Only slow passive expiratory physiotherapy techniques may have a modest effect in infants with bronchiolitis
Cochrane Pre-hospital and Emergency Care
Only slow passive expiratory physiotherapy techniques may have a modest effect in infants with bronchiolitis.
SOURCE
Roqué-Figuls M, Giné-Garriga M, Granados Rugeles C, Perrotta C, Vilaró J. (2023)
Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old.
Cochrane Database of Systematic Reviews 2023, Issue 4. Art. No.: CD004873. DOI: 10.1002/14651858.CD004873.pub6
CONTEXT
Bronchiolitis is the leading reason for consultation in emergency departments during the winter season in children younger than two years of age. The majority of episodes are benign, but between 1 and 3% of children require hospitalization. Various respiratory physiotherapy techniques are employed to reduce airway obstruction and improve the child's respiratory condition.
CLINICAL QUESTIONS
What is the efficacy of different respiratory physiotherapy techniques compared to standard care in children younger than two years of age with bronchiolitis ?
BOTTOM LINE
Conventional respiratory physiotherapy through vibration and percussion failed to show an effect on bronchiolitis severity, length of hospital stay, duration of oxygen supplementation, use of bronchodilators, or parents' impression of physiotherapy benefit (high level of evidence). Forced expiratory airflow technique failed to show an effect on bronchiolitis severity (high level of evidence) but increased serious adverse effects such as vomiting and worsening of respiratory condition (high level of evidence). Slow passive expiratory technique may lead to a mild to moderate improvement in the severity of bronchiolitis (low level of evidence) without affecting other outcome measures.
CAVEATS
The modest efficacy of slow passive expiratory physiotherapy techniques seems to be primarily related to children admitted to the hospital for moderate bronchiolitis. Data is limited for children with severe bronchiolitis and for those managed on an outpatient basis.
AUTHORS
Mathieu Oberlin
mathieu.oberlin@outlook.fr
Centre hospitalier de Selestat, Sélestat, France
Rasha Sawaya
rasha.sawaya@gmail.com
Children’s Health Ireland, Dublin, Ireland
