Clinical Efficacy of Respiratory Pediatric Physiotherapy on a Child With Hospital Treated Pneumonia

Hospital Infantil de Mexico Federico Gomez88 enrolled

Overview

The accumulation of secretions in the bronchopulmonary air network promotes the detriment of respiratory functions generating hypoxia and causing a decrease in the cardiac output requiring the use of mechanical ventilation and hemodynamic support. It is intended to control the accumulation of secretions by means of Respiratory Pediatric Physiotherapy (RPP) and to evaluate its effectiveness counting on biological plausibility.

The OBJECTIVE of this research protocol is to evaluate the effectiveness of RPP compared to postural drainage plus compression to the muscle belly of the upper limbs, as an adjuvant treatment for children with pneumonia. It is expected that the clinical severity decreases by 1.5 in the Wang score (a modification of the Silverman score), with a standard deviation of 2.6 points and a decrease of two days in the hospital stay with a α 0.05 in a one-tail test, a P of 80% and a 95.5% confidence interval.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Pneumonia Childhood Rehabilitation Recovery of Function

Interventions

Respiratory Pediatric PhysiotherapyOTHER

Prolonged slow expiration Tracheal pumping Controlled expiratory flow exercises Forced expiration technique

Control GroupOTHER

Will be subject to muscle compressions of the upper limbs. Both groups will receive the usual treatment for pneumonia prescribed by their treating doctor.

Eligibility

Sex: ALLMin age: 1 YearMax age: 7 Years

Medical Language ↔ Plain English

Inclusion criteria: 1. Patients from the Hospital Infantil de México Federico Góme with diagnosis of pneumonia (considering the diagnostic criteria of the WHO and the Guidelines for Nosocomial Pneumonia from the infectiology department. 2. Patients aged 0 to 8 years old. 3. A minimum HS of 72 hours. 4. Having informed consent. 5. Not having had previous RPP treatment. Exclusion Criteria: 1. Presenting a fever state for more than three days. Performing physiotherapy increases the body's peripheral temperature. 2. Presenting an oxygen saturation below 80%. 3. Requiring mechanical ventilation. 4. Hemodynamic instability. 5. Presenting systemic inflammatory response syndrome. 6. Inotropic support. 7. Anatomical variants in the thorax. 8. Unstable thorax. 9. Esophageal atresia. 10. Pleural effusion, pneumothorax. 11. Alterations that compromise respiratory centers and/or the phrenic nerve. 12. Neuromuscular diseases that compromise respiratory mechanics.

Outcomes

Primary Outcomes

Respiratory difficulty

The Silverman score will be used with a range of 0 to 10 points, directly proportional between the sum and the respiratory difficulty.

Time frame: 5 days

Secondary Outcomes

Hospital stay

Days of hospital stay

Time frame: 7 days