Clinical Efficacy of Respiratory Pediatric Physiotherapy on a Child With Hospital Treated Pneumonia

Clinical Efficacy of Respiratory Pediatric Physiotherapy on a Child With Hospital Treated Pneumonia: Single-Blind Clinical Trial

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.

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.

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.