Inhalation therapy for bronchial obstruction in children: traditional approaches and new opportunities
- Authors: Kamaev A.V.1, Trusova O.V.1, Makarova I.V.1, Korostovtsev D.S.2
-
Affiliations:
- Pavlov First Saint Petersburg State Medical University
- Saint Petersburg State Pediatric Medical University
- Issue: No 2 (2021)
- Pages: 123-128
- Section: Articles
- URL: https://pediatria.orscience.ru/2658-6630/article/view/77953
- DOI: https://doi.org/10.26442/26586630.2021.2.200986
- ID: 77953
Cite item
Full Text
Abstract
Acute respiratory infections are widespread in the pediatric population and represent a significant burden to the health care system and families of patients. Anatomic ans physiological features of preschool children and individual predisposition, especially atopic phenotype, determine high risk of complicated course of acute respiratory infections with bronchial obstruction syndrome. The etiological factors of recurrent AR are quite diverse – from chronic infections to foreign bodies of the bronchi or genetically determined diseases, but the most common cause of recurrent AR in children remains bronchial asthma. Therapy of acute obstructive episode in real clinical practice is most often similar to therapy of bronchial asthma attack and includes effects on the main components of pathogenesis: contraction of smooth muscles, mucus hypersecretion and inflammatory edema of the bronchial wall. There has been accumulated a great practical experience of using combined preparation of fenoterol and ipratropium bromide, which currently exists also in the form of domestic medicinal product Astmasol®-SOLOpharm. In addition to standard bronchodilator and mucoconstrictor therapy, hypertonic solutions, in particular Ingasalin® 3%, are an important component of therapy of prolonged obstruction and relapse prevention. The possibilities of this remedy in shortening of terms of obstructive disorders and decrease of risk of antibiotic therapy are demonstrated by clinical example.
Full Text
About the authors
Andrei V. Kamaev
Pavlov First Saint Petersburg State Medical University
Author for correspondence.
Email: andykkam@mail.ru
ORCID iD: 0000-0001-9654-3429
Cand. Sci. (Med.), Assoc. Prof., Pavlov First Saint Petersburg State Medical University
Russian Federation, Saint PetersburgOlga V. Trusova
Pavlov First Saint Petersburg State Medical University
Email: o-tru@mail.ru
ORCID iD: 0000-0002-0854-1536
Cand. Sci. (Med.), Assoc. Prof., Pavlov First Saint Petersburg State Medical University
Russian Federation, Saint PetersburgIrina V. Makarova
Pavlov First Saint Petersburg State Medical University
Email: allergist_PI@mail.ru
Cand. Sci. (Med.), Assoc. Prof., Pavlov First Saint Petersburg State Medical University
Russian Federation, Saint PetersburgDmitrii S. Korostovtsev
Saint Petersburg State Pediatric Medical University
Email: dsk552@mail.ru
D. Sci. (Med.), Prof., Saint Petersburg State Pediatric Medical University
Russian Federation, Saint PetersburgReferences
- Геппе Н.А., и др. Острые инфекции дыхательных путей у детей. Диагностика, лечение, профилактика: клиническое руководство. М.: МедКом-Про, 2020 [Geppe NA, et al. Acute respiratory tract infections in children. Diagnostics, treatment, prevention: clinical guidelines. Moscow: MedKom-Pro, 2020 (in Russian)].
- Острая респираторная вирусная инфекция (ОРВИ) у детей. Федеральные клинические рекомендации. М., 2018 [Acute respiratory viral infection (ARVI) in children. Federal clinical guidelines. Moscow, 2018 (in Russian)].
- Frey A, Lunding LP, Ehlers JC, et al. More Than Just a Barrier: The Immune Functions of the Airway Epithelium in Asthma Pathogenesis. Front Immunol. 2020;11:761. doi: 10.3389/fimmu.2020.00761
- Comeau M, Ziegler S. The influence of TSLP on the allergic response. Mucosal Immunol. 2010;3:138.
- Loxham M, Davies DE. Phenotypic and genetic aspects of epithelial barrier function in asthmatic patients. J Allergy Clin Immunol. 2017;139:1736-51.
- Hellings PW, Steelant В. Epithelial barriers in allergy and asthma. J Allergy Clin Immunol. 2020;145:1499-509.
- Lin SC, Cheng FY, Liu JL, Ye YL. Expression and regulation of thymic stromal lymphopoietin and thymic stromal lymphopoietin receptor heterocomplex in the innate – adaptive immunity of pediatric asthma. Int J Mol Sci. 2018;19:1231. doi: 10.3390/ijms190412
- Roan F, Obata-Ninomiya K, Ziegler SF. Epithelial cell-derived cytokines: more than just signaling the alarm. J Clin Invest. 2019;129(4):1441-51. doi: 10.1172/jci124606
- Марковская А.И., Гаймоленко И.Н., Потапова Н.Л. Профилактическое применение монтелукаста у детей группы риска развития бронхиальной астмы. Сибирское медицинское обозрение. 2020;(4):49-55 [Markovskaia AI, Gaimolenko IN, Potapova NL. Profilakticheskoe primenenie montelukasta u detei gruppy riska razvitiia bronkhial'noi astmy. Sibirskoe meditsinskoe obozrenie. 2020;(4):49-55 (in Russian)].
- Геппе Н.А., Иванова Н.А., Камаев А.В., и др. Бронхиальная обструкция на фоне острой респираторной инфекции у детей дошкольного возраста: диагностика, дифференциальная диагностика, терапия и профилактика. М.: МедКом-Про, 2019 [Geppe NA, Ivanova NA, Kamaev AV, et al. Bronchial obstruction against the background of acute respiratory infection in preschool children: diagnosis, differential diagnosis, therapy and prevention. Moscow, MedKom-Pro, 2019 (in Russian)].
- Овсянников Д.Ю., Болибок А.М., Халед М., и др. Гетерогенность бронхообструктивного синдрома и бронхиальной астмы у детей: трудности диагностики. Трудный пациент. 2017;15(1-2):43-52 [Ovsiannikov DIu, Bolibok AM, Khaled M, et al. Geterogennost' bronkhoobstruktivnogo sindroma i bronkhial'noi astmy u detei: trudnosti diagnostiki. Trudnyi patsient. 2017;15(1-2):43-52 (in Russian)].
- Бронхиальная астма. Федеральные клинические рекомендации. М., 2021 [Bronchial asthma. Federal clinical guidelines. Moscow, 2021 (in Russian)].
- Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention (2021 update). 2021. Available at: www.ginasthma.org. Accessed: 31.05.2021.
- Granell R, Henderson AJ, Sterne JA. Associations of wheezing phenotypes with late asthma outcomes in the Avon Longitudinal Study of Parents and Children: A population-based birth cohort. J Allergy Clin Immunol. 2016;138(4):1060-70.e11. doi: 10.1016/j.jaci.2016.01.046
- Cano-Garcinuño A, Mora-Gandarillas I. SLAM Study Group. Wheezing phenotypes in young children: an historical cohort study. Prim Care Respir J. 2014;23(1):60-6.
- Мизерницкий Ю.Л. Новые возможности небулайзерной терапии у детей. Медицинский совет. 2019;2:87-9 [Mizernitskii IuL. Novye vozmozhnosti nebulaizernoi terapii u detei. Meditsinskiy sovet. 2019;2:87-9 (in Russian)].
- Hallas HW, Chawes BL, Rasmussen MA, et al. Airway obstruction and bronchial reactivity from age 1 month until 13 years in children with asthma: a prospective birth cohort study. PLoS Med. 2019;16(1):e1002722. doi: 10.1371/journal.pmed.1002722
- Цветкова О.А., Воронкова О.О. Место препарата фенотерол + ипратропия бромид в лечении обострений бронхиальной астмы и ХОБЛ. Медицинский совет. 2020;17:35-9 [Tsvetkova ОA, Voronkova OO. The value of the medicine fenoterol + ipratropium bromide in the treatment of exacerbations of bronchial asthma and chronic obstructive pulmonary disease. Meditsinskiy sovet. 2020;17:35-9 (in Russian)]. doi: 10.21518/2079-701X-2020-17-35-39
- Петрова Д.В., Рудакова Д.М., Реуцкая Е.М., и др. Опыт применения ингаляционного гипертонического раствора с гиалуроновой кислотой у пациентов с хронической обструктивной болезнью легких. Практическая пульмонология. 2016;4:65-9 [Petrova DV, Rudakova DM, Reutskaya EM, et al. The use of inhaled hypertonic saline and hyaluronic acid in patients with chronic obstructive pulmonary disease. Practical Pulmonology. 2016;4:65-9 (in Russian)].
- Wark P, McDonald VM. Nebulised hypertonic saline for cystic fibrosis. Cochrane Database Syst Rev. 2018;9:CD001506. doi: 10.1002/14651858.CD001506.pub4
- Bennett WD, Henderson AG, Ceppe A, et al. Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis. ERJ Open Res. 2020;6(3):00269-2020. doi: 10.1183/23120541.00269-2020
- Zhang L, Mendoza-Sassi RA, Wainwright C, et al. Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev. 2017;12:CD006458. doi: 10.1002/14651858
- Незабудкин С.Н., Березовский A.C., Незабудкина A.C. Роль комплексной терапии в снижении неспецифической гиперреактивности бронхов у детей с бронхиальной астмой. Аллергология и иммунология в педиатрии. 2010;3:47 [Nezabudkin SN, Berezovskii AC, Nezabudkina AC. Rol' kompleksnoi terapii v snizhenii nespetsificheskoi giperreaktivnosti bronkhov u detei s bronkhial'noi astmoi. Allergologiia i immunologiia v pediatrii. 2010;3:47 (in Russian)].
- Di Cicco M, Peroni D, Sepich M, et al. Hyaluronic acid for the treatment of airway diseases in children: Little evidence for few indications. Pediatr Pulmonol. 2020;55(8):2156-69. doi: 10.1002/ppul.24901
- Геппе Н.А., Мелешкина А.В., Чебышева С.Н., Великорецкая М.Д. Приоритеты в тактике ведения детей с бронхиальной обструкцией на фоне острой респираторной вирусной инфекции: что нового? Доктор.Ру. 2021;20(3):6-10 [Geppe NA, Meleshkina AV, Chebysheva SN, Velikoretskaia MD. Prioritety v taktike vedeniia detei s bronkhial'noi obstruktsiei na fone ostroi respiratornoi virusnoi infektsii: chto novogo? Doktor.Ru. 2021;20(3):6-10 (in Russian)]. DOI: 0.31550/1727-2378-2021-20-3-6-10