Croup

One of the most serious conditions at children of the first years of life is a true and false croup. The croup is an acute subdepository laryngitis. At grain acute viral respiratory diseases, flu, diphtheria, measles cause hypostasis and an inflammation of the friable fatty tissue located under voice folds. Puffiness causes narrowing of a gleam of a throat that is followed by breath difficulty. In hard cases death from asphyxia is possible. The croup occurs at children preferential aged up to 5 years. At more advanced age there are changes in an anatomic structure of a throat: friable cellulose almost completely disappears. So, the inflammation to severe hypostasis does not bring in this area, and the croup is impossible. Most often the croup arises at the weakened children inclined to allergic reactions who were born premature and transferred birth trauma.

True croup

The true croup meets rather seldom in connection with reduction of prevalence of diphtheria now. But also presently separate cases are possible. Independently or in combination with pharynx diphtheria, mainly at small children, throat diphtheria can develop. This state is considered to be a true croup. At the same time filmy fibrous imposings extend to a mucous membrane of a throat. Further the spasm of muscles and asphyxia can develop. The true croup proceeds hard and often demands surgical intervention.

False croup

The false croup is a quickly developing hypostasis of a mucous membrane of a throat in subdepository space. Various viral diseases of upper respiratory tracts, flu, measles, a corrosive and thermal burn of a throat can become the reason of a false croup. Hypostasis seldom is followed by a spasm of muscles of a throat. The false croup can become the asphyxia reason only in the most hard cases. Usually even without treatment of grain passes within several hours though also the repeating episodes are possible. Existence of severe fever and asthma is considered adverse.

Croup symptoms

Most often the croup happens at the child at night. In process of increase of hypostasis of cellulose under voice folds croup symptoms appear and amplify. The first signs are not too noticeable. The child can show concern, a fright, begins to be capricious and cry. Then there is an abrupt, dry, as if barking cough. The child has a short wind. Breath becomes frequent and superficial. In a minute there can be till 30-60 respiratory movements. These symptoms of a croup speak about asphyxia (a lack of oxygen) and hypostasis of a mucous membrane of a throat. In process of progressing of a croup complexion at the child becomes red, then pale or cyanotic. Skin on a body and extremities can also become a bluish shade. Cough gains more rough and persuasive character. There is clearly an audible rattle at breath. Against the background of the complicated breath retractions of intercostal spaces appear. The heavy phase of a croup is followed by the expressed asphyxia. The child rushes about, becomes covered cold then, faints, pulse becomes arrhythmic, weak. If not to provide medical care, then spasms and death from suffocation develop further. Symptoms of a false croup seldom correspond to a picture of heavy asphyxia. Signs of such croup remain from several hours to one days, and then completely disappear. The true croup at diphtheria differs in heavier symptoms. Besides, at a true diphtheritic croup the voice osiplost, and then total loss of a voice very quickly appears. The child or cannot speak absolutely, or speaks in a whisper. Emergence of symptoms of a croup demands immediate actions.

Treatment of a croup

The croup demands obligatory medical care from children. Parents should not show the fear to the child not to provoke a sharp aggravation of symptoms. It is impossible to fight against a croup independently at all. It is one of the most dangerous states demanding immediate medical assistance. It is necessary to call crew of emergency medical service or the doctor from policlinic. Before arrival of doctors it is necessary to provide access of fresh air to the patient's bed – to open a window, a window leaf. The child can be taken on hands, but it is necessary to keep him in vertical position. Legs can be placed in a basin with hot water. Give to the child warm water, tea or milk. When the doctor arrives, keep judiciousness, implement accurately all recommendations. The begun hypostasis of a throat will demand immediate hospitalization in a hospital. It is not necessary to insist on out-patient treatment of a croup at children of the first years of life at all. If the child chokes, then the doctor will be forced to resort to tracheotomy. It is the small operation consisting in a section of a trachea and introduction to a gleam of a special cannula (tubule). Such measure will provide to the child intake of air in lungs, and, so will prevent a lethal outcome as a result of asphyxia. Conservative therapy without surgical intervention is possible at the initial stages of a croup. Therapy of a true croup consists in administration of antidiphtherial serum by Bezredko's method. The serum dose at diphtheria of a throat makes  40 000-50 000 international units. At treatment of diphtheria erythromycin or penicillinic drugs are considered as choice antibiotics. A role of antibiotics in treatment of a croup at diphtheria only auxiliary. The false croup is treated with use of glucocorticosteroids, antihistaminic drugs, adrenaline solution. Inhalations of normal saline solution are possible (0,9% sodium chloride). Tracheotomy at a false croup is necessary only in 1% of cases. The forecast of any croup at not too expressed throat stenosis favorable. The severe forms demanding operational treatment often are complicated by pneumonia. The greatest hazard to life is posed by a croup, purulent with a necrosis, at children of early age (up to 3 years). At the same time the most vulnerable are children with the excess body weight, a timomegaliya, allergic diseases.

Prevention of a croup

Prevention of a true croup at children is first of all prevention of diphtheria. In Russia the program of preventive inoculations successfully works. The vaccine is introduced to the child in 3 months for the first time, and then a number of repeated revaccinations to children and adults is made. It is necessary to repeat inoculations because gradually acquired immunity to diphtheria dies away.

For prevention of a true croup the major role is played by the prevention of flu and all acute viral respiratory infections. It is especially important to preserve the child during seasonal epidemics. Sick adults and other children should be isolated. The hardening of children, interferon drugs, respiratory gymnastics has some value. Remembering that more full children are inclined to a croup, pay attention to the child's weight from early age. Consult with the pediatrician about compliance of body weight of your child to his age and growth. In case of identification of excess weight it is necessary to begin fight against extra kilos actively. Exercise stresses and healthy nutrition will help the child grow active and healthy.