Safety of Airway Clearance in Non-hospitalized Infants With Acute Viral Bronchiolitis
Condition: Bronchiolitis
MeSH terms: Bronchiolitis; Bronchiolitis, Viral
Study type: Interventional

Summary: 
      Bronchiolitis is a disease that can occur in a mild form and moderate, and often does not
      require hospitalization. The technique of prolonged slow expiration followed by cough caused
      in children not hospitalized with mild and moderate bronchiolitis can improve clinical
      severity
    

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.

      Before starting the treatment protocol, a blind evaluator treats the was assigned the patient
      classifies the child according to the initial score of clinical severity proposed by Wang, in
      addition to the measurement of SO2 and heart rate measured through a pulse oximeter.

      The protocol consists of 20 minutes of FR based on nasal washes in sitting, prolonged slow
      expiration: passive technique of expiratory help applied to the baby through a slow
      thoracic-abdominal pressure that begins at the end of a spontaneous expiration and continuing
      to the residual volume. The physiotherapist through the provoked cough or stimulation of the
      trachea achieves the expectoration of the sputum.

      Care must be taken during the maneuvers of maintaining a position of the infant in supine
      decubitus in 30 degrees of slope, to avoid episodes of gastroesophageal reflux and decrease
      the risk of vomiting.

      They are considered as criteria of cessation of the physiotherapeutic intervention,
      alterations 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
      clinical manifestations, it establishes that if the father or legal guardian demands it, the
      application of the protocol would be terminated.

      In order to evaluate the immediate effect of the protocol, which is established as the effect
      evaluated 10 minutes immediately after the intervention was applied, the doctor again
      performs a measurement of SO2, heart rate and respiratory rate, and classify again according
      to the criteria of Wang's clinical severity scale and anotate any adverse event. At 20
      minutes the same medical evaluator performs the same assessment.
    

Intervention name(s): Respiratory physiotherapy
Intervention type(s): Other
Intervention description(s): The protocol consists of 20 minutes of FR based on nasal washes in sitting, prolonged slow expiration: passive technique of expiratory help applied to the baby through a slow thoracic-abdominal pressure that begins at the end of a spontaneous expiration and continuing to the residual volume. The physiotherapist through the the provoked cough or stimulation of the trachea achieves the expectoration of the sputum.
Intervention model: Single Group Assignment
Intervention model description: Prospective, quasi-experimental study
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Physical Therapy; Respiratory; Pediatric