• Obstructive bronchitis: is this pathology simple in children?

Obstructive bronchitis: is this pathology simple in children?

SOVREMENNAYA PEDIATRIYA.2017.6(86):87-96; doi 10.15574/SP.2017.86.87

Okhotnikova Ye. N., Duda L. V.
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Objective: efficiency determination and safety of the saline solution use in the comprehensive treatment of young children with obstructive bronchitis (OB).
Material and methods. In total 45 children were followed-up with OB aged from 1.5 months to 3 years. In all children an acute respiratory viral infection triggered the OB development. All patients received comprehensive treatment that included bronchodilatory therapy through a nebulizer, anti-inflammatory therapy, systemic corticosteroids; the intravenous fluid and symptomatic therapy was carried out due to medical reasons. All children were divided into three groups: I group — 15 (33.3%) patients with respiratory failure of grade II, who were administered inhalation of sodium chloride as a mono<preparation (3% LORDE); group II — 16 (35.6%) children with respiratory failure of grade III, who inhaled the combined drug, which consists of 3% hypertonic sodium chloride solution and hyaluronic acid (3% LORDE hyal hyper); group III (comparison group) comprised 14 (31.1%) patients with respiratory failure, grade IІ-III, who were not administered hypertonic solution of sodium chloride.
Results. Due to the conducted combined therapy, the patients of group I showed improvement in general condition, reduction of respiratory disorders and appearance of productive cough on average on the third day (3.08±0.95). In children of group II, a similar improvement was registered at the end of the third day (3.18±1.01), and in group III it was on the fifth day (5.46±1.05). The duration of inpatient treatment decreased in children, who received one of the hypertonic saline solutions, was on average up to seven days. Patients of group III stayed at hospital 9.46±2.4 days. Despite the fact that the children of group II had more severe respiratory disorders, better treatment outcomes were obtained due to the properties of sodium hyaluronate, which promotes the reduction of the inflammatory process intensity, moistening and reconstruction of the bronchial mucosa. There were no adverse effects of treatment.
Conclusions. The efficiency of hypertonic solutions of sodium chloride as a mono-preparation (3% LORDE) and in combination with hyaluronic acid (3% LORDE hyal hyper) in the combined treatment of OB in young children was proved. These drugs usage reduces hospital stay of children and improves the tolerability of basic therapy. Nebulizer therapy with LORDE hyal hyper due to the moisturizing effect of sodium hyaluronate, demonstrates the expressed efficacy and excellent tolerance of the drug, prevents bronchospasm as a negative effect and can be recommended for use in severe bronchial obstruction. Due to the moisturizing effect of hyaluronic acid and its addition to the hypertonic solution of sodium chloride prevents bronchospasm as a possible adverse effect.
Key words: obstructive bronchitis, young children, hypertonic solution of sodium chloride.

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