Prolonged slow expiration technique improves recovery from acute bronchiolitis in infants: FIBARRIX randomized controlled trial

Abstract

Objective:: To examine the effect of prolonged slow expiration respiratory physiotherapy treatment on the acute bronchiolitis severity scale and O₂ saturation at short-time and at medical discharge in infants and the hospital stay.

Design:: Randomized controlled trial.

Setting:: Infants' unit of university hospital.

Participants:: Infants with acute bronchiolitis ( N = 80).

Intervention:: Infants were randomized into respiratory treatment (RT) with prolonged slow expiration or treatment as usual (control) for one-week period.

Main outcome measures:: The primary outcomes were Acute Bronchiolitis Severity Scale score and O₂ saturation, recorded shortly after each intervention during the stay and at medical discharge, and the hospital stay.

Results:: The RT had a significantly lower Acute Bronchiolitis Severity Scale 10-minute after the first intervention (mean difference -1.7 points, 95% confidence interval (CI) -3.0 to -0.38), 2 hours after (-2.0 points, 95% CI -3.2 to -0.86) and the last day before medical discharge (-1.3 points, 95% CI -2.1 to 0.51). No changes were detected in O₂ saturation. The survival analysis of time at medical discharge showed decrease in the average number of days to achieve an Acute Bronchiolitis Severity Scale of less than 2 points (RT: 2.6 days, 95% CI 2.1-3.1; Control: 4.4 days, 95% CI 3.6-5.1).

Conclusion:: A prolonged slow expiration physiotherapy reduces Acute Bronchiolitis Severity Scale scores and does not change O₂ saturation. Infants in RT group stay less days in hospital than infants in control group and no adverse events were detected.

Keywords: Respiratory physiotherapy; acute viral bronchiolitis; intensive care unit; paediatrics; prolonged slow exhalation.