Daily Archive 13.12.2019

Treatment of acute bronchitis

In acute bronchitis, it is necessary to systematically ventilate the ward or room in which the patient is located. Given that the disease can be caused by a viral bacterial or bacterial infection, antibiotics are indicated for children, especially for infants and infants (ampicillin, oxacillin, methicillin, ampiox, carbenicillin, kefzol – p. 232). With viral etiology bronchitis, the use of antibiotics is less justified, although in such cases they can be effective in order to prevent bacterial complications.

Children older than three years and with a mild course of acute bronchitis can be prescribed bactrim, erythromycin, oleandomycin phosphate, sulfonamide drugs (0.15 – 0.1 g / kg / day for 4 or 6 doses).
When applying symptomatic therapy, it is important to take into account that in patients with profuse sputum, antitussive agents can make it difficult to evacuate and worsen bronchial obstruction.
If there is a thick viscous secretion in the tracheobronchial ducts, measures are shown that contribute to its dilution and evacuation. To dilute sputum, reduce inflammatory edema of the bronchial mucosa, inhalations of 1–2% sodium bicarbonate solution are prescribed 2–3 times a day. Humidification and warming of the inhaled air is shown, best of all with the help of ultrasonic humidifiers, aeroionizers, aerosol devices. If they are absent, central heating radiators are used to humidify the air in the room where the patient is located, covering them with a wet, thick cloth.

Apply therapeutic baths for 5 to 10 minutes, daily increase the water temperature from 37 ° C to 40 ° C, warm wraps, distracting agents (mustard, jars, mustard foot baths), warm drink, expectorant medicines, etc.
With an abundance of sputum, postural drainage, contributing to the outflow of it from the affected bronchi. The patient is in Quincke position (with the head down) for 15 to 20 minutes (intermittently). In this position, coughing movements are desirable. The procedure is repeated 2 to 3 times a day. The effectiveness of the drainage increases when it is combined with a vibration massage, which in older children is performed by patting the chest over the affected area with a palm folded in a “boat”. In young children, this procedure is performed by applying rhythmic hits with the ends of the fingers of one hand on the chest or on the finger of the other hand, located along the intercostal space.

To relieve bronchospasm, aminophylline and ephedrine are used. Eufillin is administered orally in a single dose of 2–4 mg / kg 2–3 times a day, intravenously in the form of a 2.4% solution at the rate of 0.1–0.15 ml / kg, but not more than 5–7.5 ml in 150 – 200 ml of 5% glucose solution. Ephedrine is prescribed orally for children up to 1 year old – at 0.002 – 0.003 g; 2 – 5 years – 0.003 – 0.01 g; 6 – 12 years old – 0.15 – 0.02 g; older – 0.025 g 2 to 3 times a day. Prescribe combined powders of ephedrine, diphenhydramine and aminophylline in age doses.

The prognosis of acute bronchitis is favorable, but complications are possible – bronchiolitis, pneumonia. Prevention of acute bronchitis boils down to the prevention of acute respiratory viral infections and increase nonspecific resistance of the body by hardening, proper care of the child, compliance with the indoor air regime, rational nutrition, etc.