Lung infections

• The lungs are so small which increases the risk of developing

respiratory distress quickly
• Bronchiolitis
• Acute viral infection in infants, esp. in first year
• Bronchiolar obstruction d/t edema and mucus accumulation
• Coughing, wheezing and dyspnea
• Resp. rate is greatly increased twice than normal (30 per
minute)
• In severe cases baby may be pale and cyanosed
• Complications include cardiac or resp. failure and
bronchopneumonia
• Requires oxygen and sometimes humidity
• In acute stage coughing, increased oedema, and obstruction
can occur so physiotherapy is not recommended but can be
done in later stages
 Bronchopneumonia
• Preceded by URTI and may be a complication
of infectious diseases such as measles and
whooping cough
• Aspiration pneumonia follows inhalation of
food or vomit
• Cough, fever and raised resp. rate
• Mucus plug may result in lung collapse
 Lobar pneumonia
• Acute condition after bacterial infection
(pneumococcus)
• Sharp rise in temp., coughing, rapid shallow
breathing, chest pain which can sometimes
referred to the abdomen simulating
appendicitis
 PT m/m of pneumonia
• In sub acute and chronic stages when there is
obstruction of bronchi, collapse/consolidation,
postural drainage with vibration, percussion or
breathing exs. can be given
• Mechanical suction may be needed
 Inhalation of a foreign body
• Common cause of lung collapse
• Persistent cough, breathless on exertion,
decreased mobility of one side of the chest,
dull note on percussion
• Bronchoscopy may be reqd. to remove foreign
body
 Bronchiectasis
• Dilatation of the smaller bronchi after
prolonged/repeated chest infection
• Congenital weakness a predisposing factor

Small bronchi Walls of the bronchi

overstretched by Elasticity and collapse, forming
accumulation of the sensitivity of the walls cavities filled with
(thick and infected) is lost thick sticky purulent
secretions, material
• Bouts of cough, purulent sputum, greenish in
color, foul smelling
• Clubbing of fingers and toes in prolonged
cases
• Child thin and small as per his age
• Bronchogram helps in diagnosis which shows
dilatation
• Lobectomy/partial lobectomy may be done
• postural drainage with vibration, percussion or
breathing exs. can be given
 Cystic Fibrosis
• An autosomal recessive disorder of exocrine glands
• Secretions are abnormally viscid and can block ducts of
the gland
• Lungs, pancreas and sweat glands are affected
• Baby may be weak and thin due to mal absorption
because of pancreatic involvement
• May pass pale, bulky, and unpleasant smelling stools
• Prone to chest infections,
• Can be fatal till the child reaches the teenage
• Diagnosis can be done by analysing sweat containing
high amt. of chloride and sodium
 Asthma
• Spasmodic episodes of wheezing and
breathlessness
• Status asthmaticus – severe attacks
• Allergy to dust, feathers, pollens
• Irritation of the mucous membrane leads to its
oedema, narrows the lumen of bronchi
• Spasm of the muscle causes further
narrowing,
• Mild wheeze, which increases after exercises,
• Acute attacks occurring in night or early
morning
• Child uses accessory muscles of respiration
• Lungs becomes hyper inflated, chest and
shoulder girdle rigid
• In severe cases appetite and general health
are poor
• Child looks pale, small and underweight
• T/T
➢ Acute Phase – bronchodilators,
(salbutamol/aminophylline), ventolin(salbutamol)
can be inhaled from aerosol spray/nebuliser,
prolonged steroids in case of severe attack
➢ Postural drainage and breathing exercises
➢ Prophylaxis – intal/becotide, both reduces the
sensitivity of the lungs,
➢ Relaxation, diaphragmatic breathing, general
mobility exercises
➢ Helps in minimizing the chance of development of
barrel chest deformity and posture
 Postural drainage
• Baby on pillow/lap
• Therapist should sit on a low chair so that knee can
be used to take apt. posture
• Baby should be positioned such that his face is visible
to look for any changes in skin color
 Exercises
• Babies usually imitate sounds
• Bubble/tissue blowing a good exercise