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.