Prevalence
Viral croup in children can be observed with flu or other acute respiratory viral infections. Especially often the cause of its development is the parainfluenza virus. In case of exposure to such an infectious pathogen, a false croup develops in a child.
Most often, the development of such symptoms is noted in children under the age of two, which is explained by the narrow glottis, elasticity and compliance of the cartilage of the larynx, the presence of loose fiber in the subglottic space. It is even more likely that the disease is typical in children prone to allergies, characterized by atopic dermatitis, since the development of edema is one of the signs of exposure to allergens.
Predisposing factors may be an abnormally narrow respiratory gap of the child, birth trauma. The largest number of infants is observed among premature babies. Due to the fact that the activity of the parainfluenza virus occurs in the autumn-winter period, acute obstructive laryngitis is more common at this time of the year.
Development mechanism
Let's talk about what obstructive laryngitis is and what is the mechanism of its development.
Pathogenic microorganisms, penetrating through the entrance gate into the body, have a pathogenic effect on the mucous membranes of the nose and throat. The larynx becomes reddened and swollen. The further pathological process is based on the narrowing of its lumen, due to the development of edema, hypersecretion of mucus. The air needed for breathing collides with an obstacle as it passes through the larynx. This mechanism underlies the development of croup.
Acute obstructive laryngitis most often develops at night.
This is due to the fact that in the prone position of the child, the prerequisites are created for narrowing the lumen of the larynx not only by developing edema, but also by flowing mucus. As a result of the development of the pathological process, hoarseness of the voice appears, a barking cough.
However, acute obstructive laryngitis is not always accompanied by the development of croup. If preventive actions are taken in a timely manner to prevent further narrowing of the larynx, the development of croup can be prevented. Parents should be alerted to a change in voice and the nature of the cough. If during the day the child's cough progressively grows, the timbre of the voice changes, then at night you can expect a worsening of the condition.
Acute obstructive laryngitis is necessarily accompanied by dyspnea of an inspiratory nature, which is characterized by difficulty breathing.
It manifests itself in noisy breathing, audible at a distance. At the same time, the participation in the act of breathing of the auxiliary muscles, muscle tissue of the intercostal spaces, jugular cavities, and the epigastric region is noted.
Diphtheria
True croup occurs when the body is infected with a diphtheria bacillus. The pathogenic microbe enters the body by airborne droplets, leading to the development of the inflammatory process. Most often, the oropharynx is affected, followed by the spread of the process to the larynx. However, in some cases, there may be an isolated lesion of the larynx. This course is accompanied by pronounced edema, narrowing of the respiratory gap and the development of croup.
True croup is dangerous because the narrowing of the respiratory gap can lead to insufficient oxygen supply to the lungs and brain.
As a result, the patient develops suffocation and hypoxia. At the same time, several stages are noted in the development of symptoms. In addition to the appointment of mandatory specific treatment, each of the stages requires the necessary therapeutic measures. With severe stenosis of the larynx, the only possible way to save the patient's life is tracheotomy.
Preventive actions
However, not only true croup is the cause of the development of life-threatening complications. If acute obstructive laryngitis is left without proper attention, the necessary therapeutic actions are not taken, the child may develop false croup. The main therapeutic and preventive measures are aimed at reducing mucus secretion, improving the breathing process.
They are as follows:
- Creation of an appropriate regime in the room, preventing dryness of mucous membranes. Acute obstructive laryngitis in a child is the reason for creating a temperature regime in the bedroom within the range of 18-19 degrees with a humidity of at least 50%. If the process develops in the warm season, it is necessary to take the child to the bathroom, open the tap with warm water;
- Moisturizing the mucous membranes is also achieved by drinking plenty of fluids. As recommended drinks, preference is given to Borjomi alkaline mineral water, warm milk;
- It is necessary to ensure a sufficient supply of oxygen to the respiratory tract, for which the vents should be opened, the collar of the child's clothes should be unbuttoned;
- Since the development of croup is accompanied by the patient's nervousness, in order to prevent further laryngospasm and improve the condition, it is necessary to create emotional peace for the child, to calm him down;
- In the event that the course of ARVI is accompanied by impaired breathing through the nose, the use of vasoconstrictor drops is indicated, which can quickly relieve swelling and reduce the secretion of discharge.
All these actions must be organized before the arrival of the ambulance. With timely implementation of these measures, acute obstructive laryngitis is characterized by a short and mild course.
Within 7-10 days, all symptoms subside, the voice is restored, the cough regresses. In case of ineffectiveness of the measures taken, there may be a further narrowing of the respiratory gap with the development of stenosis of the larynx.
Laryngeal stenosis stages
Acute obstructive laryngitis in its development goes through several stages. The initial stage is characterized by minor manifestations of respiratory failure. They are short-term, single, pass on their own. Children have a hoarse voice, barking cough. During inspiratory dyspnea, there is a slight cyanosis of the nasolabial triangle. Additional muscles do not take part in the breathing process.
At the next stage, the child's condition worsens. He becomes nervous, tossing about in bed. His skin is pale, there is cyanosis of the lips and limbs. This increases the rough barking cough. Breathing becomes noisy, audible from a distance. The child tries to take a forced position in bed with his head raised. Difficulty breathing becomes more frequent.
The participation of the auxiliary muscles in breathing is manifested by the retraction of the epigastric region, as well as the intercostal spaces and supraclavicular regions. The duration of the stage can range from several hours to five days. During this period, it is necessary to carry out intensive conservative treatment. If adequate measures are not taken, only surgical measures will be effective at the next stage.
The third stage of laryngeal stenosis is characterized by constant breathing difficulties. The child's condition is grave.He is adynamic. Breathing becomes shallow, less noisy. However, this indicates not an improvement in the condition, but an increase in respiratory failure.
Auscultation of the lungs reveals sharply weakened breathing. The only way to save a patient's life is surgery to provide access to the lungs.
In cases where such measures are not taken, the child dies from asphyxiation.
