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Often sick children. Modern pediatrician look

At present, the problem of frequently ill children (FWA) remains relevant. With the onset of the autumn-winter period and the start of schooling, schoolchildren experience overloads, fatigue increases, the number of contacts in groups increases, and children begin to suffer from acute respiratory infections (ARI) more often.

Patients with repeated episodes of ARI more than 8 times a year are referred to the group of FWB. In the structure of morbidity, viral infections account for 65–90% (influenza viruses, parainfluenza viruses, adenoviruses, respiratory syncytial virus). Viral monoinfection is detected in 52%, the association of 2 viruses or more – in 36% of cases.

The highest incidence of respiratory infections was observed in children’s organized groups in children of preschool and primary school age, the peak incidence occurs in the first years of visiting kindergartens.

So, in nursery and younger groups of kindergartens, the share of FBI can exceed 50%, while among schoolchildren this share is about 10%, gradually decreasing to 3-5% in high school.

Factors that increase the incidence of ARI recurrence in children

The psychological factor, impaired adaptation to loads, and autonomic dysfunctions contribute to the frequent development of diseases in children. FWBs of primary preschool age have a high level of personal anxiety. Children with frequently recurring respiratory infections react negatively to situations such as laying down alone, washing, reprimanding, forcibly picking up toys, isolation, eating alone.

What are the causes of the frequent incidence of respiratory infections in children? Unfortunately, this phenomenon is multifactorial in nature.

The endogenous risk factors for frequent acute respiratory infections are well known: unfavorable pregnancy, prematurity, antenatal and intrapartum damage to the central nervous system, deficient conditions, early artificial feeding, infection with tuberculosis mycobacteria. More often than children with ARI, children with exudative-catarrhal and lympho-hypoplastic anomalies of the constitution are susceptible. Significant exogenous risk factors include high contagiousness of ARI pathogens, the presence of adults or other children in the family with chronic foci of infection, passive smoking, micronutrient-deficient nutrition, visits to childcare facilities from an early age, environmental factors (air pollution), presence in water and food xenobiotics.

It is customary for children with frequent episodes of ARI to be allocated to a special group of follow-ups – the group of FBW and to consider them as threatened by the formation of recurrent and chronic forms of bronchopulmonary diseases.

Features of conducting FWB
In general pediatric practice, during the period of respiratory diseases, children are usually prescribed symptomatic, antiviral and antibacterial therapy, and sanitization of foci of chronic infection is carried out. In a family where there is a FWB, it is recommended to adhere to certain rules: establish a rational regime of the day; lead a healthy lifestyle in the family (including completely stop smoking in the presence of the child or in the room where he is); monitor balanced and nutritious nutrition; apply hardening, physiotherapy exercises, herbal medicine, oxygen cocktails and vitamin therapy, use tools and methods that increase the overall resistance of the body.

Increase of adaptive-adaptive reserves of FWB with energotropic drugs
Violation of the general resistance of the body to infections is accompanied by a decrease in energy metabolism. In recent years, the addition of generally accepted treatment regimens with energotropic drugs has become a promising area in the treatment of FVB. The use of levocarnitine helps to improve metabolism and energy supply of tissues. The drug promotes the penetration of fatty acids through cell membranes from the cytoplasm into the mitochondria, where they undergo a beta-oxidation process with the formation of ATP and acetyl-CoA. Levocarnitine improves protein and fat metabolism, inhibits the formation of keto acids and anaerobic glycolysis, reduces the degree of lactic acidosis, increases resistance to physical activity, contributes to the economical use of glycogen and increases its reserves in the liver and muscles. In addition, it has an antihypoxic, antioxidant effect, prevents degenerative damage to the cells of the nervous system, helping to restore their integrity and functions, which is extremely important given the close connection of the nervous and immune systems and the fact that among children with the consequences of perinatal CNS lesions, a very high proportion BW. Levocarnitine, being a universal stimulator and corrector of energy metabolism for various pathologies, increases the overall protective and adaptive capabilities of the body. The effectiveness and safety of the drug in the treatment of childhood diseases and their prevention, including in the treatment of FVB, has been proven.

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