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LECTURE № 17. Broncho-obstructive syndrome. Clinic, diagnosis, treatment. Respiratory failure. Clinic, diagnosis, treatment

Broncho-obstructive syndrome is a clinical symptom complex observed in patients with generalized impaired bronchial tract patency, its leading manifestation is expiratory dyspnea, asthma attacks. Diseases accompanied by airway obstruction.

The main causes of airway obstruction in children.

1. Upper airway obstruction:

1) acquired:

a) allergic rhinitis;

b) nasal polyps;

c) tonsil hypertrophy;

d) inflammation of the epiglottis;

e) viral laryngotracheitis;

e) laryngospasm (with spasmophilia);

g) a foreign body;

h) congenital stridor;

i) retraction of the language in an unconscious state;

j) mechanical compression of the trachea and bronchi;

2) congenital:

a) timomegaly;

b) an increase in lymph nodes;

c) a tumor.

2. Obstruction of large intrathoracic airways:

1) narrowing of the lumen (developmental anomaly, tumor, scar, foreign body);

2) compression from the outside (tumor, abnormal vessel);

3) excessive collapse due to weakness of the cartilage rings and (or) the membranous part (tracheomalacia).

Iii. Lower airway obstruction:

1) viral bronchiolitis;

2) bronchial asthma;

3) aspiration of vomitus;

4) foreign bodies;

5) cystic fibrosis;

6) a1-antitrypsin deficiency.

Mechanisms of disorders in obstructive syndrome.


1) inflammatory edema and mucosal infiltration and submucous edema;

2) violation of mucociliary transport, obstruction of the lumen of the bronchi viscous secretion;

3) bronchospasm.

2. Irreversible:

1) fibroplastic changes in the walls of the bronchi.

2) stenosis, deformity and obliteration of the lumen of the bronchi.

3) expiratory collapse of the bronchi, the presence of pulmonary emphysema.

The protective mechanisms of the respiratory system.

1. Mechanical.

2. Biochemical.

3. Immunological.

Mechanical protective system of the breathing apparatus:

1) aerodynamic mechanism;

2) mucociliary escalator mechanism;

3) kinetic energy of exhaled air;

4) cough impulse, biochemical protective system of the respiratory system;

5) bronchial secretion of the respiratory system (sialomucins, fukomucins, glucosaminoglycans, etc.);

6) phospholipids of the bronchial cell membranes, alveoli, surfactants;

7) BAS (serotonin, histamine, etc.).

Immunological defense system of the respiratory apparatus.

1. Specific:

1) secretory IgA;

2) plasma IgM, G, E.

2. Nonspecific:

1) alveolar macrophages;

2) lysozyme;

3) kallikrein;

4) lactoferrin;

5) interferon;

6) b-lysine.

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LECTURE № 17. Broncho-obstructive syndrome. Clinic, diagnosis, treatment. Respiratory failure. Clinic, diagnosis, treatment

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