Croup is a dangerous disease of the respiratory system that occurs as a complication of acute infectious-inflammatory processes in the respiratory organs. Due to some anatomical and physiological characteristics of a child most likely to develop this disease in small children.
The main danger of croup for the health of the patient is increasing the breathing disorder, which occurs due to narrowing of the larynx and upper trachea. Therefore, this disease has another name – stenosing (i.e. accompanied by a persistent narrowing of the lumen of the organ) laryngitis or laryngotracheitis.
There are two types of croup:
- True. It develops only in diphtheria. The basis of pathology lies specific fibrinous inflammation with the formation of films on the mucous membrane of the larynx (vocal folds). The human respiratory tract clogged by these films, and there is suffocation.
- About. Is a complication of other infectious and inflammatory diseases of the respiratory system. Obstruction of the respiratory ways with the variety of croup occurs mainly due to swelling of the walls of the larynx (and vocal cords).
- False croup occurs most often, so that he will be the main focus in this article.
Varieties of croup
Depending on the prevailing pathological changes in false croup may occur in different forms:
in edema, in which the serious condition of the patient is caused by the swelling of the airway;
in hypersecretory, characterized by the abundant formation of viscous mucus that covers the lumen of the larynx;
in a spasmodic, caused by spasm of respiratory organs;
in the mixed, in which there are several pathological manifestations (edema and hypersecretion, edema and spasm, etc.).
CAUSES OF CROUP
Croup the child may arise against the following infectious diseases:
- Influenza and parainfluenza in most cases.
- Diseases caused by respiratory syncytial virus and adenovirus.
More prone to develop false croup children from 6 months. up to 3 years in older age, this syndrome is much rarer. Such a pattern is due to some anatomical and physiological peculiarities of respiratory system of the child:
- In young children larynx is funnel shaped, and the trachea is narrow the lumen, resulting in even a small swelling of the mucous membrane may lead to the almost complete overlap of these bodies.
- The tendency of the tissues to the development of edema.
- The hyperexcitability of the muscular system the respiratory system.
WHAT HAPPENS WHEN THE CROUP IN THE AIRWAY?
Acute inflammatory process in the larynx is usually accompanied by mucosal edema and mucus production. If this edema pronounced (especially in the most narrow place of the larynx in the area of the vocal cords and under them), the lumen of the first overlapped part, and with the strengthening of pathological changes to a critical level, so the patient can’t breathe – choking. This is croup. Contributes to the violation of the airway in this disease a considerable accumulation of mucus and spasm of the muscles of the larynx. And it is very important that the child’s anxiety, screaming and crying only increase the spasm of the respiratory organs.
Especially the probability of development of croup at night. This is explained by the following physiological phenomena: when a child is long, somewhat differently, the outflow of blood and lymph from the tissues (and therefore increases swelling), drainage decreases the activity of respiratory ways (slime). If the room is dry and warm air, dries the mucous membranes, the risk of respiratory distress increases significantly.
THE SYMPTOMS OF CROUP
For croup characterized by a triad of symptoms:
- barking paroxysmal cough;
- stridor (noisy breathing), especially when the child is crying or agitated;
In addition, there appear secondary symptoms of the disease – intense anxiety, rapid breathing and heartbeat, nausea, hyperthermia.
With the increase of respiratory failure the symptoms worsen, the baby’s skin turns grey or bluish, increased salivation, wheezing is heard already in peace, and replaced the anxiety comes confusion.
DIAGNOSIS OF CROUP
Diagnose croup in a child by the characteristic clinical picture and the presence of symptoms of infectious-inflammatory diseases of the respiratory organs. To conduct any additional studies in these situations is simply no time, as aid to the patient should be given immediately.
Similar to croup symptoms may have other pathological conditions: foreign body aspiration (e.g., getting into the respiratory parts of toys), allergic swelling of the Airways, injury of the larynx, a sudden laryngospasm, epiglottitis, and other. Approach to the treatment of these diseases slightly different, so to treat a child who has symptoms of airway obstruction, it is impossible.
FIRST AID FOR CROUP
The first thing parents must do if your child has symptoms of croup, – to call an ambulance. Continue to do the following (before arrival of doctors you can try to alleviate the condition of the baby):
To take the child on hands and to calm down. As mentioned above, fear and anxiety leads to increased spasm of the Airways.
Wrap patient in a blanket and bring it to the open window or taken on the balcony (it needs the access of cold air). You can also bring the child into the bathroom, running the faucet with cool water (not hot!).
If there is a nebulizer, breathe baby with saline or mineral water.
Important! Any steam inhalations, rubbing, and other similar procedures in croup is contraindicated.
TREATMENT OF CROUP
Children with symptoms of croup hospitalization. The first thing that must be done by the physicians, to restore the airway. It is necessary to reduce swelling and spasm of the larynx, and also the release of its lumen from the accumulated mucus. Therefore, in the prehospital phase, and then in the hospital the patient is following treatment:
HOW TO GET RID OF THE PAIN?
Stitching, pressing, cutting, throbbing… She can have many faces, and we know this from our own experience. It is important to remember that the pain will never disturb us for no reason.
Introduced glucocorticoids to reduce edema of the larynx. Lately pediatricians prefer inhalation to the introduction of such medications (via nebulizer).
The cosmetics, relieving spasm of the Airways (Albuterol, Atrovent, and antispasmodics such as Baralgin), in marked spasm and an additional sedative medications.
Are inhalation of Ambroxol or other drugs that facilitate expectoration of sputum.
If necessary you can enter the antihistamine.
With the ineffectiveness of conservative therapy performed endotracheal intubation or tracheotomy with subsequent mechanical ventilation.
As false croup most often occurs in children on the background of SARS, prevent its development by preventing “colds” diseases. In addition, an important role in preventing the emergence of stenosing laryngitis is the correct behavior of parents in influenza and other similar illnesses in children. It is the implementation of the recommendations of the doctor, creation of comfortable conditions in the room of the patient (clean, wet, cool air), drink plenty of liquids, regular washing of the nose and not the advertised drugs, can reduce the severity of pathological changes in the respiratory tract.
In addition, the ARD is not advisable to do the following: put mustard, rubbing the funds with essential oils to give your baby citrus, honey, and other potential allergens. All of this can cause reflex spasm of the muscles of the larynx and trigger the development of croup.