Gomolan P.1, Varas F.2, Castro A.3, Leppe J.3, Henriquez L.2, Vega L.3
1Universidad del Desarrollo, Kinesiología, Santiago, Chile, 2Universidad del Desarrollo, Kinesiologia, Santiago, Chile, 3Universidad del Desarrollo, Medicina, Santiago, Chile
Background: Bronchiolitis is the main cause of hospital admission for infants under 1-year-old in Chile. Currently, approximately 4800 children are admitted to the hospital during the cold season affecting the public health services´ effectiveness. The most frequent causal agent is the Respiratory Syncytial Virus. To date, there is not specific treatment for this disease and only the support measures are recommended. Chest physiotherapy is a support measure that improves the mucociliary clearance and reduces obstruction of the airways however its effectiveness is not fully demonstrated.
Purpose: The purpose of this research is to determine the effect of prolonged slow expiration techniques, provoked coughing and standard therapy compared to chest wall manual vibration and standard therapy in infants between 0 and 12 months old with confirmed diagnosis of acute bronchiolitis SRV (+). The effect is measured on the respiratory insufficiency and on the use of supplementary oxygen.
Methods: Randomized controlled trial of previously healthy infants with bronchiolitis and positive for respiratory syncytial virus were divided into two groups. The active group received standard therapy, prolonged slow expiration and provoked coughing while the control group received standard therapy and manual chest wall vibrations. The effectiveness of chest physiotherapy was measured through a clinical score of respiratory distress, hours using supplementary oxygen and vital signs before and after the intervention in both groups during hospital stay in the public health service. The main outcome is clinical severity score 48 hours after admission.
Results: 204 infants were randomized to the intervention (G1 104) and (G2 100). There were not differences observed in the score of respiratory distress within 48 hours of admission between the two groups (G1 6,04 3,7) (G2 6,03-3,6) (p> 0.05) but was found difference at 36 hours of admission (G1 6-4) (G2 5,9 3,5) (p = 0.042) between the group receiving prolonged slow expiration and the group receiving vibrations. There were no differences in hours of oxygen therapy and hospital days.
Conclusion(s): Prolongued slow expiration was effective in reducing respiratory distress compared with manual chest wall vibrations at 36 hours of admission. At 48 hours both groups were equal. This could be explained by long waiting period of time in emergency area of the public health service prior to admission.
Implications: The effectiveness of prolongued slow expiration 36 hours leads to the need of respiratory physiotherapy care in early stages of hospitalization in order to avoid complications such as transfer to more complex units and optimization of hospital costs. It is necessary to spread the importance of these results for the creation of knowledge in the training of new professionals and for the decision taking in the respiratory care units.
Funding acknowledgements: Hospital Padre Hurtado, Unidad de Gestion del Niño, Universidad del Desarrollo. Chile
Topic: Cardiorespiratory
Ethics approval: Approved by Evaluation Committee Ethical Health Service (SSMSO 20/11/14)
All authors, affiliations and abstracts have been published as submitted.
