Causes of airway spasm

Kinds

Bronchospasm, symptoms in children and adults, and the general clinical picture of the disease may vary depending on its type.

Classification feature	View	Explanations
By coverage level	Partial	With the preservation of areas of normally functioning lung tissue.
By coverage level	Total	Involving all bronchial branches and bronchioles.
According to the degree of reversibility	Reversible	The attack can be stopped with the help of special medications.
According to the degree of reversibility	Irreversible	It cannot be treated with bronchodilators.
Due to the occurrence	Infectious	It occurs as a result of the development of infection against the background of a large accumulation of mucus in the airways.
	Allergic	Due to contact with an allergen.
	Neurotic (with VSD)	Appears as a result of panic attacks with vegetative-vascular dystonia.
According to asthmatic status (in the presence of asthma with prolonged irreversible bronchospasm)	Anaphylactic	It occurs instantly, most often as a result of contact with an allergen.
	Slow (metabolic)	It develops slowly, accompanied by an inflammatory process in infectious pathologies.
	Anaphylactoid	Reduction of bronchioles as a result of exposure to irritants of non-allergic origin (for example, a strong odor).
By reaction to stimulus	Paradoxical	Gives a reverse reaction to medications used to block it.
	Hidden	It appears sharply when an irritant enters the body. It has a progressive increasing character.
	Allergic	Occurs as a reaction to an allergen.

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First aid

The first thing you need to do is remove the irritant that provoked the bronchospasm, you can go out into the fresh air. To remove allergens, you should rinse the nasopharynx with clean water and free the patient from clothing that is squeezing the chest. The person needs to be in a semi-sitting position, immediately given medicine (this can be an inhaler to dilate the bronchi), and a warm drink with an expectorant effect can be prepared. If the attack cannot be stopped within an hour, then you should urgently call a doctor.

Under no circumstances should you give the patient antihistamines, sedatives, or cough medicines, especially those containing herbs, honey, or ointments. This can provoke the development of an allergic reaction, and the patient will become even worse.

Stages and degrees

Bronchospasm is a response to some external irritant. The increase in the attack and the subsequent development of the disease occurs in several stages, differing in severity and possible consequences:

The initial degree is a narrowing of the lumen of the bronchioles as a protective reaction to an irritant (infection, allergen, foreign object).
Increasing - if the irritant is not removed in a timely manner, tissue swelling increases, signs of shortness of breath and a feeling of suffocation appear.
Hypoxia – with a significant narrowing of the lumen, a sufficient amount of oxygen does not enter the body, which can lead to the development of severe pulmonary pathologies or death.

Bronchospasm is the main symptom of chronic inflammatory disease of the bronchi - bronchial asthma. It can be one of the first signs of the onset of the disease and occur during periods of exacerbation.

In this case, bronchospasm has several stages of severity:

Stage I – bouts of unproductive coughing, accompanied by rapid breathing and suffocation.
Stage II – shortness of breath, difficulty breathing (impossible to take a full breath), change in skin color, increased heart rate, arrhythmia.
Stage III – excess carbon dioxide as a result of hypoxia, the onset of coma.

A threat to life occurs already at stage II of the development of the pathology, so immediate medical attention is required.

Symptoms of an attack

The occurrence of bronchospasm is accompanied by the following symptoms:

Breathing becomes noisy and whistling. The whistle is formed when air passes through areas of the bronchi filled with mucus.
Exhalations become longer. This occurs because the lungs cannot compress with the same force, and the patient is forced to use additional muscles in the chest to exhale.
Due to difficulty inhaling, the wings of the nose are strongly retracted.
The neck veins are swollen.
The chest gradually expands and the shoulders rise.
Heart rate increases.
Shortness of breath increases, which turns into suffocation.
On auscultation, wheezing and whistling sounds are heard in the lungs.
Against the background of pale skin, the skin in the area of the nasolabial triangle acquires a bluish tint, and bruises appear under the eyes. The reason is a violation of gas exchange in the lungs.
The face swells and becomes puffy.
A severe, hacking cough appears, during which the patient’s face turns blue or red.
Sweating increases.

During an attack, the patient takes a forced position, which makes breathing easier: he tilts his body forward, focusing on his hands. During this time he experiences the following:

anxiety, fear;
fear of death;
heaviness in the chest;
lack of oxygen.

Symptoms of an attack always appear clearly.

Symptoms

Bronchospasm, symptoms in children and adults, as well as their severity, has similar features and is characterized by:

dry paroxysmal cough;
shortness of breath;
wheezing and chest congestion;
whistling breathing;
feeling of lack of air in the chest;
extended exhalation;
change in color of mucous membranes;
pallor of the skin, and in severe cases, cyanosis.

In an adult, an attack of bronchospasm begins with suffocation and a feeling of lack of air. In this case, inhalation occurs normally, but exhalation occurs with difficulty, which leads to the accumulation of carbon dioxide, and without proper assistance - to hypoxia.

Bronchospasm in children who do not yet know how to speak or cannot express what is happening to them can be recognized by the following symptoms preceding its appearance:

anxiety;
unproductive barking cough, sometimes with a small amount of sputum;
wheezing;
frequent sneezing;
the appearance of shortness of breath and severe heaving of the chest;
pallor of the face with the appearance of dark circles under the eyes and bluish skin in the area of the nasolabial folds.

Most often, an attack in children occurs in the evening or at night, or after swallowing any small objects. When it occurs, the child (like an adult) takes a sitting position with support on his hands, since it is in this position that it is better to cough and clear the airways from accumulated viscous sputum.

Symptoms of bronchospasm

An attack of bronchospasm may be preceded by signs (aura), by which patients are able to determine its approach, as we have already talked about when describing Bronchial asthma in adults - the first signs, treatment.

An attack of bronchospasm manifests itself:

increasing shortness of breath, accompanied by wheezing, prolonged exhalation, wheezing, clearly audible from afar;
increasing lack of air, suffocation;
the characteristic posture of the patient with the body tilted slightly forward, hands resting on a horizontal surface;
expanded chest, raised shoulders;
active involvement of the respiratory muscles during exhalation, visible tension in the muscles of the neck, intercostal muscles;
widening of the wings of the nose, increased sweating, dark circles under the eyes;
increased heart rate;
cyanosis of the skin - the appearance of a bluish tint due to impaired gas exchange in the alveoli - lack of oxygen and accumulation of carbon dioxide in the blood;
swelling, puffiness of the face caused by impaired lymph circulation and increased swelling of tissues;
panic, fear of death, which further intensify bronchospasm.

ENT diseases, in which the functionality of the ciliated mucous epithelium of the respiratory tract is always impaired, may be accompanied by hidden bronchospasm. Latent bronchospasm is a condition of the respiratory system in which spastic changes are compensated, do not manifest symptoms of bronchospasm, but generally impair lung function, which increases the risk of asthma.

Latent bronchospasm is observed in allergic rhinitis, adenoiditis, laryngotracheitis. The detection of this condition indicates a high probability of developing bronchial asthma in the patient, especially in children.

The state of latent bronchospasm is detected using tests with bronchodilators. A positive test means increased bronchial reactivity, a high risk of sudden bronchospasm.

Reasons for appearance

Bronchospastic syndrome in children most often occurs against the background of inflammatory diseases of the bronchi (acute bronchiolitis and obstructive bronchitis) and allergies.

Also, regardless of age, the risk group includes people susceptible to diseases of the respiratory system:

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pneumonia;
tuberculosis;
hay fever;
chronic obstructive pulmonary disease;
rhinitis;
laryngitis;
carditis.

Bronchospasm can be provoked by factors that directly or indirectly affect the functioning of the respiratory system:

viral and bacterial infections or combinations thereof;
interaction with chemicals, toxins and other substances that have a strong odor;
contact with various allergens (animal hair, dust, pollen, medications);
ingestion of foreign objects by young children;
the growth of tumors that compress the respiratory organs;
unfavorable environmental conditions;
the presence of congenital pathologies of the respiratory system;
smoking and drinking alcohol;
passive smoking (when adults smoke in the presence of children);
heredity;
excessive physical activity.

Causes and risk factors

In some cases, bronchospasm is easier to prevent than to relieve. Therefore, it is important to know what situations can trigger the development of a spasm.

The main factors causing bronchospasm:

allergens, household, food, medicinal and other;
chemical irritants, smoke, lime dust, substances with a strong odor;

mechanical irritation of the respiratory tract by a foreign body, including during medical procedures;

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intoxication of the patient due to a viral or bacterial disease of the upper respiratory tract or bronchopulmonary tree;
poisoning of the body due to helminthiasis, fungal infections;
taking drugs that act on the corresponding receptors;
the use of a number of inhalational anesthetics can provoke spasm;
exacerbation of the underlying disease (asthma, chronic obstructive pulmonary disease);
stress;
unfavorable weather conditions.

An increased risk of developing bronchospasm is associated with:

hereditary predisposition;
the patient's tendency to allergies, atopy;
bronchial hyperreactivity, characteristic of young children and people who often suffer from inflammatory respiratory diseases;
smoking, including passive smoking;
working in hazardous conditions.

Treatment of people in whom bronchospasm occurs frequently can be carried out taking into account the side effects of drugs, and additional precautions can be taken if anesthesia is necessary.

Diagnostics

Bronchospasm, the symptoms of which may differ in children and adults, is usually diagnosed by analyzing the patient's complaints and conducting an external examination.

However, to identify the cause of its occurrence and prescribe the correct treatment, a number of additional measures are required:

Laboratory diagnostic methods:

Microscopic examination of sputum to detect respiratory diseases (from 300 rubles).
General and biochemical blood tests to identify deviations from the norm and diagnose pathologies (from 500 rubles and 800 rubles, respectively).

You can take tests at any diagnostic center or clinic for a fee, or free of charge at the clinic at the place of registration, under the compulsory medical insurance policy.

Instrumental methods:

Bronchography – examination of the tracheobronchial tree using x-rays.

Addresses and prices in Moscow:

KB No. 86, Moscow, st. Gamaleya, 15 – from 3 thousand rubles;
Hematological Center of the Russian Academy of Medical Sciences, Moscow, pr-d. Novy Zykovsky, 4 – from 12 thousand rubles.
DKB named after Filatova, Moscow, st. Sadovaya-Kudrinskaya, 15 – from 5 thousand rubles.
GVKG im. Burdenko, Moscow, pl. Gospitalnaya, 3 – from 4.7 thousand rubles.
National Medical Research Center for Children's Health, Moscow, Lomonosovsky Ave., 2, building 1 – 16 thousand rubles.

Computer bronchophonography is an assessment of the spectrum of time and frequency indicators of respiratory waves using a highly sensitive microphone and special programs. The most modern and informative method used in children from 2 years of age. Addresses and prices in Moscow:

Research Institute of Pediatrics named after. Veltishcheva, Moscow, st. Taldomskaya, 2 – from 1 thousand rubles.
University Children's Clinical Hospital named after. Sechenov, Moscow, st. Bolshaya Pirogovskaya, 19, building 1 – from 1.4 thousand rubles.

Capnography is a study of quantitative indicators of carbon dioxide in the flow of exhaled air. The results are displayed in the form of a wave graph-capnogram, based on the indicators of which the depth of inspiration is assessed. Addresses and prices in Moscow:

Polyclinic No. 210, Moscow, sh. Kashirskoye, 57 – 1 thousand rubles.
KB No. 85, Moscow, st. Moskvorechye, 16 – 800 rub.

Pulse oximetry - determining changes in pulse rate, which changes as a result of spasm, and studying the level of oxygen saturation of the bloodstream (allows us to identify respiratory failure). A value in the range of 95 – 98% is considered normal. Addresses and prices in Moscow:

ABC-medicine, Moscow, st. L. Tolstoy, 10, building 1 – 500 rub.
Medsi Children's Clinic, Moscow, st. Bolshaya Pirogovskaya, 7 – 1.2 thousand rubles.
Federal State Budgetary Institution Clinical Hospital, Moscow, st. Losinoostrovskaya, 45 – 1.5 thousand rubles.

Preventive measures

Prevention of pathology is very simple. To significantly reduce the likelihood of laryngospasm, the child must be taken to fresh air as often as possible. Walks in the park are good, sometimes you also need to get out into the forest. Polluted city air negatively affects the condition of many body systems, especially in a small child.

This problem is often caused by overexertion, so the baby must get proper rest. Naturally, it must be protected from stress, which not only increases the chance of developing pathology, but also directly provokes it.

Great importance and general strengthening of the body. The child should eat right and take plenty of vitamins. This significantly reduces the number of transmitted infections. However, if they do occur, they need to be treated promptly. Laryngitis is especially dangerous, since in most cases it is what provokes spasms of the larynx.

When to see a doctor

If any symptoms of bronchospasm occur, you should immediately consult a doctor, since the disease is dangerous with severe complications, and in children under 3 years of age it can be fatal (due to the anatomical features of the structure of the respiratory organs of a growing organism).

The initial examination is carried out by a therapist (or pediatrician), then the patient is given a referral to visit more specialized specialists as necessary - an otolaryngologist, a pulmonologist, an allergist.

In cases of a severe attack with a pronounced change in the color of the skin and loss of consciousness, an ambulance should be called, and further treatment is carried out in a hospital setting.

Causes of throat spasm

In order to know how to act in a situation where a spasm in the throat occurs, the causes should be carefully studied.

There are several main reasons that contribute to the occurrence of throat spasms. These include:

irritation of the laryngeal nerve, for example due to a tumor, goiter or aneurysm;
lubricating the throat with certain medications can also cause contraction of this muscle group;
dust or other irritants entering the inhaled air;
various throat diseases, such as pharyngitis, laryngitis, which can also lead to an attack;
a spasm in the throat may be caused by a disorder of the digestive system, in which case the spasm is also accompanied by heartburn. In this case you need to consult a doctor so that he can prescribe treatment that will help improve the functioning of the esophagus.

Very often, when eating, there is a situation when a sensation of spasm of the larynx appears.
This may actually be caused by the fact that the piece of food was large and is now difficult to swallow. But, if an attack occurs just like that while talking or swallowing saliva, pain appears, and the voice becomes hoarse, most likely the cause lies in an infection or throat disease. It should be noted that a spasm in the throat can be caused by diseases such as sore throat or laryngitis. After an attack, you should immediately consult a doctor so that he can prescribe the necessary course of treatment. In such cases, at home, before going to the doctor, you can gargle with chamomile or sage infusion , which has antiseptic properties and will help remove the infection in the throat.

Prevention

Preventive measures for bronchospastic syndrome are aimed at eliminating possible risk factors that provoke the occurrence of the disease:

rejection of bad habits;
timely treatment of existing diseases, against the background of which spasm may occur;
avoiding contact with allergens;
balanced diet and vitamin intake;
avoiding hypothermia;
avoiding visiting crowded places during cold season;
preventive measures to maintain immunity in the autumn-winter period;
hardening of the body;
maintaining a microclimate in the room with a sufficient level of humidity;
walks in the open air.

Treatment

Therapeutic tactics for spasms of the respiratory muscles include two directions. The first concerns emergency care, and the second is associated with further correction. The goal of treatment, as always, is to eliminate the pathological process that caused the symptoms.

Urgent measures

Respiratory problems have serious consequences, so you should respond to the problem immediately. In case of laryngotracheitis (false croup), even before the ambulance team arrives, the child should be calmed down, distracting procedures should be carried out (steaming the legs, putting mustard plasters on), and steam inhalations. This alone will help relieve a mild attack.

If a spasm in the throat is caused by reflex factors, you can try drinking water, holding your breath, inducing vomiting, or sniffing ammonia. You should always ensure a flow of fresh air and peace. But more severe situations may require more drastic measures. Of the medications used for laryngo- and bronchospasms, it should be noted:

Glucocorticoids (dexamethasone, budesonide).
Bronchodilators (salbutamol, ipratropium bromide).
Antihistamines (Suprastin, Tavegil).
Tranquilizers (diazepam).
Calcium preparations (chloride and gluconate).

The last group of drugs is used as an emergency treatment for spasmophilia or parathyroid hormone deficiency, when the level of calcium in the blood is significantly reduced. In especially severe situations, when respiratory failure increases due to laryngeal spasm, it is necessary to perform tracheostomy or intubation.

Emergency care measures are aimed at eliminating factors that pose a serious threat to the patient’s life.

Therapy

Once the danger has been eliminated, further therapy must begin. The patient is hospitalized in a hospital, where he receives qualified medical care of the appropriate profile. In the first place are medications of various groups:

Bronchodilators.
Topical corticosteroids.
Calcium compounds and vitamin D.
Sedatives.

If tetanus is detected, then only a specific serum containing antibodies to this infection can help. Bacterial laryngotracheitis requires antimicrobial agents, and patients with neurotic reactions should pay special attention to counteracting stress factors and normalizing the daily routine. Each condition has its own treatment regimen.

Treatment methods

Treatment of bronchospasm is aimed at eliminating the irritating factor and relieving the symptom itself. If it occurs for the first time, then the prescription of medications is carried out only by a qualified specialist, since taking them uncontrolled can aggravate the situation.

First aid for symptoms of bronchospasm

Before the doctor arrives, you can try to minimize bronchospasm (symptoms in children are more pronounced and occur in an acute form) by providing first aid to the child:

free the baby from tight clothes;
provide fresh air access to the room (open the window if the child is not allergic to plant pollen);
sit the child in a pose, slightly tilting the torso forward and resting his hands on any support in front of him;
provide warm drinks;
in case of allergic bronchospasm (if such situations were previously diagnosed), rinse the mucous membranes of the mouth and nose with clean water, give an antihistamine;
in the presence of bronchial asthma, stop the attack with bronchodilators;
After the attack subsides, give the child medications to thin the sputum.

Medications

Treatment of bronchospastic syndrome begins with eliminating the attack using drugs:

Adrenergic agonists to expand the lumen of the bronchi by relaxing the smooth muscles:

Ephedrine 5% solution - administered intravenously or intramuscularly in 2 - 3 doses per day, the maximum allowable dose is 150 mg. Contraindicated for children, the cost of the drug is from 800 rubles.
Volmax - tablets in a dosage of 8 mg for adults and 4 mg for children. Allowed for children over 3 years old, take 1 tablet 2 times a day. Cost – from 100 rubles.
Salbutamol is an inhalation aerosol, approved from 2 years of age. Usually prescribed 3 times a day. Cost – from 120 rubles.
Orciprenaline - available in the form of tablets, 2% or 5% solution for inhalation, and aerosol. It is acceptable to use in infancy (from 3 drops of a 2% solution orally). The price of the drug is from 3 thousand rubles.
Glucocorticoids are hormonal drugs to relieve inflammation and eliminate signs of suffocation:
Prednisolone – tablets are prescribed to adults once in the morning (maximum dose – 30 mg), to children up to 4 times a day at the rate of 1 mg per 1 kg of body weight. Price – from 80 rub.
Hydrocortisone solution 2.5% - intended for intravenous or intramuscular administration, as well as inhalation. The drug can be used for children. Cost – from 130 rubles.
Pulmicort is a suspension for inhalation, approved for children from 6 months in a daily dosage of 0.25 mg. Adults are prescribed up to 2 mg of the drug per day. Cost – from 800 rub.
M-anticholinergic blockers are drugs for local inhalation, similar in principle to adrenergic agonists, and do not enter the bloodstream:
Berodual is a drug for inhalation in the form of a solution or aerosol. Cost – from 270 rubles.
Atropine – solution in ampoules. The price of the drug is from 30 rubles.

The dosage of medications and the duration of treatment are set strictly individually, depending on the physiological indicators, age, general clinical picture and severity of the patient’s disease.

After blocking an attack or to prevent its occurrence (in the presence of diseases of the respiratory system), the patient is prescribed mucolytics to thin and discharge sputum:

Lazolvan - in the form of syrup or solution for inhalation. The cost of the drug is from 200 rubles.
ACC - in the form of syrup for babies, effervescent tablets or granules. Cost – from 250 rubles.
Bromhexine 8 Berlin-Chemie – syrup or tablets, from 100 rub.

Further drug therapy is aimed at eliminating the causative agent of the spasm, depending on its type:

antihistamines for allergic bronchospasm (Zodak, Zirtec, Suprastin, Cetrin, Loratadine);
antiviral drugs in the presence of a virus in the body (Anaferon, Isoprinosine, Arbidol, Grippferon);
antibacterial drugs for bacterial infections (Sumamed, Amoxiclav, Flemoxin Solutab, Suprax, Azithromycin).

Additionally, for adults, the drugs Eufillin and Etimizol can be administered intravenously or intramuscularly to stimulate breathing and normalize blood pressure.

Traditional methods

An attack of bronchospasm can only be eliminated with the help of medications. If it occurs, the patient should be given plenty of warm fluids (preferably clean water).

It is prohibited to give any additives that can cause allergies:

honey;
propolis;
dairy products;
any decoctions and infusions of herbs;
Herb tea.

The use of traditional medicine recipes is allowed in the treatment of existing respiratory diseases (provided there is no allergy to components) that can provoke an attack, and boils down to:

heating with potatoes or bags of salt;
inhalations with decoctions of medicinal plants (linden, sage, tea tree) at the rate of 1 tbsp. l. raw materials for 1 glass of water, boil for 5 - 7 minutes, breathe over the steam;
taking anti-inflammatory decoctions or tea from raspberries, linden, chamomile, rose hips, viburnum (both individually and in any combination to taste) – 1 tbsp. l. raw materials per glass of boiling water;
thinning and relieving drinks - milk with honey, butter;
immuno-strengthening agents - for example, a mixture of 1 lemon and a glass of liquid honey with 30 g of grated ginger root.

Propolis is an excellent immunomodulator. Adults can take it in the form of alcohol (in a ratio of 1:10) or vodka (1:5) tincture. After 2 weeks, the product is ready for use. The tincture can be added to food or drinks, 1 tbsp. l. 3 times a day.

To strengthen the child’s immune system, use a decoction of propolis in milk. To prepare it, propolis is diluted in milk in a ratio of 1: 150, the solution is brought to a boil, and then cooled to a comfortable temperature. This composition should be prepared for no more than 1 day of use, since it is not recommended to store it for a long time.

Other methods

In addition to the main course of treatment, various physical procedures may be prescribed:

electrophoresis;
laser therapy;
massage;
breathing exercises;
UHF irradiation.

When hypoxia occurs, an effective method for replenishing the oxygen concentration in cellular structures is oxygen therapy, which involves taking increased doses of oxygen in the form of:

oxygen cocktails;
oxygen baths;
inhalations;
gas mixtures in a pressure chamber.

The use of any additional methods is possible only after eliminating an acute attack of bronchospasm, as prescribed by a doctor.

Prevention of bronchospasm

To reduce the symptoms of bronchospasms, you need to follow the recommendations of doctors:

Do not start treatment of pulmonary diseases that provoke the occurrence of bronchospastic syndrome.
Avoid mental and emotional stress and heavy physical activity.
Avoid foods that cause allergies.
For allergy symptoms, take antihistamines.
Strengthen your body, spend more time in the fresh air.

Those who have had symptoms of bronchial asthma repeatedly should not keep pets in the apartment or use down pillows. You need to regularly do wet cleaning, clean blankets, mattresses and carpets from dust.

Possible complications

Bronchospasm can last from several minutes to several hours, and the longer its duration, the higher the risk of developing serious pathologies and irreversible processes in the body.

Untimely treatment of the disease or lack thereof leads to:

development of status asthmaticus;
transition of spasm to total form;
oxygen starvation;
intoxication of the body with carbon dioxide;
venous stagnation of blood and cardiac arrest;
lethal outcome.

Bronchospasm is a dangerous disease for both children and adults, accompanied by symptoms of suffocation and shortness of breath, and occurring against the background of other existing pathologies. Failure to see a doctor in a timely manner can lead to irreversible consequences, provoke a violation of pulmonary ventilation and cause coma.

Author: Anna Lalochkina

Article design: Vladimir the Great

Causes of pathology

Having understood what laryngospasm is, we can begin to consider the reasons that cause this pathology. Most often it is provoked by microbes that settle in the upper respiratory tract.

Therefore, this disease usually develops against the background of laryngitis and bronchopneumonia.

Pathology can be a consequence of other diseases that are not directly related to the respiratory system. These include, for example, a tumor of the esophagus and inflammation of the gallbladder.

The second most common cause is allergies. They can lead to various reactions, including involuntary spasms of the laryngeal muscles.

There are other causes of laryngospasm. In children, it can occur as a result of small objects (for example, components of plastic toys) getting into the respiratory tract.

Often the corresponding problem arises in children who were bottle-fed during infancy.

Attacks of laryngospasm can also be caused by quite ordinary things, for example, coughing, strong laughter or crying, severe stress, etc.

Once the problem has been resolved, it is strongly recommended to show the baby to the doctor.