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INTRODUCTION@#Chest physiotherapy (CPT) may benefit children aged below five years who suffer from lower respiratory tract infection (LRTI). However, its effects depend on the technique used. This study aimed to determine whether mechanical CPT using the LEGA-Kid® mechanical percussion device is superior to manual CPT in children with LRTI.@*METHODS@#Children aged five months to five years who were admitted and referred for CPT from January to April 2017 were randomised to either manual CPT or mechanical CPT with LEGA-Kid. Outcomes measured before intervention and two hours after intervention were respiratory rate (RR), oxygen saturation and modified Respiratory Distress Assessment Instrument (mRDAI) score.@*RESULTS@#All 30 enrolled patients showed significant reduction in post-intervention RR and mRDAI scores. There was an 8% reduction in RR for the manual CPT group (p = 0.002) and a 16.5% reduction in the mechanical CPT group (p = 0.0001), with a significantly greater reduction in the latter (p = 0.024). mRDAI scores decreased by 2.96 in the manual group (p = 0.0001) and 3.62 in the mechanical group (p = 0.002), with no significant difference between the groups. There was no significant improvement in oxygen saturation, and no adverse events were observed after CPT.@*CONCLUSION@#Children receiving both manual and mechanical CPT showed improvements in respiratory distress symptoms, with no adverse effects. A combined strategy of nebulised hypertonic saline followed by CPT for LRTI removes airway secretions and results in improvements in moderately severe respiratory distress. The LEGA-Kid mechanical CPT method is superior to manual CPT in reducing the RR.
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Child , Humans , Percussion/methods , Physical Therapy Modalities , Respiratory Distress Syndrome, Newborn , Respiratory Therapy/methods , Respiratory Tract Infections , Single-Blind MethodABSTRACT
Background: Acute bronchiolitis is the most common respiratory tract infection in young children. Despite the high prevalence of acute bronchiolitis, no consensus exists on the management. Studies have shown that except oxygen therapy, no other treatment found to be effective. Hence, the present study was conducted to find out the efficacy of nebulised 3% saline versus is 0.9% saline for the treatment of acute bronchiolitis.Methods: A prospective randomized controlled study of 150 children between the age group of 2 months to 24 months with signs and symptoms of Acute Bronchiolitis admitted to Indira Gandhi Institute of Child Health, Bangalore from January 2016 to December 2016 formed the study group, they were randomized into 2 groups, one received 3% saline nebulization and the other received 0.9% saline.Results: A total of 150 children were enrolled in the study, 75 children (group A) received 0.9% saline and 75 children (group B) received 3% saline. At 24 hours, the mean clinical severity score for group A was 2.49'1.03 and group B was 2.16'0.49 (P=0.013). The duration of hospital stay was shorter (1-3 days) in 3% saline with a mean of 2.35 days and was longer (3-5 days) in 0.9% saline with mean value of 4.04 days which was statistically significant (p <0.001).Conclusions: 3% saline nebulization can be used as an effective treatment for acute bronchiolitis. It significantly reduced the clinical severity score and length of hospital stay compared to 0.9% normal saline.
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Objective To discuss the clinicd effect of using nebulised budesonide to treat neonatal laryneal edema caused by mechanical ventilation.Methods 43 newborns with mechanical ventilation were included in this study and divided into two groups:The Observational group(23 newborns)were treated with nebulised budesonide right before excubation once and three times after that,and the control group(20 newborns)were treated with dexamethasone once right before excubation and nebulised adrenine after that for three times.Comparisons were made between two groups about dismissing time of wheeze or hoarseness,tachypnea,PaO2 and PaCO2.Results Observational group:dismissing time of wheeze or hoarseness was(10.26±4.01)hours,dismissing time of tachypnea was(1.63±0.55)days,which was shorter than that of control group[(14.20±5.58)hours/(2.05±0.58)days],P＜0.05).PaO2 and PaCO2 of two groups had no statistical difference(P＞0.05).Conclusion Nebulised budesonide was effective in treatment neonatal laryneal edema caused by mechanical ventilation,using.
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Objective To test the hypothesis that nebulised budesonide (NB) might be an alternative to systemic corticosteroids in treatment of patients with exacerbated chronic obstructive pulmonary disease (ECOPD).Methods Patients hospitalised with ECOPD (n = 78) were randomnized into three groups.Group 1 received only standard bronchodilator treatment (SBDT),group 2 received systemic corticosteroids (SC 40 mg methylprednisolone) plus SBDT,and group 3 received nebulised budesonide ( NB 1000 mg budesonide q.i.d.) plus SBDT.Complete blood counts,detailed biochemical analysis,spirometric measurements and arterial blood gas analysis were carried out at admission.In addition,the following were recorded:adverse effects,discharging percentage of patients at 10 day and 15 day after hospitalization,exacerbation and re-hospitalization ratio within 1month after discharge.Results The improvement of SO2,PO2,FEV1 and discharge rates was ( 5.3± 0.9 ) %、(5.9 ±0.4)%、(8.7 ±0.5)% ,(8.1 ±0.8)%,(4.9 ±0.4)% and (7.2 ±0.5)% ,which were higher than that in SBDT group.These indexes were not different between 2 group and 3 group.The fraction of patients discharged on the 10th day and 15th were not different.The deteriorate rate was higher in 1 group than in 2 group and 3 group(P ＜0.05 ).Re-admission ratio in one month is higher in 1 group( 12% ) than in 2 group( 5% ) and 3 group(9% ) ( P ＜0.05 ).Absolute blood glucose level was found to be significantly higher in group 2 in 10th day (7.4 ± 1.6)mmol/L,which is greater than that in 1 group ( 5.1 ± 0.8 ) mmol/L and 3 group ( 5.6 ± 1.2 ) mmol/L ( P ＜ 0.05 ).Dysphoria and deliration appear in one patient in group 2.Conclusions Nebulised budesonide,an effective and safe alternative to systemic corticosteroids in treatment of exacerbated COPD,may substitute systemic corticosteroids in clinical practice.