Treatment of Pediatric Bronchiolitis
Condition: Bronchiolitis
MeSH terms: Bronchiolitis
Study type: Interventional

Summary: 
      Bronchiolitis (BQ) is the acute viral infection of the tract respiratory syndrome in infants
      that affects the bronchioles of babies under 24 months of age. Respiratory physiotherapy (RF)
      appears as a treatment measure complementary in the clinical guidelines and consensus on the
      management of the BQ.
    

Detailed description: 
      Once each patient legal guardians has signed the informed consent document and it has been
      verified that the inclusion criteria are met, it will be assigned the same identification
      number (ID) that is related to its Clinical History (CH) by simple coding; custody of the
      file with the relationship of each ID with its CH will be the responsibility of the principal
      investigator.

      The assignment will be made at the time of query according to a table of random numbers
      previously established and that it will only be known by physiotherapists.

      Before starting the treatment protocol, a blind evaluator who does not know the treatment to
      which the patient is assigned, classifies the child according to the initial score of
      clinical severity proposed by Wang, in addition to the measurement of SO2 and frequency heart
      rate through a pulse oximeter. The measurement of the amount of sputum collected in a meter
      measuring cup, once the respiratory physiotherapy session is finished, it will be done in a
      calibrated weight in both groups.

      The protocol in the manual maneuvers group consists of 20 minutes of FR based on prolonged
      slow expiration and coughing provoked. Is apassive technique of expiratory help applied to
      the baby through a slow thoracic-abdominal pressure that begins at the end of spontaneous
      expiration and continues to the residual volume. The physiotherapist through the cough
      provoked or stimulation of the trachea gets expectoration of sputum, to be able to assess its
      weight.

      The protocol in the high frequency compression chest wall group consists of the same protocol
      as the respiratory physiotherapy Group plus high frequency compression chest wall applied
      with Smart Vest® device, with a fixed frequency of 13 Hz and a time 15 min. The selected mode
      will be the normal (fixed parameters) and the pressure of 4 units (12 cm H2O). The patient
      remains seated on his parents, and with a cotton garment between the vest and the skin of the
      patient to prevent skin lesions.

      Attention must be paid during maneuvers to maintain a position of infant in supine decubitus
      in 30 degrees of slope, to avoid episodes of gastroesophageal reflux and decrease the risk of
      vomiting.

      Criteria for cessation of physiotherapeutic intervention, alterations will be considered
      abrupt of the respiratory rhythm (brady or tachypnea), stare, ocular revulsion, hiccups or
      hypertonia and changes in skin color (pallor or cyanosis). In addition to these
      manifestations clinics, it is established that if the parent or legal guardian so requires,
      the the application of the protocol.

      After 10 and 20 minutes of finishing both groups, the doctor again makes a measurement of
      mucus volume, SO2, heart and respiratory rate, and classify again according to the criteria
      of Wang's clinical severity scale.
    

Intervention name(s): High frequency compression of the chest wall group; Manual maneuvers physiotherapy group
Intervention type(s): Other; Other
Intervention description(s): The protocol in the high frequency compression of the chest wall group device consists of the Smart Vest® application, with a fixed frequency of 13 Hz and a time of 15 minutes. The selected mode will be the normal (fixed parameters) and the pressure of 4 units (12 cm H2O). The patient remains seated on his parents, and with a cotton garment between the vest and the skin of the patient to prevent skin lesions.; 20 minutes of manual maneuvers physiotherapy based on prolonged slow expiration: passive technique of expiratory help applied to the baby through a slow thoracic-abdominal pressure that begins at the end of spontaneous expiration and continues to the residual volume. The physiotherapist through the cough provoked or stimulation of the trachea gets expectoration of sputum, to be able to assess its weight.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Single-blind controlled clinical trial
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Physical Therapy; Respiratory; Pediatric