Heavy attack of bronchospasm - condition of acute obstructive respiratory failure.There are symptoms of bronchospasm in patients with moderate bronchial asthma and heavy currents, as well as by inhalation of irritant gases (such as chlorine) and chemical warfare agents.In this article we will discuss the symptoms of bronchospasm and first aid and further treatment of bronchospasm in humans.
bronchospasm - attack symptoms
main clinical symptom of bronchospasm, acute airway obstruction - severe expiratory dyspnea (difficulty exhaling).A patient with symptoms of bronchospasm receives forced position (eg, sitting, resting his chest on the back of the chair).Exhale becomes strained, whistling, kryahtyaschim (NPV can not be increased due to a significant increase in the duration of exhalation).The breath of the patient with symptoms of bronchospasm involved supporting muscles (inspiratory rise shoulders, exhale tightens abdominal muscles), often observed nasal flaring.This leads to an increase in intrathor
symptoms of severe bronchospasm attack when viewed
important to quickly collect anamnesis of bronchospasm.Interrogates a patient with symptoms of bronchospasm or his relatives about the presence of such conditions in the past, specific actions and preparations, which allowed to get out of this state.On palpation of the pulse can be found expressed tachycardia, often exhibit a paradoxical pulse.Auscultation of the lungs can hear plenty of wheezes, while extremely heavy attack develops auscultatory phenomenon of "silent light", ie. E. Over both halves of the chest breathing is practically not carried out.Very informative instrumental methods of investigation, to determine further assistance with bronchospasm.
First Aid bronchospasm
If the state of the symptoms of bronchospasm is not life threatening, in the outpatient setting can hold a peak flow meter to help the patient.In the first aid hospital conditions with bronchospasm immediately begin monitoring blood gas and acid-base balance, if possible, - evaluation of ERF, and more often - heartbeat, CHDTS and blood oxygen saturation in the intensive therapy unit.For symptoms of acute respiratory failure typically decrease PSV and OFVh less than 60% of predicted values, hypoxemia (ra02 below 60 mm Hg. Art.), Hypercapnia (raS02 above 45 mm Hg. Art.).
bronchospasm symptoms Treatment consists of etiopathogenetical measures aimed at the elimination of the underlying disease, and symptomatic, help to reduce the symptoms of bronchial obstruction and improve ventilation.Symptomatic treatment of bronchoconstriction includes measures of drug and non-drug exposure, which are used for relief of asthma attacks, and for supportive care in chronic bronchospasm.
to help preparations with bronchospasm
- sympathomimetic bronchodilators - Adrenomimeticalkie funds, the total in-adrenostimulyatorov and selective (selective) B2 adrenostimulyatorov;
- xanthine derivatives - eufillin etc .;
- holinoliticheskie funds - atropine, platifillin and their analogs.
Adrenomimetiki to treat the symptoms of bronchospasm
Adrenomimetiki (adrenaline, ephedrine) to assist with bronchospasm give a strong and rapid bronchodilation effect, reduces mucosal edema bronchus, but they cause side effects - tachycardia, increased blood pressure, the risk of myocardial infarctionand hemorrhagic stroke.Adrenaline acts immediately since its introduction, and ephedrine - in 40 - 60 minutes.Maximum ephedrine bronchodilatory effect observed after 3 - 4 h. Therefore, for the relief of symptoms of breathlessness attack usually administered concurrently 0.2 - 0.5 ml of a 0.1% solution of epinephrine and 0.5 - 1.0 ml of a 5% solutionephedrine, intramuscularly or intravenously.
Total In-adrenostimulyatorov to help with bronchospasm
Total In-adrenostimulyatorov - izadrin (novodrin, euspiran) ortsiprenalina sulfate (alupent, astmopent) - by acting directly on β1- and .beta.2-adrenergic receptors, inhalation application gives you fastand long-lasting (up to 3 - 4 hours) effect.However, they also cause symptoms of bronchospasm: tachycardia, dizziness, dry mouth, arrhythmia, flatulence.
Selective (Selective) β2-adrenostimulyatorov with symptoms of bronchospasm
Selective (Selective) β2-adrenostimulyatorov - berotek (fenoterol), salbutamol (Ventolin), brikanil (terbutaline sulfate) inhalation application of aid effectiveness, expand the bronchi and stimulatemovement of the ciliated epithelium, the action of drugs continues to 8 hours Technics inhalation drug for relief of bronchospasm: inhaler tube tightly cover the mouth and start to inhale, while pressing on the cap;.at this time should be tightly pinched nose.After a deep breath spray is necessary to 1 - 2 with a hold your breath, then take a slow breath.Do not do more than two breaths and use the inhaler more than four times a day, as in this case, to quickly form a stable bronchi receptors to these drugs, as well as possible "fault light" lethal with their uncontrolled use.
xanthine derivatives for the relief of bronchospasm
xanthine derivatives - aminophylline, etc. -. Help to relieve bronchoconstriction and produce a fast bronchodilation effect in the relief of bronchospasm, reduced systemic arterial pressure and pulmonary artery pressure.Aminophylline administered for 10 - 20 ml / day of 2.4% solution intravenously.Inside, he was appointed by 0.15 g every 6 hours prolonged eufillina promising drugs for relief of bronchospasm -. Athos retard, teopek (teodur, teofill, teolong), the effect of which lasts 12 hours
Holinoliticaskie agent for symptoms of bronchospasm.
Holinoliticaskie funds to help with the symptoms of bronchospasm - atropine, platifillin etc. -. have a strong bronchodilator effect.However, they cause a thickening of mucus, as inhibit bronchial secretion, as well as tachycardia and blurred vision.
Atropine to help the symptoms of bronchospasm
Atropine is used for inhalation (0.2 - 0.3 mg), including in the form of medicinal cigarettes "Astmatol";is administered intravenously and subcutaneously with bronchospasm.Combined preparation administered solutan 20 - 30 drops three times a day by mouth, Efatin (combination of ephedrine, atropine, novocaine) - two inhaled breath, total no more than 3 - 4 times per day.Promising the use of Atrovent to help the symptoms of bronchospasm (a combination of atropine with ventalinom) and combinations Atrovent with berotekom - (Flomax), which are used by inhalation for two breaths after 6 - 8 hours
Corinfar, finoptinum to help with bronchospasm
moderation.preventive bronchodilator properties have calcium antagonists - Corinfar, finoptinum.When symptoms steadily progressing to remove during bronchospasm glucocorticosteroids administered by mouth, intramuscularly or intravenously (Prednisolone 20 - 30 mg per day, or analogs thereof) or as aerosols (beclomethasone, bekotid).
Expectorants to help the symptoms of bronchospasm
for better drainage of the bronchial tree and reduce the viscosity of sputum used expectorants.Among them are sekretoliticheskim drugs for relief of bronchospasm, which act directly on the bronchial mucosa (essential oils, iodides, sodium hydrogencarbonate, etc.);SECRET-motor products that are reflexively - through the stomach and the vomiting center - increase the bronchial secretions (infusion Thermopsis, alteynogo root, leaves mother and stepmother, plantain), mucolytics (trypsin, himopsin, ribonuclease, mukaltin, bromhexine, bisolvon and others.).
Potassium iodide for symptoms of bronchospasm
Potassium iodide - the most powerful expectorant that helps to remove bronchospasm.He was appointed on 1 tablespoon of 3% solution of 5 - 6 times a day after meals, not more than 5 days in a row.Infusion termopsisa 0.8 - 1 g per 200 ml of water was administered before meals for one tablespoon 5 - 6 times a day.Good effect for relief of bronchospasm is the use of ultrasonic inhalations of trypsin and other enzymes himopsina.To improve the arterial blood oxygen saturation is used oxygen therapy.The patient breathes 24 - of 28% oxygen-air mixture through the nose by means of a T-shaped tube.