Dry (barking) cough: its signs and treatment features...

Cough is the most common problem that every child faces sooner or later, and the second most frequently reported symptom after a runny nose. The reality is that most Kaliningrad residents treat children themselves at home, not realizing that this symptom can be a sign of a number of serious diseases. In this regard, parents need to understand how important it is to correctly assess the baby’s condition, promptly respond to dangerous symptoms and show the child to a doctor. Our specialists remind parents of the most important points regarding dry cough that they need to take note of.

Causes of the cough reflex

It's no secret that in most cases the cause of cough is viral and bacterial infections. However, it makes sense to list all the possible causes of irritation of the larynx, these are:

viruses and bacteria;
allergies to tree or grass pollen, etc.;
dysfunction of the organs of the gastroesophageal zone;
foreign object caught in the respiratory tract;
psychogenic causes (anxiety).

As we mentioned earlier, an irritating dry cough can be a symptom of many respiratory diseases, including:

ARVI;
bronchitis;
bronchial asthma.

These are the most common diseases, accompanied by coughing attacks, arranged in descending order. Others are much less common, but this does not make them any less dangerous - whooping cough, tracheitis, pneumonia, etc. Consultation with an otolaryngologist is necessary to exclude pathologies of the upper and lower respiratory tract.

Types of cough: wet and dry. How to determine?

The choice of treatment tactics depends on the type of cough, so it is very important to be able to distinguish between them. Distinctive features are as follows:

Presence of sputum. A wet (productive) cough is accompanied by the discharge of sputum; with a dry irritating type of cough, it is absent, which is why it is called that.
Characteristic sound. If a dull and gurgling sound is heard when coughing, it is a wet cough. A dry cough has a rolling and crackling sound; due to its similarity to the barking of a dog, it is also called barking.
Localization of the inflammatory process. With a wet cough, the sound comes from the depths of the chest, and with a dry cough, from the larynx, since the inflammation affects only the mucous membrane of the posterior wall of the larynx and pharynx.
Duration. A dry, irritating cough usually lasts 3-4 days, after which it turns into a productive wet cough as the infection spreads to the lower respiratory tract, which can last another 2-3 weeks.

Note that a dry cough appears both at the initial stage of a cold and at the end of a cold, as a residual phenomenon.

Dry cough in a child: what is it?

A cough is a “sudden, explosive exhalation aimed at clearing the airways.” This not entirely medical, but most understandable definition of this term was given by the editor of the medical reference book “Merck Manual” Robert Berkow. The medical term sounds different and explains the mechanism of cough.

Coughing is a reflexive protective act aimed at removing irritating particles from the respiratory tract: mucus, pus, blood, dust, foreign bodies, and so on. Cough can be physiological and pathological. In the latter case, this is a symptom of diseases that parents should definitely pay attention to. A pathological cough can lead a child to vomiting, severe weakness and even loss of consciousness.

According to the formation and removal of mucus, cough occurs:

unproductive or dry. Most often it occurs in the acute period of diseases accompanied by inflammation of the respiratory tract. You can understand that a child has a non-productive cough based on the following signs: the cough is obsessive, no sputum is produced, relief does not come after an attack, and discomfort in the upper respiratory tract increases;
productive or wet. After a coughing attack, the sputum clears up and the child notices an improvement in his health. Young children often swallow sputum instead of coughing it up. Only a doctor can distinguish such a wet cough from a dry one;
mixed (alternating episodes of dry and wet cough) . This phenomenon is observed with very thick sputum. After taking drugs that dilute sputum, it may leave in small quantities, and then the cough becomes dry again.

Mechanism of cough

Coughing is one of the physiological ways to clear the airways, especially the trachea and bronchi. Cough receptors are located throughout the respiratory tract: in the nasopharynx, larynx, trachea, bronchi, pleura (the protective layer that lines the chest cavity and envelops each lung), in the maxillary and other paranasal sinuses.

The respiratory center is located in the medulla oblongata. This structure of our nervous system is responsible for unconditioned reflexes: the secretion of saliva and gastric juice, sneezing, pulling away from something hot and others. The cough reflex is controlled in the cerebral cortex, which is responsible for conscious actions. This is why we can hold back a cough or imitate it, and young children often repeat a new skill they have learned and cough on purpose, without objective reasons.

Mechanical and chemical irritants can trigger the cough reflex. The cough process occurs in 4 stages:

Inhale deeply and quickly to ensure sufficient volume of air.
At the second stage, the volume of internal space decreases, the epiglottis closes the entrance to the larynx, the diaphragm, intercostal muscles and abdominal muscles tighten.
The third stage is characterized by a sudden opening of the epiglottis and a sharp exhalation with a characteristic sound.
Recovery stage: muscles relax, pressure stabilizes in the alveoli (the end part of the respiratory organ in which gas exchange occurs), chest and abdominal cavities.

The strength of the cough depends on the structure of the respiratory tract. Therefore, at different ages and with different diseases, this indicator may change.

A dry cough can be dangerous!

Any type of cough will exhaust the child. Young children cannot formulate complaints, so parents should closely monitor the child’s condition. The following signs indicate exhaustion:

behavior is capricious, whiny, sometimes apathetic;
laughter becomes a rare occurrence, the baby is more often gloomy;
the child’s mental abilities decrease;
appetite worsens, the baby may refuse to eat and lose weight;
sleep is disturbed, daytime sleepiness is severe;
there is a fear of new coughing attacks;
in 2% of cases, a prolonged coughing attack ends in fainting.

In addition to a general deterioration in health, a prolonged, persistent dry cough causes complications from the respiratory and cardiovascular systems:

redness of the eyes due to rupture of small vessels in the sclera;
increased pressure in the pulmonary veins and arteries;
increased load on the right side of the heart, the formation of “pulmonary heart” and severe heart failure in the future;
increased pressure in the chest cavity, compression of the organs located in it;
development of pulmonary emphysema (pathological expansion of the respiratory vesicles with disruption of their function).

Frequently repeated attacks of dry cough lead to urinary incontinence, vomiting, and spontaneous pneumothorax (rupture of the protective membrane of the lung, release of air into the pleural cavity, which can lead to lung collapse). With chronic dry cough in children, hernias of the anterior abdominal wall, internal (for example, diaphragm), inguinal hernias in boys and femoral hernias in girls can form.

Do not worry about the health and safety of your child, even during particularly dangerous periods. Always know where he is now or has been during the day, with whom he has been in contact and who surrounds him, and also instantly contact him if necessary using the “Where are my children” application.

In what cases is a mandatory examination by a doctor necessary?

Parents should be aware of important symptoms, the presence of which should seriously alert vigilant parents and force them to urgently consult a doctor. The “red flags” include the following key points that reflect the child’s condition:

deterioration in the child’s general well-being;
no visible improvements within 7-10 days;
presence of fever for more than 3 days;
sudden appearance of a rash;
the occurrence of moist wheezing when breathing.

With the joint efforts of the doctor and parents, we will be able to provide timely assistance to the baby and find out the reasons that aggravated his condition. The parents' task is to immediately respond to the above physiological markers.

What can you do before the doctor arrives?

Calm your baby down and distract him with his favorite toy or book.
Ventilate and humidify the room well. In the absence of a humidifier, you can hang wet laundry in the room or breathe (5-10 minutes) with the baby the steam from hot water drawn into the bath.
Keep your baby's feet and chest warm.
Give your child more to drink (milk, juices or hot tea).
An allergic reaction can be treated with antihistamines.

All these measures are aimed at temporarily relieving symptoms. By removing the symptoms, you cannot get rid of the disease.

Cough treatment is always comprehensive!

The first task facing the doctor is to establish the form of the cough, after which adequate therapy will be prescribed. To identify a cough, the specialist will clarify the patient’s medical history, heredity, allergic and immune status, as well as the effectiveness of previous treatment, if any. In this regard, during the examination, the doctor may ask the parents:

How long has a child been bothered by a cough?
Does sputum come out, and if so, what color?
What causes a cough and how often does a child get sick?
Is there a genetic predisposition to bronchial asthma?
What medications were given to the child and how was the cough treated? Etc.

If a small patient has been diagnosed with a dry cough of viral etiology, then the doctor’s task No. 2 is to transform the dry cough into a productive one. No matter how scary a wet cough may seem, it is “useful” because it frees the body from purulent secretions.

To accomplish this task, both medicinal and non-medicinal methods will be used. The first include treatment with drugs (drops, syrups, tablets) that can change the quality and quantity of sputum:

mucolytics - agents that thin out viscous secretions;
mucokinetics (expectorants) – affect the mobility of sputum;
It is advisable to take antitussive drugs that relieve attacks before bedtime.

Non-drug options include:

increasing the volume of fluid consumed to thin the sputum;
ensuring sufficient humidity in the room;
inhalation using special steam inhalers based on solutions of herbs or essential oils.

Timely consultation with a doctor and an integrated approach to the treatment of dry cough will allow you to achieve a positive result and prevent the development of a chronic form or complications.

Prevention and treatment of false croup in children

As a preventive measure for recurrent stenosing laryngotracheobronchitis in children, the antiviral drug VIFERON Gel can be used from the first days of life. For treatment in the acute period, if a complication has developed, VIFERON Gel is applied 5 times a day for 5-7 days, then 3 times a day for the next 3 weeks.

Last year, the Russian Medical Journal published an article “Acute respiratory infections in children: optimization of treatment tactics,” which presents research data on the use of the drug VIFERON in the treatment of acute respiratory viral infections and influenza. It is interesting that in children of different ages who received therapy with the inclusion of this drug, positive dynamics were observed faster, on average two days earlier than in the control group:

body temperature tended to normal,
symptoms of intoxication decreased,
the intensity of catarrhal phenomena (cough, runny nose) decreased until it stopped
respiratory syndrome (difficulty breathing)

Nosocomial infection becomes a common problem for patients undergoing treatment in a hospital. Infection threatens to delay treatment and develop complications in addition to the underlying disease. It is important that children who received VIFERON became infected half as often [1].

Reference and information material

Author of the article

Gerasimenko Igor Olegovich

General doctor

Sources:

Nikolaeva S.V., Khlypovka Yu.N., Gorelov A.V. Acute respiratory infections in children: optimization of treatment tactics. //RMJ 2019; 1(*): pp.1-5.

i https://nczd.ru/

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Memo to parents: how to treat a cough, and how not to...

General recommendations that need to be followed at home, in addition to doctor’s prescriptions, relate to the following important points:

Provide your baby with rest, plenty of warm water and adequate nutrition. We exclude from the diet spicy and sour foods that irritate the throat.
Don't forget to ventilate the children's room. If the baby does not have a temperature, you can walk with him in the fresh air.
Warming compresses and inhalations are permissible only if the child does not have a fever.

Let us also remind you what you should not do if you have a dry cough:

Place mustard plasters, which increase blood flow to the bronchi. They can be used only for wet coughs to increase sputum discharge.
Rubbing ointments with a strong smell of camphor or menthol, which can cause further irritation of the mucous membranes and provoke new coughing attacks.
You should not give your child drugs that increase phlegm and inhibit the cough reflex at the same time. Such amateur activities can harm the child and will not help clear the airways.

We urge Kaliningrad residents not to self-medicate their child and not to ignore his lingering cough. Contact us to determine the cause of the unpleasant symptom and receive effective treatment.

Making an appointment is easy. Simply fill out the online form on our website or call one of the phone numbers: +7 (4012) 357-773 or +7 (4012) 973-100.

Symptomatic therapy

To reduce the frequency of barking cough attacks, it is necessary to eliminate provoking factors as much as possible: regularly ventilate the room, carry out wet cleaning, and avoid strong chemical odors. To reduce subjective discomfort in the throat and moisturize the mucous membrane of the respiratory tract, inhalations with herbal solutions and antiseptics are recommended. It is important to provide plenty of warm drink; instead of tea, it is better to use herbal infusions of elecampane, thyme, and chamomile.

For debilitating cough, medications are used before diagnosis. Expectorants and mucolytics, which stimulate mucus production and cleanse the airways, have a good effect. In the case of an allergic nature of a barking cough, antihistamines are prescribed. Self-use of antitussives is prohibited due to possible side effects. In case of severe cough attacks, accompanied by shortness of breath and cyanosis, it is necessary to consult a doctor as soon as possible to determine the root cause of the symptom and select therapy.