Assisted autogenic drainage in infants and young children hospitalized with uncomplicated pneumonia, a pilot study

Abstract

Background and purpose: Pneumonia is the most important respiratory problem in low-to-

Use of airway clearance therapy in children hospitalised with acute lower respiratory tract infections in a South African paediatric hospital

“…In addition to clinical outcomes, cost prevention and high demands for hospital beds in lower-resourced countries could be contributing factors for short duration of hospital stay (Argent et al 2014:7-14). However, three randomised controlled trials on children hospitalised with pneumonia reported a median duration of hospital stay of six to eight days (Corten et al 2018Lukrafka et al 2012:967-971;Paludo et al 2008:791-794), which is similar to the duration of hospitalisation for pneumonia in our study.…”

“…However, the RCT by Lukrafka et al also reported a median 2 days longer hospital stay in children who received ACT, compared to controls, which was not statistically significant, possibly owing to insufficient sample size (Lukrafka et al 2012:967-971). Other studies have not reported significant differences for length of stay when receiving ACT in children hospitalised with pneumonia (Corten et al 2018Paludo et al 2008:791-794). Prospective studies are recommended to confirm these results and to determine causality.…”

“…Although ACT may be used in the clinical management of children with LRTIs, there is a lack of evidence regarding the safety and effectiveness of ACT in this population. In children hospitalised with pneumonia, contradicting results have been found regarding the effectiveness of ACT in this population (Abdelbasset & Elnegamy 2015:219-226;Corten et al 2018Corten, Jelsma & Morrow 2015:256;Lukrafka, Fuchs & Fischer 2012:967-971;Moura Da Silva et al 2015Paludo et al 2008:791-794). In children hospitalised with bronchiolitis, however, it is agreed that ACT should not be routinely applied (Caffrey Osvald & Clarke 2015:1-3;Figuls et al 2016:CD004873).…”

Airway clearance therapy in acute paediatric respiratory illness: A state-of-the-art review

“…Assisted autogenic drainage may be performed with the infant on the physiotherapists’ lap, bouncing on a therapy ball, which may encourage relaxation of the child and improve expiratory airflow (Lee, Button & Tannenbaum 2017:2). A pilot randomised controlled trial ( n = 29) (Corten et al 2018) to determine the effect of assisted autogenic drainage in young children admitted to hospital with uncomplicated pneumonia, compared to standard nursing care alone (Corten et al 2018), reported there was a trend towards a shorter time to discharge in the intervention group ( p = 0.06), but no other significant benefit of assisted autogenic drainage. Importantly, though, no adverse events occurred, suggesting that this technique could be added to our ‘ACT toolbox’ for use in infants and children, and this warrants further investigation (Corten et al 2018).…”

Positive expiratory pressure (PEP) therapy. What pressures do we achieve in young children with cystic fibrosis? A single-centre study

“…Therapy is performed on the parent’s knee with 2 min alternating cycles of PEP and AAD (four times). 5 The initial PEP resistor diameter is set to 3.5 mm for term babies. This has been determined through clinical experience; to achieve an increase in resistance without a significant increase in work of breathing.…”