Bronchiolitis Clinical Trial
Official title:
Safety of Airway Clearance Combined With Bronchodilator and Hypertonic Saline in Non-hospitalized Infants With Acute Viral Bronchiolitis
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
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.
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