Bronchiolitis is another respiratory disease potentiated by cold days, when viruses are more present. At this time, it usually affects children especially and requires care, especially in children under two years of age. At this stage, the immune system is still immature and can be more easily contaminated by the respiratory syncytial virus (RSV), the main cause of the disease.
Bronchiolitis (inflammation of the bronchioles, the end of the bronchi) needs to be diagnosed and treated carefully to prevent it from getting worse and turning into pneumonia.
This is even more important in minors, whose airways are already small and narrow because of inflammation of the bronchioles. In these cases, there may be a respiratory effort that the child’s body is not prepared to handle.
Keep an eye out for some signs: wheezing, difficulty breathing, or asthma-like shortness of breath indicate severity.
As the first signs are quite common, it is essential that a doctor evaluates the child for the correct diagnosis.
They are similar to those of a common cold and can last from three to 15 days.
- At first, nasal obstruction, runny nose and cough usually occur. There may or may not be fever;
- Between the third and fifth days, there is an increase in the production of secretion in the airways. This makes it difficult for air to come in and out, causing wheezing and tiredness to breathe;
- It is at this stage that the symptoms differentiate. In more severe cases, the appetite decreases and the child can become prostrate, dehydrated, with drowsiness and low blood oxygenation.
Actions to prevent
As there is no specific remedy for the disease and improvement depends on the child’s immune response, it is worth investing in prevention.
The main form of contamination is through respiratory secretions and by contact – that is, children who spend the day indoors with other people, such as day care centers, are more prone to infection.
- Get the flu vaccine, as it helps to reduce the most serious symptoms of the disease;
- Avoid crowds, especially if there are other children with respiratory diseases (and don’t take your child with a fever and cold to daycare, school or children’s parties);
- Keep the environments ventilated;
- Wash your hands often and use the mask correctly;
- Do not expose the child to cigarettes, as smoke inhalation is an aggravating factor for the disease;
- Wash your nose with saline;
- Avoid long trips, shopping trips or social events with children under 3 months of age.
treatment of bronchiolitis
There is no treatment for bronchiitis, which can also be caused by other viruses, such as adenovirus and influenza.
But it is possible to contain the symptoms and in the vast majority of children there is no need to go to the emergency room.
- Inhalation with saline solution to fluidize secretions and help unclog the bronchioles;
- Continue with the nasal wash with saline solution;
- Hydrate the child well, offering water or breast regularly;
- Insist on food.
When there is no respiratory discomfort (wheezing cough or shortness of breath), it is possible to take care of the child at home, controlling the fever and keeping him hydrated and fed.
Hospitalizations are indicated for children who need help in the hospital, that is, when there is low oxygenation in the blood, need to feed the child via nasogastric tubes (insertion of the tube through the nose, down to the stomach) or nasojejunal (insertion of the tube through the nose, down to the intestine) or hydration with intravenous saline.
Children in risk groups, such as extremely premature infants, those with heart disease and lung disease (who have heart or lung disease), are more likely to be hospitalized and develop the severe form of bronchiolitis — for this group, the use of palivizumaban immunoglobulin indicated to increase the protection of babies against infection by the RSV.
In more severe cases, the baby may need non-invasive or invasive mechanical ventilators to ease the discomfort.
Sources: Werther Brunow de Carvalhopediatrician at Hospital Santa Catarina – Paulista; Milena de Paulis, pediatrician and Hospital Israelita Albert Einstein (SP); and Márcio Nehabpediatric infectious disease specialist at the IFF (National Institute of Health for Women, Children and Adolescents Fernandes Figueira) Fiocruz.