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Hospital pediatrics. Broncho-obstructive syndrome in children (the most important)

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45. Broncho-obstructive syndrome in children

Major Causes of Airway Obstruction in Children

1. Upper airway obstructions:

1) acquired:

a) allergic rhinitis;

b) nasal polyps;

c) hypertrophy of the tonsils;

d) inflammation of the epiglottis;

e) viral laryngotracheitis;

f) laryngospasm (with spasmophilia);

g) foreign body;

h) congenital stridor;

i) retraction of the tongue in an unconscious state;

j) mechanical compression of the trachea and bronchi;

2) congenital:

a) thymomegaly;

b) enlarged lymph nodes;

c) tumor.

2. Obstruction of large intrathoracic airways:

1) narrowing of the lumen (developmental anomaly, tumor, scar, foreign body);

2) compression from the outside (tumor, abnormal vessel);

3) excessive collapse due to weakness of the cartilaginous rings and (or) the membranous part (tracheomalacia).

3. Lower airway obstructions:

1) viral bronchiolitis;

2) bronchial asthma;

3) aspiration of vomit;

4) foreign bodies;

5) cystic fibrosis;

6) alpha1-antitrypsin deficiency.

Mechanisms of disorders in obstructive syndrome.

1. Reversible:

1) inflammatory edema and mucosal infiltration and submucosal edema;

2) violation of mucociliary transport, obturation of the bronchial lumen with a viscous secret;

3) bronchospasm.

2. Irreversible:

1) fibroplastic changes in the walls of the bronchi.

2) stenosis, deformation and obliteration of the bronchial lumen.

3) expiratory collapse of the bronchi, the presence of emphysema.

Protective mechanisms of the respiratory apparatus.

1. Mechanical.

2. Biochemical.

3. Immunological.

Author: Pavlova N.V.

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