Clinical Evaluation of the Response to Chest Physiotherapy in Children With Acute Bronchiolitis
Condition: Bronchiolitis
MeSH terms: Bronchiolitis
Study type: Interventional

Summary: 
      The objective of this study is to evaluate the clinical response of children diagnosed with
      acute bronchiolitis, relative to a chest physiotherapy protocol. Comparing this treatment
      with standard care of the nursing staff and auxiliaries of infants patients aged 1 month to 2
      years.
    

Detailed description: 
      This randomized clinical trial has an intervention group and a control group. All treatment
      will be made by physiotherapist with extensive clinical experience and training in techniques
      of Chest physiotherapy (CPT). Performing at least one session per day during the time of
      patient admission. This session takes an average of about 15 minutes, begins by fogging of
      hypertonic saline, and ends with the nasal and oral suction of the patient. The evaluation of
      clinical data is done 10 minutes before, 10 minutes later, 2 hours after physiotherapy
      treatment. The evaluation will be do it for a doctor who will, in all patients, a clinical
      examination that includes all items scale clinical severity of acute bronchiolitis.

      Patient Registries:

      SELECTION OF THE POPULATION Reference population. Patients diagnosed acute viral
      bronchiolitis during the conduct of the trial and have been admitted to the University
      Hospital Virgin of Arrixaca.

      Sample size

      The sample calculation was done considering a reduction of 2 points after physiotherapy in
      bronchiolitis severity scale. Whereas:

      Variances: sames Detect mean difference: 2,000 Common standard deviation: 2,370 Ratio of
      sample sizes: 1,00 Confidence level: 95,0%

      The standard deviation values were obtained from: JM Fernández Ramos et al Validation of a
      clinical scale of severity of acute bronchiolitis. An Pediatr (Barc). 2014; 81 (1): 3-8,
      article in which the mean and standard deviation (SD) score of patients admitted was 7 ±
      2.37. There are no items to compare this scale before and after treatment, so the
      investigators have assumed that value of common standard deviation (SD) and whereas a
      decrease of 2 points on the scale post-physical therapy would be clinically relevant.

      Power (%) Sample size Cases Control Total 85,0 27 27 54 90 31 31 62

      Finally it was decided to increase to 60 cases / group considering that the number of losses
      may be higher (the investigators calculate 50%).
    

Intervention name(s): Nebulization of hypertonic saline; Prolonged slow expiration technique (PSE); Patient coughing Provocation (TP); inspiratory maneuver to rhinopharyngeal cleaning DRR; Aspiration of secretions
Intervention type(s): Other; Other; Other; Other; Other
Intervention description(s): application of hypertonic saline serum through a mask fogging or a box fogging; Passive expiratory aid implemented baby. the child is placed supine on a hard surface. Thoracoabdominal slow manual pressure that begins at the end of a spontaneous and continuous exhalation to residual volume is exercised. Oppose reaches 2 or 3 breaths. Vibrations can accompany the art. The goal is to achieve a greater expiratory volume.; Tp is based on the mechanism reflects cough induced by stimulation of the buttons on the wall of the trachea extrathoracic mechanoreceptors. The child is placed supine. A short pressure is done with the thumb on the tracheal conduit (in the sternal notch) at the end of inspiration, or at the beginning of expiration. With the other hand holding the abdominal region we prevent the dissipation of energy and make the explosion tussive more effective. It is done after the PSE.; After the inspiratory reflection following the PSE, the TP or crying. At the end of expiratory time the child's mouth is closed with the back of his hand just finished his chest support, raising the jaw and forcing the child to an inspiration with the nose; Suctioning with a probe by a vacuum system installed on the wall.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Bronchiolitis; Chest; Physical therapy