Bronchospasm

Description:

The Bronkhospastichesky syndrome represents morbid condition of which sudden reversible narrowing of a gleam of bronchial tubes, and, as a result, reduction of their capacity is characteristic. These pathological changes in bronchial tubes give start to deficit of oxygen in fabrics, to development of an asthma and emergence of feeling of suffocation.

Bronchospasm symptoms:

At a bronchospasm the beginning of process looks as well as usual defense reaction, however does not occur further relaxation of a bronchial tube, and hypostasis continues to accrue, there is a situation when the mechanism designed to protect begins to do harm to the patient. It turns out that because of narrowing of gleams of bronchial tubes, air cannot fully arrive to alveoluses, and, respectively, oxygen does not come to blood, and carbon dioxide is not removed outside.

This state, subjectively extremely heavy for the patient, which can constitute serious danger to his life. If not to provide to the person medical care in time, then deficit of oxygen will increase, he will faint, and then all bodies and tissues of the patient will begin to receive irreversible changes in result of air hunger that as a result can lead to the death of the patient.

At a bronchospasm explicit symptoms are noted:

  1. The person suffers a shortage of air, sensation of fear, weights and a congestion of a breast;
  2. Loud breath of the patient can be heard at distance, extended exhaled, whistle is noted;
  3. Emergence of dry painful, hoarse cough with the dense and hard departing transparent phlegm (or without it);
  4. The patient, silently sits, having feathered on hands, shoulders are shifted forward and raised, the head is involved, on a face the feeling of a fright is brightly expressed;
  5. Complexions pale, under eyes blue. At breaths muscles of a stomach and a neck participate, retractions of wings of a nose and intercostal spaces are observed;
  6. It is possible to hear the dry whistling rattle in lungs on an exhalation.

Bronchospasm reasons:

2 layers of bronchial tubes from three are involved in development of a bronchospasm. In fact the bronchospasm is too strong defense reaction on any irritant. Normal at hit blood begins to come to lungs of aggressive substances to a mucous membrane of bronchial tubes actively, it becomes in order that cells of immune system could get access to the pathological center and created an inflammatory barrier around toxin.

If to draw an analogy, it looks probably on reddening and hypostasis around scratch or a cut when in skin there is a similar process, however the bronchial tube is a hollow tube and when its mucous it is thickened because of hypostasis, its internal gleam quite naturally decreases. Also in addition to hypostasis at hit of toxin there is a spasm of muscles of a bronchial wall, and the bronchial tube clenches even stronger, narrowing the gleam. It becomes to protect underlying departments from harmful substances and to accelerate removal of slime which will be quicker is removed on a narrow gleam of a bronchial tube.

The bronchospasm can also be a consequence of impact of some drugs on an organism, namely:

•  in - adrenoblockers;
•  blockers of calcium channels;
•  cholinesterase inhibitors;
•  ASK and other NPVS;
•  APF inhibitors;
•  penicillin.

The Bronkhospastichesky syndrome is especially characteristic of people with tendency to an allergy and the persons having bronchial asthma, actually, the bronchospasm is the leading cause of death from this disease. Even the easy course of bronchial asthma can be complicated by the heavy bronkhospastichesky syndrome capable to lead to the death of the patient. Practically all patients with bronchial asthma very sharply react to tobacco smoke: it causes in them an asthma, breath difficulty if the asthmatic also smoked before developing of the disease, then after several attacks of suffocation it stops doing it.

Treatment of the Bronchospasm:

At a bronchospasm at children follows:

    * As the bronchospasm can have the allergic nature, it is necessary to eliminate at once effect of allergen (whenever possible), whether it be contact with a cat or dust. At emergence of allergic reaction to pollen of plants or dust at once close a window and take away the child from the pulverulent place. Wash a face to the child, rinse a throat and a mouth, wash out a nose;
    * Seat the child, having given semi-sitting position. It is necessary to undo close clothes if there is a belt - to take off it. If the child has no allergy to pollen — open a window;
    * Apply bronchodilatory medicine or an inhaler;
    * Give to the child warm drink, it is also possible to apply additional drugs which improve outflow of a phlegm;
    * Surely call the doctor if after the taken measures, attacks of a bronchospasm are not eliminated for one hour.

At a bronchospasm at children it is impossible at all:

    * To pound the child odorous substances as turpentine, an aromamasl, balms, to give herbs and honey, to apply mustard plasters. It you can strengthen allergic reactions;
    * To apply medical drugs which suppress cough. Do not use antihistaminic drugs of the 1st generation, these drugs promote deterioration in an otkhozhdeniye of a phlegm at a bronchospasm;
    * To give calmatives.

Treatment has to be urgent and intensive. Intravenous injections of such drugs as cholinolytic (atropine or Methacinum), antispasmodics (an Euphyllinum or Halidorum), antihistaminic drugs (Suprastinum, Pipolphenum or Dimedrol), corticosteroids (a hydrocortisone or Prednisolonum) are shown.

Use of adrenaline, morphine and their analogs contraindicated!

Vagosympathetic blockade is useful. In hard cases — forced ventilation of the lungs and dehydration (for prevention of a fluid lungs). The patient has to be under observation of the resuscitator or it is transferred to the relevant department.

Single question costs prevention and therapy of a bronchospasm during an anesthesia. At emergence only of one bronchospasm it is necessary to increase fractional concentration of oxygen in the inhaled air to 100%, to immediately begin the artificial ventilation of the lungs (AVL) with a bag for definition of a pliability of a pulmonary parenchyma and identification of need for IVL under big pressure. Increase in concentration of inhalation anesthetics (a sevoflyuran, isoflurane), except for a desflyuran because of its irritating influence on respiratory tracts, especially at smokers often can give help. The need for anesthesia deepening by intravenous administration of anesthetic (propofol) as the bronchospasm connected with a trachea intubation can be caused by the inadequate depth of anesthesia is possible.