Immediate Effects and Safety of High-Frequency Chest Wall Compression Compared to Airway Clearance Techniques in Non-Hospitalized Infants With Acute Viral Bronchiolitis

• Published in: Respiratory care Vol. 66; no. 3; p. 425
• Main Authors: González-Bellido, Vanesa, Velaz-Baza, Verónica, Blanco-Moncada, Elena, Del Carmen Jimeno Esteo, Maria, Cuenca-Zaldívar, Juan Nicolás, Colombo-Marro, Alicia, Donadio, Márcio Vinícius Fagundes, Torres-Castro, Rodrigo
• Format: Journal Article
• Language: English
• Published: United States 01.03.2021
• Subjects: Bronchiolitis; Bronchiolitis, Viral - therapy; Chest Wall Oscillation; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Respiratory Therapy; Sputum; prolonged slow expiration; safety; high-frequency chest wall oscillation; acute viral bronchiolitis
• DOI: 10.4187/respcare.08177

No studies have investigated the use and safety of high-frequency chest wall compression (HFCWC) for non-hospitalized infants with acute viral bronchiolitis (AVB). The aim of the present study was to evaluate the immediate effects and safety of HFCWC as compared to airway clearance techniques in children with AVB. In this randomized clinical trial in non-hospitalized infants (0-12 months old) with mild to moderate AVB, children were randomized into 2 groups: airway clearance techniques (20 min of prolonged slow expiration and provoked cough) or HFCWC (15 min). A single session was performed and children were evaluated at baseline and at 10 min and 20 min after treatments. Outcomes measures were the Wang severity score, [Formula: see text], sputum wet-weight, and the presence of adverse events. A total of 91 infant subjects, mean age 7.9 ± 2.6 months, were included. Significant ( = .004) between-group differences were found in the Wang score, which was 0.28 points lower in the airway clearance techniques group. There was a greater increase of infants classified as normal and a greater decrease of those classified as mild according to the Wang score when airway clearance techniques were used compared to the use of HFCWC ( = .009). The sputum wet-weight was lower in subjects treated with the airway clearance techniques ( < .001). Although [Formula: see text]improved in both groups, no differences were found between them. There was also no difference for adverse events, and the majority of children did not present any adverse events after 20 min. The use of HFCWC induced similar clinical effects as airway clearance techniques and was safe for non-hospitalized infants with AVB. Both techniques reduced respiratory symptoms and acutely improved [Formula: see text]. (ClinicalTrials.gov: NCT03835936.).