Croup in children: symptoms, treatment. Croup: false and true: causes, signs and differences, help, how to treat False circle

False croup is a pathological condition of the respiratory system associated with an inflammatory process in the mucous membrane of the larynx. False croup appears in children on the background infectious diseases, including SARS and influenza, and is accompanied by an attack of shortness of breath. An attack of false croup should not be confused with the state of true croup that occurs when - there are differences in both symptoms and treatment. The croup itself is a condition of acute stenosing or laryngotracheitis, which, based on the name, indicates its symptoms and the nature of the occurrence. With false croup, a state of acute inflammation of the mucous membrane in the larynx is observed, accompanied by swelling in the subglottic region. The resulting edema predisposes to the appearance of stenosis of the larynx and leads to blockage respiratory tract, whereas with true croup, stenosis does not occur.

false croup is a pathological condition of the respiratory system

The disease occurs most often in children 1-5 years old, and the most severe is the obstructive type of false croup in children after 2 years. In any course of the disease, the developed stenosis in the larynx leads to insufficient oxygen supply to the lungs, which ends with hypoxia and disruption of work. internal organs. All this means that croup cannot be left unnoticed and must be treated in a timely manner. It has been proven that if croup is not treated in a timely manner, then it is repeated with each new case of acute respiratory viral infections, tonsillitis and other diseases that affect the respiratory system. In addition to possible complications, the child in acute period suffers from a lack of oxygen, which causes severe, shortness of breath and other unpleasant symptoms. Let us first consider the causes of this complication.

The reasons

There is a group of reasons for which false croup most often occurs. In the first place is a viral infection, that is, a child can get the flu, adenovirus infection, parainfluenza, and he will have complications in the form of inflammation of the mucous membrane of the larynx.

In addition, other infectious diseases cause croup, that is, the reasons:

scarlet fever;
chicken pox;

Not in last place is the virus, which can also lead the child to the development of pathology. Not only viruses cause croup, but also bacteria. Other causes include streptococcal infection, infection with pneumococcus, Haemophilus influenzae.

Note! Despite the fact that a bacterial infection is not as often the cause of croup, the disease is more severe with it, and complications often occur.

Among the common diseases affecting children, tonsillitis, especially with a chronic course, acute rhinitis, pharyngitis, can lead to an attack of stenosis of the larynx. In the post-vaccination period, there is a cough associated with false croup due to a reaction.

There are factors predisposing to pathology:

In the first place is an allergic predisposition, since it is the swelling of the tissues that leads to stenosis, and with allergies, edema is characteristic.
Excessive body weight of a child, often accompanied by a metabolic disorder in the body.
Prematurity of children, since in childhood they are in a weakened state, and they are exposed to frequent colds and infections.
Transferred birth trauma, hypoxia, rickets and diathesis.

It should be emphasized that up to six months the disease practically does not occur, especially in children on breastfeeding, the reasons for this are due to the fact that the child is protected by innate immunity. But at the age of one to one and a half years, as a rule, the disease is most often recorded, as your immunity begins to work. After 5-6 years, signs of false croup are also practically not recorded.

Classification

There is a certain classification, depending on the cause of the development of the disease and on the stage pathological process. If the disease is associated with a viral etiology, then a viral croup occurs, and, accordingly, a bacterial croup is associated with the penetration of bacteria into the body. Also, the pathology can proceed in an uncomplicated form and complicated, requiring immediate treatment.

In total, 4 degrees of false croup are distinguished:

The first degree is manifested by compensated stenosis, in which there is inspiratory dyspnea with difficulty breathing during exercise or anxiety of the child.
The second degree is characterized by subcompensatory stenosis, that is, an attack of shortness of breath can develop at rest and disappears after drug relief or the supply of a sufficient amount of oxygen.
In the third degree, a state of decompensatory stenosis occurs, in which there is an attack of mixed shortness of breath and paradoxical breathing, even at rest.
The fourth stage is dangerous for the life of the child, since severe hypoxia occurs, therefore it is necessary urgent care provided with false croup and hospitalization in the intensive care unit. This stage is called the terminal stage.

In addition, there are three forms of croup that occur at different ages. So, the edematous form develops in a child aged from one to one and a half years and is associated with the anatomical structure and development of children. The second form affects a child older than 2 years and is called infiltrative. With it, the subglottic space in the larynx area thickens, therefore, drug treatment is necessary to eliminate puffiness. The last form is obstructive croup, more common in a child after the age of 2 years. This form of the disease develops when a secondary infection joins, which is why descending laryngotracheitis and false croup are combined.

Symptoms

True and false croup have similarities in symptoms, for example, in both cases there is hoarseness of the voice, attacks of shortness of breath. But there are also differences. First of all, with diphtheria croup, stenosis of the larynx develops gradually, accompanied by signs of aphonia, when, as a false croup, it is characterized by a sharp stenosis and a violation of the voice, although the voice does not completely disappear.

Consider how false croup manifests itself, that is, its symptoms. Pathology begins with the manifestation of symptoms of acute respiratory viral infections and acute respiratory infections. The child's body temperature rises, there is (runny nose), cough. The cough resembles that of a false croup.

A few days later, the classic symptoms appear:

the voice changes, signs of hoarseness, dysphonia appear;
attacks of rough, dry cough increase, which eventually becomes barking;
breathing becomes difficult, noisy with a whistle during inspiration.

Such symptoms do not accompany the child all the time. Most attacks occur in the evening and at night. Due to the lack of oxygen, the child becomes nervous, tries to pull the collar of a T-shirt or shirt. There is a dry cough and heavy breathing, the frequency of which reaches 40 or more breaths per minute. If a strong edema develops in the larynx, then the child is tormented by a state of lethargy, weakness. The skin becomes pale with cyanosis of the lips. Sometimes there are signs of confusion, and even fainting, which requires emergency assistance to kid. Consider what kind of help with false croup should be provided.

First aid

If an attack begins in a child, then help should be provided at home to alleviate his condition. First of all, it is necessary to overcome the child's fear, as it aggravates the clinical picture. Since laryngitis and false croup are similar, the goal of fighting an attack is aimed at normalizing breathing, eliminating coughing. The child must be put to bed in such a state that the top of the body is on a hill. After that, you can give the child a drink by giving him a warm alkaline drink in the form of milk with 1 tsp of soda or 2 percentage solution soda.

If there is a nebulizer at home, then with the help of it it is required to carry out inhalation of physical. solution, if not, then the usual mineral water. Fresh air allows you to remove the attack, so you need to ensure the ventilation of the premises. Next, we remove the attack of croup with the help of instillation vasoconstrictor drops. If available heat, allergy symptoms, then you will need to give the child funds, among which Fenistil, Eden, Claritin is popular. To reduce spasm of the larynx, it is recommended to take antispasmodics (, Drotaverine, Papaverine). The temperature is reduced with the help of Nurofen or Panadol.

With the help of a nebulizer, you can carry out inhalation of physical. solution

Diagnosis and treatment

Consider how to treat false croup, but before that you need to establish the correct diagnosis. To do this, you need to be examined by a pediatrician. Diagnosis of a false croup includes a visual examination, auscultation (listening to the sounds of internal organs), listening to breathing with a phonendoscope. To identify the presence of inflammation or allergies in the body, the child is assigned to take blood and urine tests. If necessary, it may be necessary to x-ray examination respiratory organs, ultrasound.

Consider how to treat false croup with drug therapy. Treatment of an attack in a hospital setting begins with oxygen therapy, the introduction infectious forms antihistamines, antispasmodics. If the child is dominated by nervous excitement, then the reception is indicated sedatives. Treatment of false croup with aggravated symptoms includes taking hormonal drugs(Prednisalone, Hydrocortisone), diuretics (Lasix). Often, inhalations of Adrenaline, Naphthyzinum are prescribed.

Subsequent treatment will be aimed at getting rid of the cause that caused the attack of croup. At bacterial infection antibiotics are prescribed if the disease is of viral etiology, then antiviral agents. Antitussive drugs are prescribed only at the discretion of the doctor, as sometimes they can aggravate the condition of the child.

Having considered the symptoms and treatment of croup, we can conclude that from an early age the child needs to strengthen the immune system, make sure that he does not get cold. It is necessary to consult a doctor in a timely manner with signs of SARS, influenza or.

Sometimes it happens that in a small child against the background of an infectious disease of the respiratory tract, involuntary difficulty in breathing occurs. The study can frighten parents, because their baby is diagnosed with false croup. This pathological condition is quite dangerous, because in the absence of adequate medical measures may result in death. To prevent this from happening, you should understand in more detail the causes that provoke the pathology, its symptoms and the main methods of treatment.

False croup in children: features of the disease

False croup disease is not considered in clinical practice true. Most likely, this condition can be called a syndrome that occurs when infectious lesion larynx and characterized by the appearance in babies of hoarseness, barking, dry cough and unexpected attacks of suffocation. The disease is always associated with the development of an inflammatory process in the region of the larynx, on its mucous membrane. False croup in children is characterized by the appearance in the throat, in the area vocal cords, swelling associated with catarrhal phenomena occurring there. In concept this disease included several species with an infectious etiology.

Doctors call false croup the following varieties this otolaryngial disease:

stenosing laryngitis. Acute inflammation larynx, which in severe cases can spread to the trachea and bronchi. Usually develops after viral infection the bacterial type of microorganisms will join;
subglottic laryngitis. The pathological process is localized directly in the subvocal space. Depends on the features of the anatomical structure of the larynx in babies;
subglottic laryngitis. The main area of inflammation in this form of pathology is the subglottic region. Such localization is associated with its filling not with elastic tissues, but with loose fiber, which does not give it a snug fit and facilitates the penetration of pathogenic microorganisms.

False croup in a child can occur once, but most often this pathological phenomenon is characterized by episodic bursts that are associated with the ingestion of any, even the most harmless infection, into the baby's body. In clinical practice, there have been cases re-development such an unpleasant and dangerous syndrome even with a common cold. This ailment is seasonal in nature and most often the disease overtakes children in the autumn and winter period, but sometimes it is diagnosed in crumbs and in the summer.

Types and types of false croup in children

The classification of this rather dangerous in babies depends on several factors and helps specialists in choosing the right treatment. There are two types of false-type croup - bacterial and viral. Such a division of pathology is directly related to the nature of the origin of the disease. It is also customary to classify false-type croup according to the presence of complications into complicated and uncomplicated.

But most often in clinical practice in children, which is considered a false croup, is divided according to the degree of development in the laryngeal stenosis:

Compensated. Signs of pathology are minimal, there is only inspiratory dyspnea, characterized by difficulty in breathing. It appears only after physical exertion or with a strong anxiety of the baby;
Subcompensated. Inspiratory dyspnea can occur in a child even when he is at rest;
Decompensated. Shortness of breath becomes pronounced and very severe. A baby with this type pathological condition paradoxical breathing is often observed, in which there is a reverse movement of the chest, that is, it increases on exhalation and decreases on inspiration;
Terminal. With this type of laryngeal stenosis, young patients almost always develop severe hypoxia ( oxygen starvation), almost always leading to the death of the child.

As can be seen from the above classification of the disease, laryngitis with stenosis in children, called false croup in medical circles, is a very dangerous pathological condition that requires immediate medical attention.

Causes of false croup in childhood

The problems associated with pathological swelling of the larynx are of concern to many parents, which is why it is worthwhile to figure out what causes false croup in very young children and whether it is possible to avoid the appearance of this syndrome in a baby. The main reason that provokes the development of this negative breath-holding syndrome that accompanies some ENT diseases in crumbs is the anatomical structure of their upper respiratory tract. The baby's larynx and trachea still have an increased softness of the structure, so the edematous tissues surrounding them easily squeeze weak breathing tubes, thereby blocking the flow of air into the lungs.

This is the main cause of false croup in children, but there are a number of certain anatomical and physiological features that are capable of short time lead to the fact that the infectious disease of the larynx will end with this negative syndrome.

Specialists note the following factors risks inherent only in small patients:

functional immaturity of some reflexogenic zones, in which the parasympathetic nervous system becomes temporarily predominant. She's in charge of slowing down physiological processes such as breathing. With age, by the age of 6 children, their maturity comes, and the threat of developing a pathological condition after any cold recedes;
small diameter, softness and suppleness of the cartilaginous skeleton of the larynx, contributing to its regular compression by the surrounding edematous tissues;
its narrow lumen and funnel-shaped shape;
increased excitability of the muscular corset, located in close proximity to the glottis;
excessive friability of the mucous membrane associated with a minimum amount of elastic fibers, which are penetrated by many blood vessels;
disproportionate size and high location of the vocal cords.

But not all children are prone to the occurrence of a pathological condition of the larynx, although its anatomical and physiological structure is the same for all children. This factor is connected with the fact that in order for a false croup to develop, the reasons must be accompanied by a number of negative features. It is they who increase the likelihood of swelling in the larynx that is dangerous for a small child.

The main risk factors that provoke the occurrence of a pathological syndrome are considered to be the tendency for crumbs to allergic reactions, the trauma or paratrophy suffered by him during birth ( overweight infant associated with improper feeding).

False croup: symptoms and manifestations in children

The disease begins against the background of a cold, usually on the 2-3 day of an acute inflammatory process in the larynx. The initial stage of this pathological syndrome, which proceeds with the development of edema in the upper respiratory tract, is characterized by the appearance of the main signs in the evening or at night. Only the false croup that begins in young children has rather mild symptoms, but any parent should know them. This will make it possible to notice the development of the disease in a timely manner and contact a specialist for emergency medical care, which can save the baby's life.

Varieties of the disease

First warning signs, indicating the beginning of the pathological process in the larynx, are:

dry and rough cough of a croaking or barking character;
shortness of breath due to the inability to take a normal breath;
shallow, noisy and very rapid breathing.

This triad of signs is the most characteristic of false croup. It is on it that the development of the disease can be suspected in a timely manner. In addition to specific manifestations, attention should also be paid to general symptoms. As noted by leading otolaryngologists, it lies in the fact that a sick child becomes restless and tearful, often takes a forced position of the body, in which negative symptoms. Also, experts note that in some cases there may be a fever and an increase in body temperature up to 40 ° C. Clinical manifestations with this pathology directly depend on the stage of development of laryngeal stenosis in a particular clinical case.

Their characteristics can be seen in the table:

STAGES OF STENOZIS	CLINICAL MANIFESTATIONS
1 STAGE	Seizures are quite rare, in the absence of seizures, the baby is active and cheerful. The attack itself is characterized by the appearance of a slight cyanosis on the nasolabial triangle, the child's voice is "hoarse", and at night there are short periods accompanied by a dry and barking cough. Also at this stage of the disease, children have moderate shortness of breath.
STAGE 2	The child becomes restless and overly excited. Very noisy and heavy breathing is accompanied by tension of the neck muscles and retraction intercostal spaces. Almost constant shortness of breath appears, and periods barking cough noticeably increase. Paleness of the skin of the face and perilabial cyanosis are constantly present. Also at this stage, the heartbeat noticeably accelerates, and tachycardia appears.
STAGE 3	The baby is constantly in intermittent states of inhibition or excitement, his mind is mostly confused. Shortness of breath becomes so sharp that it makes it difficult to inhale. Exhalation is very short. The breathing process itself is also accompanied by retraction of the intercostal spaces and a noticeable tension of the neck muscles. The skin becomes earthy and constantly covered with cold, sticky sweat, and the legs, arms and face become bluish. The heart beats irregularly and very fast
STAGE 4	Signs of false croup in children at this stage of development are very severe. The baby is completely unconscious. He tries to inhale, but instead gasps for nothing. open mouth. The skin of the crumbs becomes completely cyanotic, the pupils are dilated, and breathing is superficial. Convulsions, irregular pulse and slowing of cardiac activity indicate the onset of complete suffocation

The symptoms of false croup in children listed in the table arise and progress when therapeutic and preventive measures are ignored or serious errors are made in their implementation. If parents are attentive to the health of the crumbs and notice the appearance of any deviations in it, such a development of events, ending in death for the crumbs, can be completely avoided. All that is needed for this is to treat colds in a timely manner, as well as those that can provoke an attack of false croup in a baby. You should also remember the first alarming symptomatology, indicating the onset of a pathological condition. This will make it possible to call a doctor in a timely manner and take emergency measures to save the life of a child.

Diagnosis of false croup

The identification of a negative phenomenon that has affected the region of the glottis does not present any problem for an experienced specialist. In order to detect swelling in the child's throat, the doctor only needs to conduct an initial visual examination of the throat using a laryngoscope based on the patient's symptomatic complaints. With stenosis of the larynx, there is a very characteristic clinical picture, which facilitates its detection. The only difficulty is that it comes in 2 forms, to get rid of which completely different treatment methods are used. That is why parents often ask the question of how to identify false croup in a child without confusing it with another disease.

Otolaryngologists explain that this requires differential diagnosis. Only with its help it is possible to exclude a more dangerous true form disease caused by diphtheria. All studies should be carried out very quickly, since the score in these pathological conditions associated with laryngeal edema is minutes.

Diagnosis of false croup in children is performed using the following methods:

microscopic and bacteriological research throat swab, including bioculture and PCR (polymerase chain reaction), allowing with the greatest accuracy to identify the pathogenic causative agent of the disease and its sensitivity to antibiotics;
ELISA (enzyme-linked immunosorbent assay). It makes it possible to identify the pathogen by detecting specific antibodies in the biomaterial;
study of the acid-base state and gas composition of the blood, helping to identify the level of redox reactions in the body and the ratio of oxygen and carbon dioxide in it. These tests are necessary in order to assess the degree of hypoxia (oxygen starvation).

From instrumental methods studies in the differential diagnosis of stenosis of the larynx are used pharyngo- and laryngoscopy. In the event that a specialist suspects the development of complications, a small patient undergoes rhinoscopy, otoscopy and radiography. Treatment of false croup in children can only be prescribed after the doctor has received all the test results and confirmed the diagnosis.

How and how to treat false croup in children: drugs, drugs, inhalations

The main therapeutic task in this pathological condition is the relief of stenosis of the larynx, as well as the elimination of edema and inflammation from its mucous surface. If a child has been diagnosed with false croup, treatment should be prescribed by a qualified doctor and carried out under his direct supervision. In addition to the use of certain therapeutic measures that can completely stop the disease, doctors advise completely eliminating the influence of negative factors provoking an attack on his body.

Important! What to do with a false croup in a child. All therapeutic measures for this disease should be prescribed to children only by a qualified doctor. Any self-medication can lead to tragic consequences, therefore, if the first signs of alarming symptoms are found in the baby, it is necessary to call an ambulance.

First aid for false croup in children is to carry out the following activities:

calm a frightened child. Any negative emotions, screaming and crying will only make it worse serious condition and cause new spasms;
ensure free access fresh air. To do this, in warm weather, windows open, and in cold weather, a window will be enough;
drink the crumbs with any warm drink with a liquid temperature in the range of 38-40 ° C. It can be like this or juice diluted with water. If the baby cannot drink on its own, it is worth drinking it from a spoon;
give the child an anti-allergic antihistamine drug, such as Claritin, or Tavegil, in an age dosage;
make hot baths for the hands and feet, providing an outflow of blood from the throat and inhalation with a soda solution (a teaspoon of soda per liter of water).

Such emergency care for false croup in children should be known to all parents, since thanks to it it is possible to prevent the onset of asphyxia before the doctors arrive. After the baby is placed in a hospital, and the doctor confirms the diagnosis, he will be prescribed a course of treatment.

Features of drug therapy

Important! If the doctors who came to the call recommend placing the child in a hospital, in no case should you refuse. In most cases, effective treatment of this pathology is possible only in a hospital setting.

Therapeutic measures are assigned to each child individually and depend on the results of the diagnosis, which reveals the degree of development of the pathology. There are also general appointments for severe stenosis of the larynx. In no case should we forget that the listed medicines should not be used on their own, without consulting a doctor, in any case, as this can lead to serious consequences, and even provoke a death in a child:

glucocorticoids. Almost always, doctors prescribe Pulmicort. For false croup in children, it is considered very effective, and is administered rectally, by injection, or orally;
antispasmodics. Best of all, No-shpa helps babies, which is in the first place in the doctor's appointments;
antihistamines. In this group medicines preference is given to Dimedrol, Suprastin or Fenistil;
sedatives, sedatives. The most harmless among them is valerian extract, which is prescribed for babies;
carried out with humidified, medical oxygen.

If the pathology is of a bacterial nature, and against its background, infectious complications, it is mandatory to assign antibacterial drugs, and with a viral one - . Treatment of false croup is also carried out with bronchodilators. It is also necessary to take into account how the cough syndrome is removed with this disease. Here, with an unproductive, dry and barking cough, preference is given to antitussive drugs, and if abundant sputum is noted in the larynx, specialists prescribe intravenous administration calcium gluconate.

When the above course of conservative therapy is ineffective, resort to surgical intervention, in which a tracheostomy (dissection of the trachea) or intubation (the introduction of a special tube into the larynx to facilitate air access) is performed.

Treatment of false croup in children at home: traditional medicine recipes

Many parents are concerned about the question of whether it is possible to carry out therapeutic measures at home in such a pathological condition without going to the hospital for this. For the most part, the response of otolaryngologists to it is negative, since an acute attack of false croup in children
bought only in stationary conditions. But if a pathological condition arose in a child for the first time, and is not accompanied by pronounced symptoms or any complications, such a therapeutic approach is quite acceptable.

Considers possible false croup and Komarovsky, a recognized pediatrician and famous TV presenter doctor. But, as he notes, only after the necessary diagnostic studies have been carried out, and the doctor has prescribed an appropriate medication course. Recipes traditional medicine not only effective, but also safe, as they do not cause addiction and development serious consequences. Despite this, they cannot be used as monotherapy for childhood stenosis of the larynx.

Treating false croup at home with folk remedies permissible only in combination with traditional medicines. Only such therapy can be effective in stopping the pathological phenomenon.

Effective help with false croup in children can be provided by the following medicinal potions prepared according to folk recipes:

infusion from peppermint Designed for spraying baby's throat. To prepare it, pour 250 ml of boiling water into a tablespoon of chopped herbs. The agent is infused in a glass jar closed with a towel for half an hour, after which it is filtered and used to irrigate the neck of the crumbs after each meal;
decoction of herbal collection treats the inflammatory process and swelling of the pharynx from the inside. The composition is mixed from 1 part of crushed licorice root, coltsfoot leaves and plantain taken in 1 part. A teaspoon of the prepared composition is placed in a small bowl, poured with a glass of boiling water and aged for 20 minutes in a water bath. Drink this decoction warm, three times a day, 100 ml.

The above recipes effectively help in the treatment, but they cannot be used if false croup has occurred in children under one year old. Also, do not forget that to achieve positive results With the help of these funds it is possible only on initial stages development of the pathological condition.

Consequences of the disease

At timely diagnosis disease and an adequate course of therapy, the prognosis will be positive, which cannot be said about the complete disregard for the inflammatory process. In this case, the consequences of a false croup can be disastrous.

After the pathogenic bacterial microflora joins the inflammatory process in the glottis, a purulent film begins to form in the larynx.

Against this background, the following complications of false croup arise:

obstructive bronchitis;
pneumonia;
purulent meningitis.

All of them pose a direct threat not only to the health, but also to the life of the baby. In order to prevent such a development of the situation, it is necessary not only to take all measures for the timely detection and treatment of the pathological condition, but also to prevent it.

Prevention of false croup in children and adolescents

When a young child has a tendency to colds, he has a tendency to regular relapses of stenosis of the larynx. Mothers of such babies need to have at home a device for determining humidity, a humidifier and an inhaler. They will help in a timely manner to prevent the development of the next attack in the crumbs. Also, parents of babies who are at risk for the development of this pathological syndrome should know what measures should be taken to prevent its occurrence.

Prevention of false croup in children is as follows:

compliance with the child's daily routine, in which sufficient time is allocated for sleep;
obligatory hardening of the baby, which includes walking barefoot, cold and hot shower and other general strengthening activities;
proper nutrition. Children should consume those foods that contain sufficient amounts of vital trace elements, minerals and vitamins;
development prevention viral diseases. To achieve this goal, it is enough not to visit crowded places. This advice is of particular relevance during mass epidemics.

Some parents give the baby small pieces of ice to suck on to strengthen the baby's throat. But it should not be ordinary, but healing. It is not difficult to get such ice. It is enough to freeze decoctions of those herbs that have an anti-inflammatory effect, such as calendula, sage or chamomile.

By following all these recommendations, it is possible to prevent the occurrence of a pathological condition even in those children who are prone to its development. The above preventive measures it is necessary to closely engage until the child is five years old, since in children 4-5 years old, such a pathology of the larynx occurs in exceptional cases. This is due to the age-related increase in the trachea, and at the same time its lumen.

Informative video

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

The disease can carry a danger to the life of the child, therefore, at its first signs, urgent qualified assistance is needed.

Reasons for the appearance

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

flu;
adenovirus;
herpes.

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

hemophilic bacillus;
staphylococci;
streptococci;
pneumococci.

The disease can occur as a complication:

tonsillitis;
rhinitis;
adenoiditis;
after vaccination.

Children with overweight and a tendency to allergic reactions can be attributed to a special risk group. 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 false croup less often than boys. After 6-8 years, children "outgrow", false cereals disappear.

Classification and types of disease

By its nature, acute stenosis of the larynx can be viral or bacterial. Downstream - complicated and uncomplicated.

There are 4 degrees of false croup:

compensated (1 degree)- characterized by difficulty in breathing during physical exertion or experiences;
subcompensated (grade 2)- Difficulty breathing is also observed in a calm state;
decompensated (grade 3)- characterized by heavy paradoxical breathing, severe shortness of breath;
terminal (4 degree)- a severe attack with hypoxia, which can lead to death.

Symptoms

Basically, acute stenosis of the larynx occurs against the background of acute respiratory infections. Symptoms of the disease appear a few days after the onset of acute respiratory infections. This usually happens in the evening. AT daytime the child may have a fever, runny nose. In the evening, the nature of breathing changes. It becomes bubbling, wheezing and difficult (stridor), the child has difficulty breathing and lacks oxygen.

The stronger the swelling of the larynx, the stronger the noise becomes when inhaling and exhaling. A harbinger of stridor in many cases 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 pronounced swelling of the larynx.

In addition, there are symptoms characteristic of colds:

general weakness;
joint pain;
enlargement of the cervical lymph nodes;
increase in body temperature;
lethargy.

With 4 degrees of stenosis, the symptoms are as follows:

cessation of barking cough;
the disappearance of noise during breathing;
pressure drop;
arrhythmia and weakness of breathing;
There are seizures and bradycardia.

The child's consciousness is confused, he may faint. Without timely first aid measures, asphyxia is possible.

Acute stenosis of the larynx must be differentiated from bronchial asthma. With a false croup, inhalation is very difficult, the noise during exhalation is almost inaudible. Asthma attacks, on the contrary, are accompanied by a free breath and a difficult whistling exhalation.

Diagnostics

To identify false croup and start in a timely manner proper treatment, ENT or pediatrician prescribes a thorough examination of the patient. He examines the child's larynx, listens to the airways.

Held:

microlaryngoscopy;
bakposev material from the pharynx;
otoscopy;
x-ray of the lungs and sinuses;
rhinoscopy;
pharyngoscopy;
blood tests (PCR and ELISA, gas composition).

Treatment Methods

It is desirable to carry out treatment in a hospital, attacks of false croup are very dangerous. Be ready to give first aid to the child.

Important! At the first symptoms of acute stenosis of the larynx, it is necessary to call an ambulance. Swelling of the larynx can be a danger to the life of the child.

On our site you can learn about other diseases of the ENT organs in children. Read about sinusitis; it is written about catarrhal angina; about what to do if a child has an earache, find out the articles. About tracheitis written page; we have an article about the treatment of the common cold with folk remedies.

First aid during an attack

Before providing qualified medical assistance, parents should take measures to alleviate the condition of the baby:

Reassure the child, put him on the bed. Top part the body should be on a hill. A regular pillow will do.
Open a window, humidify the air in the room (with a humidifier or with wet towels);
Release the child from squeezing clothing that constrains the chest.
Give the child a warm alkaline liquid to drink (2% soda solution or Borjomi). This will help moisturize the mucous membranes and thin the mucus.
Make an inhalation with mineral water. It is good to use a nebulizer. (For more information about inhalation with a nebulizer, read the article).
Drip vasoconstrictor drops into the nose.
To relieve swelling, you can give antihistamine(Erespal, Fenistil).
At temperature and fever, give an antipyretic (Nurofen, Paracetamol).
If breathing stops, induce vomiting. This will excite the respiratory center.

Medical therapy

After the arrival of the ambulance, the doctor will assess the severity of the child's condition and determine his treatment regimen. In severe attacks, you can not risk the health of the child and hospitalize him in a hospital.

Therapeutic measures for 1 degree of false croup:

good air supply;
plentiful frequent drinking in a warm form;
mustard plasters on the calf muscles;
inhalations with a solution of sodium bicarbonate, vitamin A, hydrocortisone, aminophylline;
taking antispastic drugs (Papaverine, Atropine);
reception hyposensitizing and sedatives(Pipolfen, Dimedrol);
vitamin therapy.

If there is no effect of such treatment, it is carried out novocaine blockade into the nose. It reduces swelling of the mucous membranes, relieves reflex spasm. With fever at stage 1 of laryngotracheitis, antibiotics are prescribed.

False croup 2 degrees are treated in the same way as 1. Additionally apply:

humidified oxygen;
hypertonic solutions of glucose, calcium gluconate are injected intravenously to relieve edema;
hormone therapy (hydrocortisone, prednisolone);
intravenously prescribed cardiac solutions (Korglikon, Strofantin);
neuroleptic drugs (Promazin, Aminazin).

With stenosis of the 3rd degree, Prednisolone is administered intravenously. The first dose should be ½ daily. Expand the intake of cardiac drugs, give sodium oxybutyrate.

Antibiotics are being introduced a wide range actions:

Tetraolean;
Tseporin.

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

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

At the address, read about how to make a gauze diaper for a newborn with your own hands.

Prohibited actions

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

In order not to increase the swelling in allergy sufferers, you can not give citrus juice, honey, raspberry jam.
In order not to cause spasm of the muscles of the larynx, do not use essential oils, mustard plasters.
No need to rush to give antitussives. Moist cough – protective function organism. When coughing, sputum with harmful toxins is excreted.

Prevention measures

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

harden the child;
strengthen immunity; (Learn articles on how to increase a child's immunity with the help of folk remedies);
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 moisten it.

False croup is a common condition in children, which is facilitated by the anatomical structure of their respiratory organs. It can occur with any manifestation of ARI. Therefore, parents should be prepared for an attack and provide all the means at hand to stop it. Need to call an ambulance with symptoms of false croup, since there is a risk of complications, up to asphyxia.

False croup is a disease that is a lesion of the walls of the larynx. In adults, false croup is extremely rare, much more often, in terms of statistics, true croup is found in them.

The disease has another name: acute stenosing laryngotracheitis. But speaking in a language understandable to a person far from the world of medicine, false croup is a pathology in which a person experiences a severe attack of suffocation and this can end in death.

What is false croup

The term "croup" is translated from the Scottish language as "croak", the disease got its name thanks to characteristic symptom: barking, croaking cough. However, despite the fact that this symptom is indeed included in the clinical picture of patients with croup in most cases, it is not the main one.

The main symptom of croup is a violation of the breathing process, which, in case of improper or untimely assistance, can lead to death as a result of developed hypoxia (oxygen starvation).

Before considering what a false croup is, you should know how it differs from the true one.

With true croup, films form in the human airways, which are a significant physical barrier to normal air circulation. The provocateur of true croup is diphtheria, so true croup is sometimes called diphtheria.

False croup is a consequence of laryngeal edema against the background of an inflammatory process during a bacterial or viral infection (flu, pharyngitis, etc.)

Both true and false croup are dangerous conditions that can lead to suffocation.

Moreover, in both cases the sharp and violent attack shortness of breath is a strong stress for a person, so it is important to know how and why this pathology arises and develops, how to avoid it, how to treat it, and how to properly provide first aid to a person with an attack.

Main causes and pathogenesis

False croup is not independent disease, it is a pathology that accompanies a viral or bacterial infection.

The causes of false croup can be classified as follows:

In adults, a bacterial infection is more common as the cause of the development of a false croup.

Clinical picture

Symptoms of false croup begin with a strong "barking cough" in which little or no sputum is produced. Due to damage to the vocal cords, a person develops hoarseness or even complete aphonia (lack of voice) and stridor - a pronounced whistle during the breathing process.

It is by the severity of the stridor that we can talk about how badly the edema affected the mucous membrane of the larynx.

The symptoms of false croup include signs of the underlying disease that provoked an asthma attack: high fever, intoxication, sore throat, rhinitis.

Considering the fact that adult patients are more likely to experience croup due to a bacterial infection than a viral infection, the signs of false croup are distinguished by a brighter and broader clinical picture.

The development of an attack proceeds in the form of 4 stages, while they can replace each other very quickly, and the time interval from the first to the last stage will take only a few hours.

Stages of development of the disease

The development of an attack of false croup directly correlates with the prevalence of edema: first, it narrows the lumen of the larynx, then it affects the vocal cords, then it involves other body systems (nervous, cardiovascular), suffering from a lack of oxygen.

The onset of an attack of false croup indicates a violation of the breathing process only when physical activity or great excitement. Reflexively seeking to compensate for hypoxia in the body, a person changes the depth and rhythm of breathing: his inhalation becomes longer, and his exhalation is short, with strong wheezing and whistles.
At the second stage, suffocation begins already in a state of complete rest of a person. If you look at his diaphragm during the breathing process, you will notice that the space between the ribs and the jugular cavity are drawn inward during inspiration. Due to the lack of oxygen, the heart begins to work faster, so by feeling the pulse, the patient can detect tachycardia. The skin around the mouth brightens and then acquires a blue tint.
In the third stage, the difficulty in the breathing process is aggravated even more, when inhaling, the area under the diaphragm (epigastric zone) is strongly drawn in, and at the exit - a barking cough. Due to swelling of the larynx, the patient develops dysphonia, because of which he can only speak in a whisper. Hypoxia of the body leads to damage to the central nervous system, as a result of which an attack of strong emotional arousal is replaced by sudden lethargy, drowsiness.
During the fourth stage of false croup, wheezing on exhalation and a barking cough disappear completely. Breathing becomes weak and shallow, blood pressure and pulse drop, confusion gradually gives way to coma. If a person is not brought out of a coma with the help of emergency medical measures, the risk of death is very high.

How before a man adequate health care, the lower the risk of developing severe hypoxia and associated adverse effects.

Diagnostic methods

The first step must be carried out differential diagnosis to exclude the presence of true croup, provoked by diphtheria. For this, the following is carried out:

examination of the patient's larynx, in order to detect dense films there (typical for true croup) or edema (typical for false croup);
a swab from the throat to determine the causative agent of the disease (including diphtheria).

In addition to diphtheria, it is important to exclude the following pathologies:

allergic edema;
pharyngeal abscess;
bronchial asthma;
presence in the respiratory tract foreign body;
tumors in the throat.

During the examination, the doctor listens to the patient's lungs, collects an anamnesis about comorbidities, events preceding the attack, and medications taken.

First aid

Emergency care for false croup is a set of measures that can save the patient's life. Most often, the attack occurs at night, when the patient is in horizontal position therefore, action must be taken immediately.

First of all, you need to call an ambulance service, which will help relieve the attack quickly and efficiently, and then, most likely, hospitalize the patient. But before the arrival of the team of doctors as part of first aid for false croup, the following measures must be taken:

remove any tight clothing from the patient;
ensure the flow of fresh air into the room (open a window, window);
humidify the air to facilitate the breathing process using a special device or water containers placed throughout the room;
give the patient a drink;
when breathing stops, press on the root of the tongue, induce vomiting;
give an antihistamine, if the patient cannot swallow a pill, make an injection (Prednisolone, Suprastin, Ruzam).

It is important to reassure the patient, since stress only exacerbates the symptoms of an attack, to let him know that emergency care has already been provided for croup, the attack will soon pass, there is no danger to life.

After the arrival of the doctors, you need to inform the team about all the drugs that were used as first aid measures.

Treatment Methods

Treatment of false croup takes place in a hospital: this allows the use of more effective treatment methods, as well as, in the event of a repeated attack, immediately provide the necessary assistance.

Treatment of false croup at home is possible if the attack was stopped at an early stage, and the person feels satisfactory.

The main emphasis is on etiological therapy, that is, on the treatment of a disease that entailed such a serious complication as respiratory failure. For this, antibiotics and antiviral agents are used.

You can choose the exact drug after laboratory diagnostics (blood test, examination of a throat swab), but before the results of the research, the doctor prescribes a mutually compatible complex of broad-spectrum drugs.

To stop and prevent seizures, it is necessary to eliminate edema in the larynx. With great success, glucocorticosteroids, for example, Prednisolone, are used for this.

This drug has a wide range of side effects, but given the short course of therapy, one should hardly be afraid of the development undesirable consequences medical treatment.

Symptomatic treatment is carried out with the help of inhalations, which relieve inflammation from the mucous membrane of the throat and vocal cords, and also facilitate the breathing process.

Inhalation with cold vapor, carried out using a nebulizer, is considered safe. The device is filled with normal saline, alkaline mineral water or Naphthyzin.

Considering the fact that excitement exacerbates the symptoms of the disease and provokes the development of a new attack, light sedatives may be recommended to the patient.

Since attacks mainly occur at night, a person may develop a neurosis, as a result of which he will be afraid to go to bed. Properly selected sedatives will eliminate this problem.

Also appointed special diet with the necessary amount of calories, vitamins and trace elements, which helps the body recover faster after an illness.

Thus, the answer to the question of what to do with false croup includes both first aid and the etiological treatment of the underlying disease, the dynamics of which will not allow the development of an asthma attack that is life-threatening.

False croup is a manifestation of acute respiratory infection, in which children experience choking and an unusual "barking" cough. Parents should know how to alleviate the condition of the baby before the arrival of the ambulance, what procedures will restore breathing. You should not try to cure a child on your own, using dubious advice. With this disease, an examination is required for an accurate diagnosis, since similar symptoms occur in other pathologies. Particular care must be taken when providing first aid to a child with allergies.

Usually false croup appears in children older than 6 months. At an earlier age, a breastfed child is protected from the effects of infection by maternal immunity.

Most often, false croup affects children aged 1-5 years. In children older than 6 years, this pathology is extremely rare, since the organs of the respiratory system are more developed, and the immune system is quite strong.

Causes of infectious stenosis

The main cause of false croup is the presence of acute or chronic infectious diseases of the respiratory system.

Premature babies, as well as those with a birth injury, are most at risk of such a complication. It often occurs in children with allergies or chronic diseases respiratory organs. Contributes to the emergence of croup increased excitability of the nervous system.

Infectious diseases with similar manifestations are especially susceptible to children with immunodeficiency syndrome, as well as babies who have beriberi, rickets.

Boys get sick more often than girls. The state of suffocation and painful cough can occur repeatedly, with any cold, until the body gets stronger (this happens after 6 years).

Possible consequences in children

If the parents managed to stop the attack of croup at home, the baby felt better, he still needs to be taken to the doctor. If proper treatment is not carried out, bronchitis, otitis, sinusitis, conjunctivitis may develop. Inflammation of the larynx can develop into pneumonia, purulent meningitis.

What can be confused

True croup. In this case, children experience suffocation due to the formation of films in the larynx that block the airways. This condition, unlike false croup, develops gradually. It is recognized by the presence gray-white coating on the tonsils.

With false croup, you can improve the condition of the child by eliminating swelling and causing a cough, which allows you to clear the lumen of the larynx from mucus. The patient's voice becomes hoarse, but does not disappear at all. With true croup, it is imperative to remove the films with a laryngoscope and a suction device. The voice disappears completely.

Bronchial asthma. This disease is also characterized by suffocation, but there is a significant difference: with a false croup, it is difficult to inhale air, it exhales normally. And with asthma, on the contrary, inhaling is easy, and exhaling is difficult.

Allergic stenosis of the larynx- spasm occurs suddenly, the patient's condition is rapidly deteriorating. The difference is that stenosis and suffocation are the body's response to the effects of any allergen.

Entry of a foreign body into the trachea. Just like with allergies, the cause of suffocation is not the development of an infection in the body.

Types and forms of false croup

The infectious form develops as a result of both viral and bacterial diseases. Depending on the severity of manifestations, the following types of stenosis of the larynx are distinguished:

compensated, in which difficulty breathing occurs in a state of physical activity;
subcompensated, when choking occurs even if the child is lying or sitting;
decompensated manifests itself in a child both at rest and during movement;
terminal (asphyxia) occurs in the form acute attack, in which breathing is completely blocked. If help is not provided urgently, cardiac arrest occurs.

False croup has three forms.

edematous form occurs in babies under the age of 1.5-2 years. The diameter of the lumen of the larynx is too small, and it is shortened. Such features of the anatomical structure lead to the fact that even the slightest edema significantly complicates breathing.

Infiltrative. It develops at the same age, if a purulent inflammatory process occurs in the upper part of the larynx.

Obstructive. Inflammation and swelling spread to the entire larynx, and if a bacterial infection joins a viral infection, the process also develops in the bronchi. This is the most dangerous form of croup and leads to asphyxia. This development of the disease occurs in children older than 2 years.

Symptoms of false croup

As a rule, an attack occurs in a child at night or in the morning. The baby wakes up screaming, he has the following symptoms:

Hoarse breathing with difficulty in inhaling.
Hacking "barking" cough. The child tries to cough up obstructive sputum, but it is scanty and viscous. Due to strained coughing, damage to small blood vessels in the bronchi can occur, and then bloody streaks appear in the sputum.
The voice changes, it becomes hoarse.
The child is afraid that he cannot breathe normally, he is very excited, his eyes are open.
Cough is often accompanied by vomiting.
As a result of lack of air, the child's skin turns pale. Lips and fingertips take on a blue tint.
There are symptoms of the underlying disease that led to the appearance of such a complication.
There are sore throats, runny nose, fever.

When a false croup in a child passes into a terminal form, the skin on the whole body turns blue, the child’s breathing becomes superficial, heart failure appears, feverish state. If a bacterial infection joins a viral infection, fever occurs, progressive shortness of breath, necrosis of the tissues of the larynx may occur, which sometimes causes death.

Signs of bacterial croup are most severe in children under 2 years of age. They usually increase on the 3rd-5th day of illness. Urgent treatment is required to eliminate the bacterial infection.

If there is no bacterial lesion, then suffocation and other dangerous signs completely disappear on the 2nd day of illness.

Video: Signs of false croup. First Home Aid

Diagnostics

The diagnosis is made after studying the external manifestations of the disease and establishing the nature of the disease that caused such a complication.

To distinguish false croup from other diseases, the doctor pays attention to the presence of the following signs:

bluish skin tone, pallor of the nasolabial triangle;
difficulty breathing, retraction of the pectoral muscles between the ribs;
increased respiratory movements;
wheezing noisy breathing, increased heart rate.

After examining the patient and listening to the respiratory organs, laryngoscopy is performed, which allows to study the patency of the respiratory tract. Research in progress in an indirect way(with the help of a reflector located on the doctor's forehead), as well as in a direct way (introduction of a laryngoscope into the larynx).

A throat swab is examined using PCR and ELISA methods to determine the type of infection. In case of doubt about the nature of the pathology, culture is done to detect the sensitivity of bacteria to antibiotics.

A blood test for leukocytes is carried out. If necessary, a chest x-ray is taken. With the help of mirrors, the condition of the mucous membranes of the nose is studied, as well as an examination of the auditory canal and eardrum.

First aid for a child during an attack

If a child has an attack of barking cough, while there are other signs of false croup, it is necessary to call an ambulance, and before it arrives, try to ease the suffocation. It is necessary to try not to show the child your anxiety, otherwise he will be even more frightened, which can increase the spasm of the muscles of the larynx.

To facilitate breathing, it is necessary to provide an influx of fresh, cool and moist air. If it is too dry, it is necessary to moisten it artificially. To do this, hang in the room wet towels, sprinkle water, put a basin of water.

The child can be given a breath of steam, for this go into the bathroom with him, open the tap with hot water or shower. It is necessary to warm his hands with warm water. Mustard plasters are placed on the soles of the feet in order to improve the outflow of blood from the larynx and reduce its swelling.

You can inhale saline with a nebulizer.

Warning: You can not do inhalation over the potato, as the irritating effect of the substances contained in it will cause an increase in cough and increase the spasm of the larynx. It is useful to carry out inhalation over a solution of soda, but this must be done carefully so that the child is not afraid and does not break out, otherwise he may, firstly, get burned, and secondly, nervous stress will only aggravate suffocation. You can breathe steam over a thermos or kettle without covering the child with a towel, but throwing it, for example, on an umbrella, under which to sit with the baby.

If the child cannot breathe through the nose, it is necessary to drip a vasoconstrictor (otrivin, nazivin). give a drink warm milk mixed with alkaline mineral water(for example, Borjomi) or with the addition of a drop of soda. This will help reduce throat irritation and ease coughing.

In order to free the larynx from sticky sputum, you can induce vomiting by pressing on the root of the tongue or the back of the throat. If the baby is not allergic to plants, give him a warm drink. chamomile tea, infusion of plantain or sage (within 10-15 minutes insist 1 tablespoon of dried herb in 1 cup of boiling water). It is necessary to drink in small portions, but often.

If the condition is serious, the child is hospitalized.

Treatment in the hospital

The hospital provides treatment to normalize the patient's breathing. Antihistamines (suprastin, pipolfen, tavegil) are administered intravenously. Calming agents are used. To eliminate swelling of the muscles of the larynx, diuretics are prescribed.

Oxygen therapy is carried out, that is, to weaken the attack of false croup, the child is allowed to breathe air with high content oxygen. When treating in a hospital with the help of a nebulizer, inhalations are made with naphthyzinum (a vasoconstrictor), as well as with pulmicort ( hormonal drug). To suppress cough, corticosteroid drugs are also administered intramuscularly or intravenously during treatment. Doses of prednisolone or hydrocortisone are selected strictly individually, taking into account the weight and age of the baby.

In addition to emergency therapy, treatment with antiviral drugs (such as arbidol, viferon, algirem) is also carried out. If a bacterial infection is detected, antibiotic treatment is prescribed.

To speed up the excretion of sputum, agents are prescribed that have an expectorant effect (ambrobene, bromhexine, lazolvan). These drugs are given to children in the form of syrup. Erespal (an anti-inflammatory drug) is used in the same form. Vitamins are prescribed.

Doctors advise parents to turn Special attention the need for preventive vaccination against the most severe infectious diseases, dangerous complication which is a false croup. During SARS epidemics it is recommended to use antiviral drugs(grippferon, viferon) in the form of ointments or nasal drops.