Chest physiotherapy using passive expiratory techniques does not reduce bronchiolitis severity: a randomised controlled trial.

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Serval ID
serval:BIB_4AB9A0E2204B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Chest physiotherapy using passive expiratory techniques does not reduce bronchiolitis severity: a randomised controlled trial.
Journal
European Journal of Pediatrics
Author(s)
Rochat I., Leis P., Bouchardy M., Oberli C., Sourial H., Friedli-Burri M., Perneger T., Barazzone Argiroffo C.
ISSN
1432-1076 (Electronic)
ISSN-L
0340-6199
Publication state
Published
Issued date
2012
Volume
171
Number
3
Pages
457-462
Language
english
Abstract
Chest physiotherapy (CP) using passive expiratory manoeuvres is widely used in Western Europe for the treatment of bronchiolitis, despite lacking evidence for its efficacy. We undertook an open randomised trial to evaluate the effectiveness of CP in infants hospitalised for bronchiolitis by comparing the time to clinical stability, the daily improvement of a severity score and the occurrence of complications between patients with and without CP. Children <1 year admitted for bronchiolitis in a tertiary hospital during two consecutive respiratory syncytial virus seasons were randomised to group 1 with CP (prolonged slow expiratory technique, slow accelerated expiratory flow, rarely induced cough) or group 2 without CP. All children received standard care (rhinopharyngeal suctioning, minimal handling, oxygen for saturation ≥92%, fractionated meals). Ninety-nine eligible children (mean age, 3.9 months), 50 in group 1 and 49 in group 2, with similar baseline variables and clinical severity at admission. Time to clinical stability, assessed as primary outcome, was similar for both groups (2.9 ± 2.1 vs. 3.2 ± 2.8 days, P = 0.45). The rate of improvement of a clinical and respiratory score, defined as secondary outcome, only showed a slightly faster improvement of the respiratory score in the intervention group when including stethoacoustic properties (P = 0.044). Complications were rare but occurred more frequently, although not significantly (P = 0.21), in the control arm. In conclusion, this study shows the absence of effectiveness of CP using passive expiratory techniques in infants hospitalised for bronchiolitis. It seems justified to recommend against the routine use of CP in these patients.
Keywords
Acute Disease, Bronchiolitis, Viral/complications, Bronchiolitis, Viral/therapy, Female, Hospitalization, Humans, Infant, Infant, Newborn, Kaplan-Meier Estimate, Male, Respiratory Syncytial Virus Infections/complications, Respiratory Syncytial Virus Infections/therapy, Respiratory Syncytial Virus, Human, Respiratory Therapy/methods, Severity of Illness Index, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
19/03/2012 18:55
Last modification date
01/10/2019 6:17
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