tendency to allergic reactions, exudative-catarrhal and lymphatic-hypoplastic diathesis, birth injuries, fetal hypoxia suffered during childbirth, paratrophy, post-vaccination period, artificial feeding, congenital stridor, hypertrophy of the lymphadenoid ring.

Forms

Depending on the cause of the disease, viral and bacterial false croup are distinguished.

Based on the presence/absence of complications, false croup in children can be complicated or uncomplicated.

Based on clinical manifestations, four degrees of stenosis are distinguished:

1. Compensated.
2. Subcompensated.
3. Decompensated.
4. Terminal (asphyxia).

Symptoms of false croup in children

Symptoms of false croup in children depend on the degree of laryngeal stenosis. The syndrome usually develops on the second or third day of an acute infectious disease with damage to the upper respiratory tract, mainly in the evening or at night. The onset is sudden and acute. The child becomes restless, noisy breathing, inspiratory type of shortness of breath, and rough, barking coughing attacks appear. The severity of the condition is determined by obstructive respiratory failure, the severity of toxicosis, and the addition of complications.

Source: fantasyclinic.ru

With 1st degree laryngeal stenosis the following are observed:

• no signs of impairment external respiration at rest, inspiratory dyspnea during physical exertion and anxiety;
• shortening or loss of respiratory pauses between inhalation and exhalation;
• increase in depth and noise of breathing;
• the presence of isolated wheezing in the lungs, appearing mainly on inspiration;
• bradycardia and compensated respiratory acidosis.

Before the doctor arrives, it is first necessary to provide the child with access fresh air, calm down, give a warm alkaline drink.

For 2nd degree stenosis clinical symptoms increases, the phenomena of stenosis can be permanent or paroxysmal in nature. Signs of 2nd degree:

• stenotic breathing at rest and during exercise, constant shortness of breath of an inspiratory nature, audible at a distance;
• significantly hoarse voice;
• retraction of yielding places chest(jugular fossa, supraclavicular and subclavian fossae, intercostal spaces, epigastrium) due to increased work of the respiratory muscles;
• dry wheezing in the lungs;
• pallor of the skin and visible mucous membranes, perioral cyanosis (bluish coloration of the nasolabial triangle), worsening during a coughing attack;
• tachycardia, anxiety, sleep disturbances;
• subcompensated respiratory or mixed acidosis.

Grade 3 stenosis is characterized by signs of respiratory decompensation and circulatory failure, a sharp increase in the work of the respiratory muscles. Symptoms of grade 3 stenosis:

• superficial, quiet cough;
• sharply hoarse voice;
• pronounced cyanosis of the nasolabial triangle, pallor of the skin;
• paradoxical breathing, inspiratory shortness of breath with extremely difficult inhalation;
• an increase in breathing resistance, which leads to activation of the respiratory muscles and a sharp retraction of the yielding areas of the chest;
• maximum excursions of the larynx during inhalation and exhalation;
• rough wheezing of various sizes, and then a uniform weakening of breathing in the lungs during inhalation and exhalation;
• hypoxemia (low oxygen content in the blood);
• sticky cold sweat on the scalp and face;
• muffled heart sounds, arrhythmia, tachycardia, pulsus paradoxus(loss of pulse wave or slowing of pulse on inspiration);
• anxiety, feeling of fear or lethargy, drowsiness, confusion.

You can use reflex therapy: prepare foot bath to cause reflex vasodilation, press on the root of the child’s tongue to provoke vomiting, tickle his nose, causing a reflex sneeze.

With grade 4 stenosis, there is a sharp deterioration in breathing, and the severity of inspiratory dyspnea and obstructive syndrome increases. Terminal symptoms:

• shallow, frequent, intermittent or arrhythmic breathing with periodic apnea;
• the skin is pale with an earthy tint, the nail phalanges are sharply cyanotic;
• atony of the diaphragm, vocal folds;
• thread-like pulse, difficult to determine;
• convulsive syndrome;
• sharpening of facial features, dilation of pupils;
• a fall blood pressure, muffled heart sounds, bradycardia, then asystole;
• hypoxemia and hypercapnia, deep combined acidosis;
• confusion, possible hypoxic coma.

The child's condition is extremely serious, he becomes indifferent, indifferent, and does not ask for help. False croup with grade 4 stenosis has high risk death due to paralysis of the respiratory center.

Diagnostics

The diagnosis of false croup in children is based on the presence of a characteristic triad of symptoms, auscultation data, and laryngoscopy.

When auscultating the lungs, wheezing and stridor breathing are heard.

In order to visually assess the condition of the mucosa, laryngoscopy is performed. During laryngoscopy, swelling of the mucous membrane of the subglottic space and prolapse of the epiglottis can be detected.

Bacteriological analysis (smears from the surface of the palatine arches and back wall pharynx, nose) are carried out in order to exclude diphtheria, identify and identify the causative agent of a bacterial nature. The establishment of mycoplasma or chlamydial flora is carried out using ELISA and PCR methods.

To assess the degree oxygen starvation The body's blood gas composition and acid-base balance are examined.

Diagnosis of complications, if necessary, includes pharyngoscopy, rhinoscopy, otoscopy, radiography of the lungs and paranasal sinuses.

Hospitalization in the intensive care unit and intensive care Children with stage 3 false croup, as well as those with progression of grade 2 stenosis during therapy, are eligible.

Differential diagnosis is carried out with true diphtheria croup, epiglottitis, acute obstructive bronchitis, foreign body in the larynx or trachea, laryngeal papillomatosis, retropharyngeal abscess, and other diseases that may be accompanied by laryngeal stenosis.

Treatment of false croup in children

Treatment of false croup in children involves early hospitalization with complete and timely etiopathogenetic therapy.

Before the doctor arrives, first of all, it is necessary to provide the child with access to fresh air, calm him down, and give him a warm alkaline drink.

You can use reflex (distractive) therapy: prepare a foot bath to cause reflex vasodilation, press on the root of the child’s tongue to provoke vomiting, tickle his nose, causing a reflex sneeze.

Further treatment is carried out in a hospital. The choice of methods is determined by a specialist and depends on the severity of the stenosis and the severity of the child’s condition.

Etiotropic therapy involves taking antiviral drugs, interferons. In case of bacterial complications and severe laryngeal stenosis, antibacterial therapy is prescribed. For subcompensated and decompensated stenoses of the larynx, it is indicated parenteral administration corticosteroids, inhaled hydrocortisone. To influence the spasmodic component, drugs are used that reduce the contractile activity and tone of the muscles of the larynx and trachea.

Considering the possibility of an allergic component participating in the development of false croup, to eliminate edema in a complex therapeutic activities include antihistamines.

Non-infectious causes of false croup in children include laryngeal injuries, allergic edema, kidney and cardiovascular diseases. Mechanical blockage of the lumen of the larynx can occur due to aspiration of foreign bodies.

Mucolytic and expectorant drugs help thin and remove mucus from the respiratory tract; they are usually prescribed in the form of aerosols and inhalations, sometimes in the form of syrups, throat softening lozenges.

A fairly common syndrome during a viral or, less commonly, bacterial infection respiratory tract is false croup in children. Its danger lies in the rapid and sometimes lightning-fast development, the need to take certain measures even before the arrival of the medical team. Children from one to 5 years of age are most susceptible to it, especially those who have suffered birth trauma, hypoxia during childbirth, or those who are artificially fed.

But even absolutely healthy, rarely ill children can suffer from false croup: an excessive immune response to the introduction of certain viruses and bacteria into the mucous membranes of the respiratory organs is assumed.

False croup is a lack of air intake into the child's body, caused by a narrowing of the glottis due to edema. A child’s larynx is narrow (from 0.5 cm), and during infection its walls thicken and swell, which significantly reduces the lumen windpipe. Increased mucus production in response to infection also reduces the diameter of the airway. In addition, a reflex spasm of the ligaments is often associated, which makes it difficult for air to enter the lungs.

The cause of false croup is catarrhal diseases: ARVI, and parainfluenza (most often), scarlet fever,. If microbes from the tonsils penetrate into the larynx during a sore throat, false croup of bacterial origin may develop. It occurs less frequently than viral cereals, but is no less difficult to tolerate.

Children prone to allergies are predisposed to developing croup during an infectious disease.

Important! Unlike true croup, when an obstacle to the movement of air is created by dense diphtheria films blocking the throat, false croup occurs precisely because of the narrowing of the glottis.

Most often, false croup in children is an acute and ongoing condition. Subacute (gradually developing) course is observed in children with chronic processes - tonsillitis, adenoids, nasal polyps, diseases of the oral cavity. In this case, the symptoms of the disease are not detected immediately, but appear gradually, the body adapts to new conditions before the condition becomes more complicated. Therefore, laryngeal stenosis is often not detected immediately. Children with a clear picture of croup in subacute development feel satisfactory when acute course the condition is severe.

False croup in children: symptoms and treatment

Symptoms of false croup and stages of development of the syndrome

The main sign that the likelihood of developing false croup in a respiratory disease is high is: respiratory failure. The slightest signs of shortness of breath should alert parents, force them to be on alert, and take preventive measures.

Croup can occur suddenly, develop quickly, and in a short period of time go from a mild illness to a severe irreversible condition. But in most cases before terminal stage does not reach, from the bright manifestations of the disease the body returns to its original state just as quickly. But for this you need to know the symptoms and be able to help the child in time.

False croup occurs in 4 stages. If timely measures are taken, negative dynamics can be stopped at stages 1–3. Symptoms of the disease are shown in the table.

Stage I. Compensation

Breathing features: shortness of breath only during emotional or physical stress. It is expressed not so much by increased breathing, but by lengthening the inhalation, the disappearance of the pause between inhalation and exhalation.

Feeling satisfactory, symptoms of the underlying disease (fever, cough, runny nose, etc.)

Outcome: Recovery or transition to the second stage.

Stage II. Subcompensation

Features of breathing: shortness of breath, even at rest, rapid breathing. Inhalation is difficult and accompanied by wheezing. To ensure breathing, auxiliary muscles are activated - the muscles of the chest, abdomen, and when inhaling, the wings of the nose inflate. Cyanosis (blueness) of the nasolabial triangle. Rough barking cough.

The child is restless, touches the collar of his shirt, feels afraid, and cries.

Outcome: Reverse development of the syndrome or transition to the stage of decompensation.

Stage III. Decompensation

Features of breathing: suffocation, paradoxical breathing - superficial and infrequent, pallor of the skin.

The child is lethargic, apathetic, there is no activity, the consciousness is unstable, confused.

Important! Spontaneous resolution of the syndrome at this stage is rare; urgent assistance is required.

Stage IV. Terminal

Features of breathing: respiratory arrest and drop in cardiac activity.

Increased pallor, loss of consciousness, involuntary passage of urine and feces.

Outcome: Clinical death.

Treatment of false croup syndrome

At the first signs of shortness of breath, it is necessary to take measures to stop the attack and eliminate the conditions for its development. The patient's parents should:

• Call immediately ambulance– if croup is suspected, the child needs medical checkup and, based on the results, hospitalization or outpatient treatment;
• Create a calm atmosphere around the patient - do not shout, do not even talk loudly, express confidence in your behavior that the situation is under control;
• If the patient is frightened, take the child in your arms, do not leave him alone in the room - nervous tension causes a reflex contraction of the ligament muscles, which aggravates the situation;
• Ensure an influx of cool, moist air - it is best to open a window, even in winter (wrap up the child first) - cool air reduces the volume of mucous membranes, and moisture dilutes the secretions;
• You can carry out inhalation using a nebulizer - inhaling cold steam will improve the child’s condition;
• If an inhaler is not available, the child is brought into a bathroom filled with steam (it cools in the air), where it is useful to perform distracting foot baths.

These simple but urgent measures should help stop the development of false croup and wait for the arrival of doctors.

Important! In most cases, doctors suggest hospitalization - you should not refuse it: only in a hospital setting is it possible to provide round-the-clock qualified monitoring of the development of the disease.

Prevention of false croup

False croup is a disease of young children. This condition can occur in one child more than once, as a relapse during one illness or during the next illness.

And in adults and children over 6 years of age, croup is extremely rare, as is the case in infants under one year of age. To the younger one school age the danger of a severe development of events is very unlikely - the experience of overcoming various childhood illnesses takes its toll.

Since false croup in children occurs during infectious diseases, it is obvious that it is necessary to ensure that the child gets sick less. However, this does not mean that isolation is necessary to prevent infection. In children, whose immunity is rarely associated with infection, the body's reaction to accidental contact with a pathogen, even the most trivial one, may be excessive. And this is a direct road to the croup.

The most important thing is hardening the body. It is necessary to ensure that the temperature change environment, wind or draft did not become a problem or cause of infection. From the first days of life, children should breathe clean air, walk a lot every day, and be active. Warm and dry air irritates the respiratory tract more than frosty air. Nutritious food will provide correct exchange substances and age-appropriate development.

Contacts with peers will teach immune system respond correctly to germs and viruses, most of which will not harm the child. These measures, of course, do not guarantee that the child will avoid croup, but it will be easier for the body (and parents) to cope with it.

Remember that only a doctor can make a correct diagnosis; do not self-medicate without consultation and diagnosis. qualified doctor. Be healthy!

Stenosing laryngitis (false croup) often develops as a complication viral disease, affecting organs nasopharynx. As a result of the resulting inflammation, swelling appears and a significant increase in the amount of secretion produced. During the course of the disease, there is a significant narrowing of the lumen in the larynx (stenosis), which can lead to difficulty breathing and even suffocation. If false croup is diagnosed, treatment should be comprehensive and based not only on the use of medications, but also on ensuring optimal climatic conditions in the room, balanced diet, sufficient fluid intake.

Causes

Stenosing laryngitis occurs mainly in children between six months and six years of age. The main reason False croup is considered to be a characteristic of a child in the first years of life. Due to the extremely small opening in a child's larynx, even slight swelling can cause breathing difficulties.

The structure of the larynx creates favorable conditions for the development of stenosis before the age of six:

• elastic cartilaginous skeleton;
• narrow and short vestibule of the pharynx;
• high up vocal cords;
• a large number of cellular elements and blood vessels on the mucous membrane of the pharynx.

Important! How younger age a child suffering from false croup, especially serious consequences may cause illness.

Children with a predisposition to allergies are at risk for developing stenosis. reduced immunity, increased emotional excitability. It is also known that boys get croup more often than girls. After the age of six, croup is extremely rare, this is explained by a significant increase in the lumen in the larynx, which becomes wider, so swelling with laryngitis is no longer life-threatening.

False most often appears as a complication as a result of exposure to an infectious disease on the body, often caused by a virus (parainfluenza, influenza, herpes). Much less often, stenosing laryngitis occurs when the body is exposed to bacteria (Haemophilus influenzae, staphylococcus). False croup of a bacterial nature is more complicated.

There are several reasons for the development of edema in stenotic laryngitis:

• a significant reduction in the opening in the larynx due to swelling;
• involuntary spasm of the laryngeal muscles, which significantly aggravates the manifestation of stenosis;
• increased production viscous secretion due to excessive active work glands of the nasopharynx, which causes obstruction of the reduced lumen of the larynx.

Warm and very dry air, poor nutrition, insufficient fluid intake - all this can cause stenosis against the background of an existing infection.

Symptoms

Signs of stenosing laryngitis often develop on the second or third day from the onset of the underlying disease. Doctors identify certain symptoms that indicate that a child is developing false croup:

• barking, dry, annoying cough;
• burning and sore throat;
• rapid, noisy breathing, accompanied by shortness of breath.

These symptoms occur against the background of hyperthermia (body temperature is often above 38 degrees), overexcitation, and increase in size cervical lymph nodes, wheezing, audible when inhaling.

Important! Symptoms of false croup can change during the day; the patient’s condition often worsens during night sleep, which is when attacks of suffocation occur.

Exacerbation of croup symptoms during night sleep is associated with several factors:

• a significant increase in the tone of the parasympathetic nervous system at night, which increases the secretion and contractile activity of the tracheal muscles;
• horizontal position during sleep, which significantly impairs the drainage functions of the lungs.

Experts identify several stages of the development of the disease, each of which corresponds to certain symptoms.

1. The first stage is the initial stage of development of stenosis. The disease is accompanied by difficulty breathing, shortness of breath, which manifests itself solely as a result of physical activity. When examined by a doctor, increased inhalation and dry wheezing may be heard.
2. The second stage of the disease is characterized by the appearance of shortness of breath even in the absence of physical activity. Breathing becomes difficult, inhalation is accompanied by confluence of intercostal spaces. Oxygen deficiency increases, the condition is accompanied by pallor of the skin, cyanosis of the nasolabial triangle. At this stage, excitement increases significantly, the child cannot fall asleep.
3. The third stage requires urgent assistance from specialists. The shortness of breath becomes stronger, the cough becomes more painful. The body's compensatory functions are insufficient, the stenosis worsens, and the cyanosis spreads to the skin. The pulse quickens, the child becomes lethargic.
4. The fourth stage of the disease poses a real threat to life due to asphyxia. At this stage, cough and difficulty breathing, characteristic of stenosing laryngitis, practically disappear, breathing becomes shallow, and arrhythmia occurs. Vital statistics(pressure and heart rate) decrease, the condition may be accompanied by seizures.

Treatment

Treatment of false croup in children should primarily be aimed at preventing and quickly relieving attacks of stenosis, as well as reducing inflammation and swelling.

To prevent attacks of croup, you must:

Often false croup is accompanied by a dry, irritating cough. In this case, you can use antitussive drugs (Sinekod, Codelac). However, the use of these drugs should be done only after consultation with a doctor, and only in situations where false croup is not accompanied by the formation of a large amount of viscous secretion. If false croup produces a large amount of secretion, it is advisable to use expectorants and mucolytics(Lazolvan, Erespal).

Complex treatment of stenosis in children should include the use of antiallergic drugs to reduce tissue swelling, for example, Diazolin, Suprastin, Loratadine.

On late stages development of the croup, it is advisable to use:

• For quick removal for swelling, glucocorticoid drugs (Dexamethasone, Prednisolone) are recommended;
• sedatives to relieve laryngeal spasm, reduce muscle tone (Novo-Passit, Barboval, Valerian);
• anti-inflammatory drugs that reduce swelling and normalize body temperature (Ibuprofen);

Important! IN complex treatment In cases of inflammatory processes occurring in children, the use of an anti-inflammatory drug such as Aspirin is contraindicated due to the risk of developing Reye's syndrome.

• at viral nature false croup, used in complex treatment antiviral drugs(Groprinosin, Arbidol);
• if false croup is bacterial in nature, treatment is carried out using antibacterial therapy(Sumamed, Augmentin).

The use of diuretics helps remove excess fluid from the body, which helps reduce the severity of swelling. For this purpose, special diuretic drugs are used, for example, Arifon, Lasix, Diuver.

Often attacks of croup are accompanied by a reflex spasm of the laryngeal muscles. In order to reduce the symptom, it is necessary to induce the opposite reflex, for example, induce vomiting by pressing on the tongue, or try to induce sneezing by tickling the nose.

Hot foot baths are used as a distracting non-drug procedure. IN in this case blood flows to the extremities, reducing swelling. Warming the chest and larynx area with warm compresses will help reduce muscle tone and relax muscles.

Inhalations are an effective way to reduce the severity of stenosis. For false croup, inhalations using alkaline solutions are indicated, for example, Borjomi, Polyana Kvasova. You can prepare such a solution yourself, at the rate of one teaspoon baking soda per liter of warm boiled water.

First aid

Along with drug treatment, it is important to know the basic principles and methods of providing first aid to a patient with stenosing laryngitis, because without timely measures the disease will develop and can cause death. Therefore, a common viral infection in a child is accompanied by shortness of breath and other symptoms characteristic of stenosing laryngitis, you should:

• call a doctor;
• raise the patient's upper body by placing an additional pillow;
• try to calm the patient, as anxiety can only aggravate the signs of laryngeal spasm;
• ensure a flow of fresh air (open the window), make breathing easier (remove tight clothes);
• be sure to observe optimal climatic conditions in the room: humidity not lower than 50% (with cereals about 70%), temperature not higher than 18-20 degrees;
• Give your child plenty of warm liquid, preferably just water or herbal decoction(chamomile, sage), excluding juices, carbonated drinks;
• can be used before the ambulance arrives antihistamines, described above, antispasmodics (Drotaverine, Papaverine).

Further therapy should be carried out exclusively in a medical facility and carried out under the supervision of a specialist.

Important! In later stages of stenosis development, it may be necessary to surgical intervention: intubation (insertion of a special tube into the trachea) or tracheostomy (insertion of a cannula into the trachea or suturing the trachea wall to the skin).

Inhalations

Inhalations are simple and in an effective way providing first aid and treatment for stenosing laryngitis in children and adults.

1. The easiest way to inhale with a nebulizer is to use alkaline mineral waters. 2-4 ml of liquid is poured into the device, the procedure is carried out for ten minutes, repeated three to five times throughout the day. If the necessary device is not available, then soda can be dissolved in warm water and the child can be given alkaline air to breathe.
2. Inhalation with a nebulizer with a solution of Berodual, Eufillin or Salbutamol is also indicated for the development of stenosis. In this case, the drug is diluted in an age-appropriate concentration with 2 ml of saline, inhalations are carried out 2-3 times a day as prescribed by the doctor.
3. The use of hormonal antiallergic drugs by inhalation also has higher effectiveness compared to oral administration. For stenosing laryngitis, the use of Dexamethasone, Pulmicort, Cromohexal is indicated.

Prevention

In order to reduce the likelihood of stenosing laryngitis in a child, it is important to prevent the occurrence respiratory diseases and treat on time sharp forms diseases.

1. Hardening of the throat. This is a simple procedure that needs to be done regularly. The child should gargle with water, using water first room temperature. Gradually, over several months, the water temperature should decrease, reaching about five degrees. The main thing is not to rush, reducing the temperature by one or two degrees per week, because otherwise the child may get sick.
2. Proper nutrition. Daily diet The child’s diet should be balanced and rich in vitamins and microelements that help in developing immunity and resisting viral infections. It should also be noted that false croup is often caused by allergic reactions for some food products.
3. Compliance with the work and rest regime. Full sleep It is especially important in childhood, as it helps the body restore strength and resist the development of infections.
4. To reduce the likelihood of developing stenosing laryngitis that occurs against the background of viral infections, it is necessary to monitor the cleanliness, temperature and humidity of the air in the apartment where the child lives. Thus, dusty, too warm and dry air can cause drying out of the nasopharyngeal mucosa and the development of complications.

False croup is enough serious pathology, which most often occurs in childhood. This anomaly is characterized by laryngeal stenosis and can lead to very dangerous consequences. To prevent this from happening, the first signs of illness should be a reason to visit a doctor.

False croup in children

This term means inflammatory lesion larynx, which is characterized by swelling of its subglottic area.

As a result, a person develops stenosis and the upper respiratory tract becomes clogged.

This disease is characterized by the appearance barking cough, hoarse voice and shortness of breath. The severity of the pathology depends on the level of damage and constantly changes throughout the day.

Most often, stenosis appears at 2-4 years of age. However, sometimes this condition is observed in children under one year of age. After 5 years, the frequency of pathologies decreases significantly, which is associated with age characteristics structures of the larynx.

Stages

There are several stages of development of stenosis:

1. The first degree is called compensated stenosis. The child remains conscious, but has increased anxiety. With anxiety, inspiratory shortness of breath appears, making it difficult to inhale. Also observed. In a calm state, even breathing and hoarseness in the voice are observed. Skin retain their color.
2. The second degree is a subcompensated stenosis. General state not very severe, but the child experiences increased anxiety and sleep disturbances. Calm breathing is replaced by bouts of rough coughing. This condition is accompanied by an increase in symptoms of inspiratory dyspnea. Hoarseness or hoarseness appears. The skin turns pale, with the exception of the nasolabial triangle, which takes on a blue tint.
3. The third degree is called decompensated stenosis. This is a very serious condition, during the development of which the baby becomes agitated or lethargic. Impaired consciousness may occur. Inhalations are accompanied by a depression of the chest. At the same time, the exhalation is shortened. This degree is characterized by pallor of the epithelium and mucous membranes, sometimes they acquire an earthy tint. The tips of the fingers turn blue, cold sweat appears.
4. The fourth degree represents a state of asphyxia. This is an extremely serious condition in which loss of consciousness and dilated pupils are observed. There is also a risk of seizures. Breathing becomes shallow and silent. The skin takes on a blue tint.

The photo shows the degree of laryngeal stenosis

Causes

The main causes of false croup in children include the following:

1. . The appearance of a barking cough can be caused by measles, parainfluenza, diphtheria, and whooping cough viruses. Once infected, they multiply in the larynx and can cause stenosis.
2. . Wool, household allergens, and food can cause laryngeal spasms in children.
3. Anatomical structure. A child may have a congenital condition, which is characterized by a loose structure of the mucous membranes. This significantly increases the risk of swelling. There may also be a thickening of the fatty layer of the larynx, which increases the risk of narrowing of its lumen.
4. Reception medications. Children should be treated with throat sprays very carefully. A stream of the drug, which is directed towards oral cavity, can provoke the appearance of a reflex spasm.
5. Stressful situations. When false croup appears, any stress can lead to a significant deterioration in the baby's condition. Nervous system children is not as perfect as adults. That's why she reacts inadequately to any external factors. Therefore, during illness, the child needs to be provided with maximum rest.

Provoking factors

The following viruses can cause laryngeal stenosis:

• flu;
• rhinovirus;
• measles;

During development infectious process the mucous membrane swells as a result inflammatory process and the amount of mucous secretions increases. As a result, a spasm of muscle tissue occurs, the space of the larynx narrows and breathing is impaired.

Symptoms

Signs of false croup occur when acute infections for about 2-3 days. The following symptoms appear:

• severe barking cough;
• wheezing when breathing;
• increased anxiety;
• up to 40 degrees;

As the disease progresses, symptoms increase. So, at the initial stage of development, the signs do not cause any particular inconvenience. At the second stage, the manifestations increase, breathing problems arise, wheezing, insomnia and minor symptoms appear.

With the development of the third degree of pathology, noticeable shortness of breath appears, coughing, drowsiness, muffled heart sounds. In advanced cases, the child even loses consciousness.

The severity of the disease varies throughout the day. However, the most dangerous time for a sick baby is night. It is during this period that stenosis manifests itself most strongly, increases and provokes a state of panic, severe shortness of breath and cough.

First aid

Before emergency assistance arrives, you should do the following:

1. Calm the baby and do not show him fear. A state of increased arousal leads to a worsening of the condition.
2. Open a window to provide fresh air. In this condition, the child experiences a lack of oxygen.
3. Make the indoor air warm and humid. A humidifier can help with this. If it is not there, you should place pots with hot water, hang wet towels.
4. If you have an inhaler, you can inhale using soda solution. This will help make the mucus thinner and easier to remove.
5. Give your child plenty to drink to avoid dehydration.
6. At normal temperature You can do foot baths. This will help distract the child and make him more comfortable, since there are many nerve endings on the feet.

How to provide first aid during an attack of false croup, watch our video:

Diagnostics

To identify pathology, you need to conduct a detailed examination, which includes the following procedures:

• analysis clinical picture illness;
• examining the child and listening to the respiratory system;

To assess the severity of the pathology and identify possible complications, the following studies are performed:

• radiography of the sinuses and lungs;
• rhinoscopy.

To make sure that the croup is false, the larynx is examined. If the reason this state is diphtheria, there is a characteristic coating on the walls of the throat.

The photo shows the throat with true and false croup

Treatment algorithm

To cope with pathology, it is very important to choose complex therapy. This should be done by the attending physician, depending on the clinical picture of the disease.

Medication

In case of stenosis of 1-2 degrees, the baby is hospitalized in the infectious diseases department. Pathology of 3-4 degrees requires placement of the child in the intensive care unit.

For severe stenosis, the following drugs are prescribed:

1. - drugs such as and can be administered parenterally, orally or rectally.
2. Antispasmodic drugs - the doctor may prescribe Inhalations

   The most simple method pathology therapies are:

   1. An effective method of treatment is the use of alkaline mineral waters. To do this, pour 2-4 ml of liquid into the device and do the procedure for 10 minutes. Carry out such inhalations 3-5 times a day.
   2. A good method of therapy is inhalation using salbutamol, aminophylline,. In this case, the drug in the required dosage must be mixed with 2 ml of saline solution. The procedure is carried out 2-3 times a day.
   3. An effective method of treatment is inhalation administration of cromohexal.

   Homeopathy and folk remedies

   Unconventional remedies must be used with great caution. Using honey or citrus fruits can only worsen the child's condition. For false croup, it is useful to drink warm milk mixed in equal parts with mineral water. You can also put mustard plasters on your feet.

   Dr. Komarovsky tells how to treat false croup:

   Forecast

   Timely detected croup has a favorable prognosis, provided adequate treatment is provided. If pathology therapy begins at the stage of decompensation, there is a risk of developing severe complications and the onset of the terminal stage. This can be fatal.

   – dangerous pathology, which can lead to the appearance serious complications. To avoid this, it is very important to contact a specialist in a timely manner and strictly follow his recommendations.

The scientific name for false croup, a common childhood disease, is acute stenosing laryngotracheitis. This is very dangerous disease upper respiratory tract, which can have quite serious consequences. False croup occurs more often in the cold season, when the child is most susceptible to attack by microbes and colds. In the article we will consider the features of this disease, its causes and symptoms, how to treat and provide emergency care.

Laryngotracheitis is caused by viruses and bacteria such as:

• Pseudomonas aeruginosa;
• enterococcus;
• staphylococcus, including aureus;
• hemophilus influenzae;
• various E. coli;
• streptococcus.

These are the bacteria and microbes that are directly responsible for the development of laryngotracheitis in a child.

Prerequisites for the disease

What factors anatomical structure baby can lead to the appearance of false croup.

• A peculiar funnel-shaped larynx. This form is typical for the vast majority of children. As the baby grows, this form changes to that of an adult.
• The narrowed lumen of the larynx often becomes an aggravating factor, which leads to the development of false croup.
• If the vocal cords are high, this also complicates the baby’s health.
• The looseness and therefore vulnerability of the connective tissue of the larynx is a factor leading to the rapid development of viral infections.
• Weak respiratory muscles.

Causes of the disease

Why a child may develop false croup. Let's consider what its reasons are.

False croup is not an independent disease, but a complication after major infections. A previous adenoviral infection, as well as influenza, whooping cough, scarlet fever or measles may well provoke the development of laryngotracheitis. This happens, as a rule, in the case of advanced or untreated underlying disease. Chickenpox can also cause complications in the form of false croup.

The narrowing of the larynx, characteristic of false croup, often manifests itself as a reaction to the toxins with which the viral infection “bombards” the baby’s body.

It should be noted that false croup is an exclusively childhood disease, since the child’s respiratory tract is not yet sufficiently developed. And this is a specific “children’s” structure of the bronchi, as well as great amount blood vessels and those located nearby The lymph nodes cause the child to develop false croup.

Most often, cases of the disease occur during transition periods - autumn, spring. It is in the off-season that a child has the greatest chance of catching an unpleasant cold and false croup as its complication. In addition, mothers often wrap their children up excessively in the spring or fall, causing them to sweat and then catch a cold.

False croup- the disease is contagious and is transmitted, like most of them - by airborne droplets. Therefore, contact of a sick child with other children is excluded. It is also necessary to disinfect toys, household items and furniture in the baby's room - the risk of infection remains when using common things.

Video of false croup in children: symptoms and treatment:

Risk factors

In what cases is it most likely that a child will develop this disease?

• Boys get sick more often than girls. Incredible, but this is a real documented fact. Moreover, boys get sick twice as often as the weaker sex.
• Congenital narrowing of the airways often leads to the onset of the disease.
• If a child is prone to colds and suffers from them for a long time, then there is a high risk of developing false croup as a result of one of the colds.
• Childhood obesity under three years of age can also lead to the disease.
• Various allergies to food or medicine are a complicating factor in children's lives.
• If there was a birth injury, the child becomes especially vulnerable.

Symptoms

It should immediately be noted that attacks of this disease are, as a rule, quite threatening in nature. And if medical care is not provided, the consequences can be dire. How exactly does false croup manifest itself in children?

During the day the child breathes heavily, with slight hoarseness. But since this condition does not bother him much, parents usually do not worry much for the time being. But it is very important to know.

At night, an attack of suffocation may begin. It is night attacks of asphyxia that are characteristic of this insidious disease. Night dyspnea is characterized by a number of breaths of about 50, while average rate - 35.

Shortness of breath is usually accompanied by a cough, which becomes sharp and barking. The body tries to use it to remove mucus accumulated in the upper respiratory tract.

If croup is complicated infectious disease or a cold, then along with the listed symptoms the temperature may also rise. Sometimes it can rise to 40 degrees. Allergy, in combination with croup, will manifest itself as itchy, very disturbing rashes.

On video symptoms false croup:

The cervical lymph nodes increase in size, the child has no appetite.

The symptoms listed are related to mild stage false croup. Subsequent signs of the disease may be more dangerous.

These include:

• Nervous inhibition or, conversely, extreme excitement.
• Fingers and lips turn blue.
• Cardiac activity is activated, the pulse quickens.

If these symptoms appear, the child's condition requires immediate attention. In this case, parents need to call doctors and begin providing first aid.

Which herbal cough syrups for children are the most popular and effective will help you understand the contents of this

Urgent Care

How parents and loved ones can alleviate the condition of a child suffering from false croup.

It must be said right away that if you notice a child’s characteristic wheezing shortness of breath during the day, then medical care call immediately, without waiting for the night, when a severe suffocating attack may occur. It is better to prevent illness or make a mistake than to force a child to experience such painful attacks.

Methods of providing emergency care to a child

If an attack of false croup begins, the child breathes with difficulty, he is most likely very frightened by this. Therefore, it is necessary to calm the baby, pick him up, rock him: do everything to ease his uncomfortable psychological and physical state.

The larynx must be cleared of accumulated mucus. The best remedy This is done by inducing vomiting by pressing on the root of the child's tongue.

In the bathroom, fill the bathtub with baking soda. This will help humidify the air in the room and warm it up. Bring your child to the bathroom and sit him on a high chair. At the same time, his legs should be in a basin with warm water. The water should be closer to hot than cool. Such a temperature as the child can tolerate.

On video urgent Care with false croup:

You can give your baby an antispasmodic tablet. No-shpa or papaverine will do.

If the case is very severe, the child’s condition is of serious concern, and the doctors are still not coming, you can inject a 20% glucose solution and 10% calcium gluconate. Prednisolone administered intravenously is also an excellent way to alleviate the baby’s condition.

But if you don’t know how to give injections, then it’s better to wait for the doctors without risking the child’s already serious condition.

Treatment

The famous doctor Komarovsky has repeatedly stated that false croup can be cured most effectively when the symptoms and treatment correspond to each other. He says that the antibiotics that doctors usually prescribe for false croup are not always necessary, and more gentle methods can often be used.

Komarovsky for providing more treatment natural ways, taking into account all manifestations of the disease, its stages and level of complexity. Antibiotics, Komarovsky believes, should be prescribed to a child only when there is a danger of developing a bacterial infection in the body, or it has already begun.

On video how to treat false croup in children:

Treatment methods:

• The child must always lie in bed. No games, walks or other active activities.
• In the event of a suffocation attack, the baby must be calmed down.
• The room needs a flow of fresh air. While the child is being ventilated, the child must be taken out of the room.
• To prevent the mucous membranes of the larynx from drying out during shortness of breath, an excellent solution would be to humidify the air with a steam generator or a special humidifier. If you don’t have these devices in your house, you can spray water into the air from a spray bottle.
• The child should drink more. In this case, the sputum dilutes faster and, accordingly, it leaves the respiratory tract faster.
• Inhalations with alkaline compounds will help alleviate the child’s condition.
• Cough suppressants are necessary if shortness of breath is accompanied by a dry cough.
• Pulmicort injections help in most cases both in the treatment of laryngotracheitis and in relieving acute symptoms.

What children's flu and cold powders should be used first, and how to choose the right one, will help you understand this

But which children's ultrasonic inhaler is the best, and how it should be used correctly, is described in great detail in this

What is the price of Tantum Verde children's spray, and in what case is it used and used, this will help you understand

It will also be interesting to learn about how to apply and use

Prevention

What measures can be taken to reduce the risk of developing false croup.

Every effort should be made to ensure that the baby gets fewer colds and suffers from seasonal infections. To do this you need:

• Do not take your child to places where there is a risk of contracting an infection - in crowded places, shops, hospitals. If someone at home is sick, it is necessary to limit the child’s communication with him.
• Don't wrap your baby up. Overheating often leads to a child getting sick.
• Correct complete diet- deposit good health And normal development baby. Include vitamins, vegetables, herbs and fruits in your menu.
• Hardening helps the child get sick less. Carry out hardening activities according to his age.

On video, prevention of false croup in children:

It is imperative that colds be treated promptly. Don't start the disease. If left untreated, the risk of developing false croup increases many times over. Methods:

• During colds, the child should stay in bed.
• Ventilation and wet cleaning can clean the air and destroy many pathogenic microbes.
• Air humidification is a wonderful measure that can significantly reduce the risk of developing false croup, and simply alleviate the baby’s condition.
• Smoking is prohibited in the areas where the baby is.

As you can see, false croup is a rather dangerous childhood disease. We reviewed the main signs, symptoms, methods of treatment and prevention of this disease. Monitor your child's condition carefully so as not to miss warning signs. Conduct preventive measures and cure completely colds- and the risk of developing false croup will be reduced many times over.