Pneumonia Childhood, Recovery of Function, Rehabilitation
Conditions
Keywords
Pneumonia, Respiratory Pediatric Physiotherapy
Brief summary
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.
Detailed description
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.
Interventions
OTHERRespiratory Pediatric Physiotherapy
Prolonged slow expiration Tracheal pumping Controlled expiratory flow exercises Forced expiration technique
OTHERControl Group
Will be subject to muscle compressions of the upper limbs. Both groups will receive the usual treatment for pneumonia prescribed by their treating doctor.
Sponsors
Hospital Infantil de Mexico Federico Gomez
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
1. A sequence of aleatory numbers in blocks of 2 will be generated in each of the study groups using the software randomization.com, done by a person foreign to the research. 2. Using the randomized numbers generated by the software, it will be decided what group each participant belongs to (control or intervention) and what maneuver will be assigned to them. 3. These numbers and their maneuvers will be placed inside dark envelopes. 4. The whole randomization and assignment sequence will be performed by a person foreign to the research and without the knowledge of the researchers. Support will be provided from the coordination for nursing research, who will select the personnel for the process.
Intervention model description
The population will consist of children aged from 0 to 8 years old diagnosed with pneumonia with a development time less than 7 days. he sample calculation corresponds to 40 participants per group. The intervention group will be exposed to techniques such as prolonged slow expiration, controlled expiratory flow exercises, tracheal pumping and tracheal reflex. The control group will be subject to postural drainage plus compressions to the muscle belly of the upper limbs. Both groups will go through 10 sessions: One daily session from Monday to Friday with a duration of 10 to 15 minutes each
Eligibility
Sex/Gender
ALL
Age
1 Years to 7 Years
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory difficulty | 5 days | The Silverman score will be used with a range of 0 to 10 points, directly proportional between the sum and the respiratory difficulty. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital stay | 7 days | Days of hospital stay |
Countries
Mexico
Outcome results
None listed