Physiotherapy Department, Le Havre Hospital, Le Havre, F-76600, France.
ERPHAN, Paris-Saclay University, UVSQ, Versailles, F-78000, France.
Ital J Pediatr. 2024 Sep 27;50(1):196. doi: 10.1186/s13052-024-01770-2.
Chest physiotherapy for airway clearance is not recommended in children hospitalized with bronchiolitis. The updated Cochrane meta-analysis suggests that slow expiratory techniques could slightly improve clinical severity, but the evidence certainty is low and the clinical significance of this change is unknown. We investigated whether the prolonged slow expiration technique (PSET) would impact the 24-h food intake of these children.
We conducted a two-arm double-blind randomized controlled trial. Hospitalized children aged from 1 to 12 months, bottle-fed or diversified and referred for airway clearance were included. Both groups received upper airway clearance at inclusion and standard treatments. The experimental group received PSET including rhinopharyngeal unclogging and targeted unprovoked cough. The primary outcome was the 24-h food intake. Clinical severity, vomit episodes and sleep quality were also recorded. An ordinary least squares linear regression for quantitative variables was modelled for between-group comparisons.
From January 9, 2019, to December 1, 2022, 42 children were randomized with a 1:1 ratio (mean age: 5.0 (± 2.9) months). The 24-h food intake did not differ between groups (estimate: 1.8% (95%CI -7.0 to 10.6); p = 0.68). PSET had no effect on SpO2, clinical severity, RR and HR at the follow-up assessments (5 min, 30 min and 24 h after intervention), nor on the number of vomit episodes, total sleep time and SpO2 during sleep.
PSET did not affect food intake or the 24-h course of bronchiolitis more than standard treatment in children hospitalized for moderate bronchiolitis.
NCT03738501 registered on 13/11/2018, Slow Expiratory Technique to Improve Alimentation in Children With Bronchiolitis (BRONCHIOL-EAT); https://classic.
gov/ct2/show/NCT03738501.
不建议患有细支气管炎住院的儿童进行胸部物理治疗以清除气道。更新后的 Cochrane 荟萃分析表明，缓慢呼气技术可能会稍微改善临床严重程度，但证据确定性低，这种变化的临床意义尚不清楚。我们研究了延长缓慢呼气技术（PSET）是否会影响这些儿童的 24 小时食物摄入量。
我们进行了一项双臂、双盲、随机对照试验。纳入年龄在 1 至 12 个月、奶瓶喂养或多样化喂养、因气道清除而转诊的住院儿童。两组均在纳入时接受上气道清除和标准治疗。实验组接受包括鼻咽部疏通和有针对性的无诱因咳嗽的 PSET。主要结局是 24 小时食物摄入量。还记录了临床严重程度、呕吐发作和睡眠质量。对定量变量进行了普通最小二乘线性回归模型组间比较。
从 2019 年 1 月 9 日至 2022 年 12 月 1 日，42 名儿童以 1:1 的比例随机分组（平均年龄：5.0（±2.9）个月）。两组 24 小时食物摄入量无差异（估计值：1.8%（95%CI-7.0 至 10.6）；p=0.68）。PSET 对 SpO2、临床严重程度、RR 和 HR 的随访评估（干预后 5 分钟、30 分钟和 24 小时）、呕吐发作次数、总睡眠时间和睡眠期间的 SpO2 均无影响。
与标准治疗相比，PSET 对因中度细支气管炎住院的儿童的食物摄入或细支气管炎 24 小时病程没有影响。
NCT03738501 于 2018 年 11 月 13 日注册，缓慢呼气技术改善细支气管炎儿童的喂养（BRONCHIOL-EAT）；https://classic.。
gov/ct2/show/NCT03738501。
