Abstract
To determine the effectiveness of chest physiotherapy (CPT) in children hospitalized with asthma exacerbations and provide evidence-based support for this therapy. Prospective-controlled randomized study of 40 hospitalized children (4–18 years) with diagnosed asthma. Patients were classified (mild or moderate/severe asthma), then randomized to the intervention (+CPT; 6 treatments [1 every 4 h for 24 h]) or control (−CPT) group. Outcome endpoints at (t = 0 h; baseline) and end (t = 24 h) of the study were improvement in airway resistance (AR) between groups, ability to be weaned from supplemental oxygen, degree of improvement in respiratory distress measured by thoraco-abdominal motion, phase angle (PA), and improvement in peak flow (PF) measurements. AR was unchanged in both groups and was within standard limits for age, height, and gender. There was no difference between treatment groups (+CPT vs. −CPT) over time. Oxygen saturations were normal as a function of group and over time. PA decreased (P < 0.005) in both groups over the same time interval, suggesting overall improvement in synchrony. An improvement (P < 0.005) in PF measurements was shown in both groups over time. All of the above findings were independent of CPT. Endpoint parameters of asthma recovery improved overall in pediatric patients hospitalized with asthma independent of CPT. These findings suggest that with standard emergency room stabilization, the expense, time, and effort involved in treating hospitalized patients with status asthmaticus by CPT may not be justifiable.
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