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Acute obstructive bronchitis in children
Last reviewed: 04.07.2025

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Acute obstructive bronchitis is acute bronchitis with bronchial obstruction syndrome. Acute obstructive bronchitis is characterized by wheezing. Acute bronchiolitis is a type of acute obstructive bronchitis with damage to small bronchi and bronchioles. Bronchiolitis is characterized by respiratory failure and an abundance of fine-bubble wheezing (children in the first two years of life are more often affected).
Acute obstructive bronchitis is acute bronchitis occurring with bronchial obstruction syndrome, accompanied by impaired bronchial patency due to swelling and edema of the bronchial mucosa (mainly small bronchi), vasosecretion and accumulation of viscous mucus on the walls and in the lumen of the bronchi. In addition, there is an addition of partial reflex spasm of the bronchi due to irritation of the interoreceptors of the mucous membrane.
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What causes acute obstructive bronchitis in children?
Parainfluenza viruses type 3, adenoviruses, respiratory syncytial viruses (RS viruses).
Edema and cellular infiltration of the mucous and submucous membranes of the bronchi, spasm of the smooth muscles of the bronchi, hypersecretion and microcirculation disorder. Obstructive ventilation disorder of the lungs develops.
How does acute obstructive bronchitis manifest itself in children?
Signs of difficulty breathing may appear on the 1st or 2nd day of ARVI and during the viral infection. Breathing becomes noisy, with prolonged exhalation and wheezing audible at a distance. In infants, despite the prolongation of exhalation, dyspnea with retraction of the compliant parts of the chest appears, which indicates difficulty in inhaling as well. A paroxysmal, obsessive cough is characteristic. Percussion over the lungs reveals tympanitis, harsh breathing, multiple wheezing rales over the entire surface of the chest, wheezing is audible at a distance. The timbre of wheezing heard during auscultation depends on the level of bronchial damage: the smaller the bronchi involved in the process, the higher the timbre of the wheezing. When liquid secretion accumulates in the bronchi, wet wheezing occurs; unlike wheezing in acute pneumonia, they are not sonorous, are not constantly localized, and disappear after coughing; they are inconsistent throughout the day.
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Treatment of acute obstructive bronchitis in children
Hospitalization is indicated for infants and young children with moderate to severe acute obstructive bronchitis. A gentle regimen is prescribed, excluding external irritants (unnecessary procedures, examinations). The presence of the child's mother is mandatory. Maximum access to fresh air is necessary (frequent ventilation of the room in which the sick child is located). A physiological diet is given the child's age; force-feeding should not be done. It is important to ensure sufficient water intake not only taking into account age-related needs, but also to ensure sufficient hydration of sputum to improve its evacuation from the respiratory tract. Taking into account what has been eaten, it is recommended to increase the volume of liquid by 1.3-1.5 times. Tea, fruit decoctions, vegetable and fruit juices are used.
Antibiotics are not indicated unless there are changes in blood tests indicating bacterial inflammatory changes. The main treatment for acute obstructive bronchitis is the successful elimination of bronchial obstruction. This is the use of beta2-adrenergic agonists, which give a positive effect quite quickly in most cases. In case of mild obstruction, salbutamol can be prescribed orally 1 mg per dose for children aged 2-4 months and 2 mg per dose for children aged 2-3 years 2-3 times a day.
Treatment of acute obstructive bronchitis
Treatment of obstructive bronchitis in children is a labor-intensive process. Parents need to be patient, first of all, because the child will have to endure not only the intake of unpleasant medications, but also intramuscular injections if the disease progresses rapidly.
The main medicines for this disease are antibiotics. When wheezing appears in the chest, which can be heard even from a distance, it indicates that the bronchi are almost completely clogged with mucus that is produced and is unable to be eliminated on its own. To alleviate the condition, thinning agents are taken, among which inhalations are the most effective.
It is important to remember that at this stage you need to induce a cough, not fight it, so you need to give expectorants, not antitussives. It is necessary to force the sputum from a viscous state to go liquid. After this transition, a cough appears, which is usually called "raw", when during the coughing process you can observe the release of mucus.
Before proceeding directly to inhalations, it is necessary to consult a pediatrician. It is very easy to provoke a child's body to develop allergic reactions, which will greatly complicate the course of an already serious disease. In addition, the disease itself strikes at the immune system, and weakened immunity is an excellent ground for the addition of various infections. Therefore, even the most insignificant step in achieving recovery is best done under the supervision of doctors.
Acute obstructive bronchitis in children deserves special attention. It occurs more than once and is accompanied by severe bronchial spasms, reminiscent of an asthma attack. Such children should be treated only in a hospital, under constant medical supervision. Medicines often require intravenous administration for faster and more effective relief of the causes of the disease. An inhaler with a medicinal substance that relieves bronchospasm should always be at hand.
To restore nasal breathing, nasal lavage and vasoconstrictor drops are used. If body temperature is within normal limits, then physiotherapy procedures can be carried out, which will be aimed at both thinning phlegm and relieving nasal congestion.
Most often, obstructive bronchitis is aggravated by the addition of a viral infection, so the body temperature, as a rule, remains high. In such cases, thermal procedures cannot be carried out. Many parents, at the time of chest congestion, resort to the help of mustard plasters or other improvised means. Until the body temperature is reduced to normal values, the child's chest cannot be warmed.
Special massage exercises are very helpful in thinning mucus in the bronchi. In order to master them, parents should seek help from children's massage therapists. During a consultation with specialists, you should learn about breathing exercises, which will also significantly ease the situation and help the bronchi get rid of excess mucus.
With such a serious disease as obstructive bronchitis, the entire body suffers, so the treatment is not symptomatic, aimed at relieving some individual symptoms, but complex. This includes vitamin preparations and immunostimulants, and drugs to maintain normal intestinal microflora. In the presence of concomitant diseases, parallel treatment may be prescribed.
Obstructive bronchitis in children should be treated with bed rest and a special diet. The diet should prioritize dairy products, plenty of fluids, preferably fruit drinks, and foods with increased vitamin content. Introduce more vegetable dishes, soups, and low-fat broths.
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