Efficacy of Chest Physiotherapy in Pediatric Patients With Acute Asthma Exacerbations

DiDario, A. Geoffrey; Whelan, Meg Anne; Hwan, W.H.; Yousef, Ejaz; Cox, Timothy; Oldham, Helen M.; Padman, Raj; Bunnell, H. Timothy; Shaffer, Thomas H.; McGeady, Stephen J.

doi:10.1089/pai.2009.0004

Cited by 8 publications

(20 citation statements)

References 17 publications

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“…Those studies were of good, 26 fair, 16,19,20,42 and poor 30,40 quality for this outcome. One good study of Flutter in mechanically ventilated subjects, and one fair study of IPV in subjects with COPD reported improved oxygenation in the intervention arms.…”

Section: Oxygenation and Gas Exchangementioning

confidence: 88%

“…19 CPT included 6 sessions (one each hour over 24 h) of percussion with a pneumatic chest percussor for 20 min, after nebulized albuterol administration. Medical therapy included inhaled ␤ 2 agonists and systemic steroids.…”

Section: Studies Evaluating Cpt In Non-postoperative Subjectsmentioning

confidence: 99%

“…Seven studies of CPT in various populations, including children with asthma, 19,20,30 adults with COPD 16 or bronchiectasis, 26 and mechanically ventilated or postoperative subjects 40,42 reported no significant between-group differences in oxygenation. Those studies were of good, 26 fair, 16,19,20,42 and poor 30,40 quality for this outcome.…”

Section: Oxygenation and Gas Exchangementioning

confidence: 99%

“…14,17,19,24,25,29,32,34,37,40,42,43,44 Three studies reported improved results: a poor quality study of IPV ϩ CPT versus CPT in ICU subjects, with COPD reported better pulmonary function tests in the intervention group 18 ; and a poor quality study of spirometry plus Deep breathing exercises, sustained maximal inspiration, postural drainage, manual percussion Ambrosino 32 …”

Section: Pulmonary Function Testsmentioning

confidence: 99%

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Nonpharmacologic Airway Clearance Techniques in Hospitalized Patients: A Systematic Review

et al. 2013

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SummaryNonpharmacologic airway clearance techniques are used to reduce the sequelae of obstructive secretions. We systematically reviewed comparative studies of nonpharmacologic interventions that health professionals can employ to achieve mucus clearance in hospitalized or postoperative patients without cystic fibrosis, over the age of 12 months. We searched MEDLINE and other databases from 1990 to 2012 to identify relevant literature. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers also independently extracted data regarding subject and intervention characteristics and outcomes, and assigned overall quality ratings. The 32 studies meeting the review criteria included 24 randomized controlled trials, 7 crossover randomized controlled trials, and one prospective cohort study. Studies were typically small and together included a total of 2,453 subjects (mean 76/study). Studies generally examined chest physical therapy/physiotherapy modalities in postoperative or critically ill subjects or those with COPD. Interventions, comparators, and populations varied considerably across studies, hampering our ability to draw firm conclusions. Interventions, including conventional chest physical 2160RESPIRATORY CARE • DECEMBER 2013 VOL 58 NO 12 therapy/physiotherapy, intrapulmonary percussive ventilation, and positive expiratory pressure, typically provided small benefits in pulmonary function, gas exchange, oxygenation, and need for/duration of ventilation, among other outcomes, but differences between groups were generally small and not significant. Harms of the techniques were not consistently reported, though airway clearance techniques were generally considered safe in studies that did comment on adverse effects. Further research with clearly characterized populations and interventions is needed to understand the potential benefits and harms of these techniques.

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Section: Oxygenation and Gas Exchangementioning

confidence: 88%

Section: Studies Evaluating Cpt In Non-postoperative Subjectsmentioning

confidence: 99%

Section: Oxygenation and Gas Exchangementioning

confidence: 99%

Section: Pulmonary Function Testsmentioning

confidence: 99%

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Nonpharmacologic Airway Clearance Techniques in Hospitalized Patients: A Systematic Review

et al. 2013

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“…A prospective trial included 40 children 4 to 18 years old who were hospitalized with asthma. 83 Children were randomized to receive CPT. Measurements of oxygen saturations and work of breathing showed no difference between the control and experimental groups.…”

Section: Review Of Current Evidencementioning

confidence: 99%

Continuing to Challenge Practice to Be Evidence Based

Makic

Rauen

Jones

et al. 2015

Critical Care Nurse

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E nsuring that we provide safe, evidence-based, cost-effective care to all patients is an assumption of today's health care system. All patients and health care providers should expect a health care system that is committed to preventing harm and improving patient care by having clinicians use evidence-based safe practices.1 The call for evidence-based practice (EBP) was made in the hallmark publication of the Institute of Medicine's report "To Err Is Human" more than a decade ago. Feature Practice habits continue in clinical practice despite the availability of research and other forms of evidence that should be used to guide critical care practice interventions. This article is based on a presentation at the 2014 National Teaching Institute of the American Association of Critical-Care Nurses. The article is part of a series of articles that challenge critical care nurses to examine the evidence guiding nursing practice interventions. Four common practice interventions are reviewed: (1) weight-based medication administration, (2) chest tube patency maintenance, (3) daily interruption of sedation, and (4) use of chest physiotherapy in children. For weight-based administration of medication, the patient's actual weight should be measured, rather than using an estimate. The therapeutic effectiveness and dosages of medications used in obese patients must be critically evaluated. Maintaining patency of chest tubes does not require stripping and milking, which probably do more harm than good. Daily interruption of sedation and judicious use of sedatives are appropriate in most patients receiving mechanical ventilation. Traditional chest physiotherapy does not help children with pneumonia, bronchiolitis, or asthma and does not prevent atelectasis after extubation. Critical care nurses are challenged to evaluate their individual practice and to adopt current evidence-based practice interventions into their daily practice. (Critical Care Nurse. 2015;35[2]:39-50)

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Breathing exercises for children with asthma

Macêdo

Freitas

Chaves

et al. 2016

Cochrane Database of Systematic Reviews

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We could draw no reliable conclusions concerning the use of breathing exercises for children with asthma in clinical practice. The breathing exercises were part of a more comprehensive package of care, and could not be assessed on their own. Moreover, there were methodological differences among the three small included studies and poor reporting of methodological aspects and results in most of the included studies.

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Efficacy of Chest Physiotherapy in Pediatric Patients With Acute Asthma Exacerbations

Cited by 8 publications

References 17 publications

Nonpharmacologic Airway Clearance Techniques in Hospitalized Patients: A Systematic Review

Nonpharmacologic Airway Clearance Techniques in Hospitalized Patients: A Systematic Review

Continuing to Challenge Practice to Be Evidence Based

Breathing exercises for children with asthma

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