Chest physiotherapy for pneumonia in children

Chaves, Gabriela; Fregonezi, Guilherme; Dias, Fernando Al; Ribeiro, Cléa Elisa Lopes; Guerra, Ricardo Oliveira; Freitas, Diana Amélia de; Parreira, Verônica Franco; Mendonça, Karla Morganna Pereira Pinto de

doi:10.1002/14651858.cd010277.pub2

Cited by 18 publications

(7 citation statements)

References 32 publications

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“…However, the usefulness of airway clearance therapy in children with uncomplicated pneumonia is debateable. Several clinical guidelines and two systematic reviews have been published, which do not support the use of airway clearance therapy for children with pneumonia (Chaves et al, 2013;Corten, Jelsma, & Morrow, 2015;Harris et al, 2011;Zar, Jeena, Argent, Gie, & Madhi, 2005). Three randomized controlled trials (RCTs) have been published in the past 10 years, with inconclusive results (Abdelbasset & Elnegamy, 2015;Lukrafka, Fuchs, & Fischer, 2012;Paludo et al, 2008).…”

mentioning

confidence: 99%

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

Corten

Jelsma

Human

et al. 2017

Physiotherapy Res Intl

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mentioning

confidence: 99%

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

Corten

Jelsma

Human

et al. 2017

Physiotherapy Res Intl

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“…Es gibt einzelne Hinweise, dass Physiotherapie bei Patienten mit einer Pneumonie sogar nachteilig sein und zur längeren Dauer von Fieber führen kann [57]. Eine Metaanalyse von 3 Studien bei Kindern mit Pneumonie konnte weder positive noch negative Effekte einer Physiotherapie belegen [59]. Möglicherweise ist eine sitzende Position bzw.…”

Section: Physiotherapieunclassified

S2k-Leitlinie Management der ambulant erworbenen Pneumonie bei Kindern und Jugendlichen (pädiatrische ambulant erworbene Pneumonie, pCAP)

et al. 2020

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ZusammenfassungDie vorliegende Fassung der deutschsprachigen AWMF-Leitlinie soll unter Berücksichtigung der vorliegenden Evidenz die medizinische Versorgung von Kindern und Jugendlichen mit ambulant erworbener Pneumonie (pediatric community acquired pneumonia, pCAP) verbessern. In Mitteleuropa steht einer Prävalenz von ca. 300 Fällen pro 100 000 Kinder/Jahr eine sehr geringe Mortalität gegenüber, die Prävention umfasst Hygiene-Maßnahmen und Impfung z. B. gegen Pneumokokken, Hämophilus, Masern und Influenza. Hauptsymptome der pCAP sind Fieber und Tachypnoe, die Diagnosestellung erfolgt primär klinisch durch Anamnese, körperliche Untersuchung und Pulsoxymetrie. Das zusätzliche Vorliegen von Warnsymptomen wie stark reduzierter Allgemeinzustand, Nahrungsverweigerung, Dehydratation, Bewusstseinsstörung oder Krampfanfälle definiert die schwere pCAP in Abgrenzung zur nicht-schweren pCAP. Das Erregerspektrum ist altersabhängig, zur Differenzierung zwischen viraler, bakterieller oder gemischt viral-bakterieller Infektion stehen jedoch keine zuverlässigen Biomarker zur Verfügung. Die meisten Kinder und Jugendlichen mit nicht-schwerer pCAP und O2-Sättigung > 92 % können ohne weitere Röntgen-, Labor- und Erreger-Diagnostik ambulant betreut werden. Der Einsatz von Antiinfektiva ist nicht grundsätzlich indiziert, vor allem bei jungen Kindern, bronchialer Obstruktion und anderen Hinweisen auf virale Genese kann darauf i. d. R. verzichtet werden. Zur kalkulierten Antibiotika-Therapie sind Aminopenicilline Mittel der Wahl, bei gewährleisteter Einnahme und Resorption sind die orale (Amoxicillin) und intravenöse Verabreichung (Ampicillin) von vergleichbarer Wirksamkeit. Nach 48 – 72 Stunden ist eine Verlaufsbeurteilung notwendig, um den Behandlungserfolg und mögliche Komplikationen wie z. B. parapneumonische Ergüsse oder Pleuraempyeme, die eine Erweiterung bzw. Änderung der Therapie erforderlich machen, rechtzeitig zu erfassen.

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“…Systematic reviews have reported that there is insufficient data to show whether or not ACT is beneficial or harmful in a number of clinical outcomes in children with acute uncomplicated pneumonia (Chaves et al 2013:CD010277; Corten, Jelsma & Morrow 2015:256). One of the two randomised controlled trials included in these reviews (Lukrafka et al 2012:967–971) may have been underpowered to detect a 2-day increase in hospital length of stay in the intervention group, and the other study (Paludo et al 2008:791–794) also reported a longer duration of coughing ( p = 0.04) and adventitious sounds on auscultation (rhonchi) ( p = 0.03) in those who received ACT compared to controls.…”

Section: Airway Clearance Techniquesmentioning

confidence: 99%

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

Morrow

2019

South African Journal of Physiotherapy

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Background Despite unclear evidence of effectiveness or safety, airway clearance therapy (ACT) is frequently performed in infants and children with acute pulmonary disease. Objectives The aim of this review was to critically synthesise published evidence, expert opinion and pathophysiological principles to describe the indications, effects, precautions and application of commonly used ACT modalities for managing infants and children with acute pulmonary disease. Method A comprehensive narrative review of published literature was conducted. Articles describing paediatric populations were prioritised, but adult and animal studies were also considered where appropriate. Results There is a dearth of high-level evidence supporting the use of ACT in acutely ill infants and children. Conversely, studies have highlighted the lack of effect of different modalities for a variety of conditions, and in some cases serious associated complications have been reported. Airway clearance therapy may be considered when there is retention of pulmonary secretions, and the consequential airway obstruction impacts either acutely on respiratory mechanics and gaseous exchange and/or has the potential for long-term adverse sequelae [a condition that is the consequence of a previous disease or injury]. However, it should not be considered a routine intervention. Conclusion Airway clearance therapy should not be performed routinely in children admitted to hospital with acute respiratory conditions. Patients should be clinically assessed and treatment planned according to individual presentation, in those with signs and symptoms that are potentially amenable to ACT. Clinical implications This review can serve as a guide for physiotherapists in the respiratory management of children with acute respiratory illness, as well as identifying areas for clinical research.

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Chest physiotherapy for pneumonia in children

Cited by 18 publications

References 32 publications

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

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

S2k-Leitlinie Management der ambulant erworbenen Pneumonie bei Kindern und Jugendlichen (pädiatrische ambulant erworbene Pneumonie, pCAP)

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

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