Prise en charge de la bronchiolite du nourrisson texte court

Stagnara, J.; Balagny, E.; Cossalter, Bernard; Dommerges, J.P.; Dournel, C.; Drahi, Éric; Gauchez, H.; Guillot, F; Javault, D.; Lagardère, B; Masne, A. Le; Lesprit, Emmanuelle; Maidenberg, Marc; Maufroy, D.; Picherot, G.; Renaud, H; Robert, Jason Scott; Undreiner, F.

doi:10.1016/s0929-693x(01)80150-0

Cited by 3 publications

(4 citation statements)

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“…A recent updated Cochrane Review on the efficacy of "conventional chest physiotherapy" (cCPT), mainly vibration, percussion and postural drainage, in infants with acute bronchiolitis found no reduction in the length of hospital stay, oxygen requirements or clinical severity in the intervention group [19]. Nonetheless, other "new" techniques using passive expiratory manoeuvres to allow the mobilisation of secretions without airway collapse are nowadays routinely used in some regions of Europe [20] and were part of the French 2001 national consensus statement for the management of bronchiolitis in infants [24]. Only recently, the use of chest physiotherapy with passive expiratory techniques has been challenged and studied in bronchiolitis [10].…”

Section: Introductionmentioning

confidence: 99%

Chest physiotherapy using passive expiratory techniques does not reduce bronchiolitis severity: a randomised controlled trial

et al. 2011

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Chest physiotherapy (CP) using passive expiratory manoeuvres is widely used in Western Europe for the treatment of bronchiolitis, despite lacking evidence for its efficacy. We undertook an open randomised trial to evaluate the effectiveness of CP in infants hospitalised for bronchiolitis by comparing the time to clinical stability, the daily improvement of a severity score and the occurrence of complications between patients with and without CP. Children <1 year admitted for bronchiolitis in a tertiary hospital during two consecutive respiratory syncytial virus seasons were randomised to group 1 with CP (prolonged slow expiratory technique, slow accelerated expiratory flow, rarely induced cough) or group 2 without CP. All children received standard care (rhinopharyngeal suctioning, minimal handling, oxygen for saturation ≥92%, fractionated meals). Ninety-nine eligible children (mean age, 3.9 months), 50 in group 1 and 49 in group 2, with similar baseline variables and clinical severity at admission. Time to clinical stability, assessed as primary outcome, was similar for both groups (2.9 ± 2.1 vs. 3.2 ± 2.8 days, P = 0.45). The rate of improvement of a clinical and respiratory score, defined as secondary outcome, only showed a slightly faster improvement of the respiratory score in the intervention group when including stethoacoustic properties (P = 0.044). Complications were rare but occurred more frequently, although not significantly (P = 0.21), in the control arm. In conclusion, this study shows the absence of effectiveness of CP using passive expiratory techniques in infants hospitalised for bronchiolitis. It seems justified to recommend against the routine use of CP in these patients.

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Section: Introductionmentioning

confidence: 99%

Chest physiotherapy using passive expiratory techniques does not reduce bronchiolitis severity: a randomised controlled trial

et al. 2011

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“…Oxygen administration must therefore be carefully codified, even in resource limited settings like ours. According to the Consensus Conference (CC) guidelines, all patients with peripheral oxygen saturation below 94% should be hospitalised and given oxygen [ 11 ]. Nonetheless, because of the potential dangers of excessive oxygen administration, increased cost of care and the potential increased risk in the transmission of nosocomial infections using oxygen delivery devices, some authors have proposed lower targets for oxygen saturation [ 41 – 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…In September 2000, a consensus conference (CC) organised by the HAS (Haute Autorité de Santé) in France recommended diagnostic and management guidelines for acute bronchiolitis [ 11 ]. Though these management guidelines have been updated in November 2019, both guidelines recommend comprehensive symptomatic therapy, with emphasis on nasopharyngeal wash (NPW) and prohibit the use of antibiotics (unless in cases when secondary bacterial infection is confirmed), corticosteroid therapy, or bronchodilators [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

“…In Cameroon, acute bronchiolitis has been reported as the third commonest lower respiratory infection [ 9 ]. Though consensual management guidelines for acute bronchiolitis are not yet known, the use of medications like bronchodilators and corticosteroids are not recommended [ 11 – 13 ]. In 2003, in France, adherence to these guidelines was reported at 6% of cases, which improved to 52.5% in 2013 [ 14 , 15 ] with subsequent reduction in mortality [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Predictors of prolonged length of hospital stay and in-hospital mortality in patients aged 1–24 months with acute bronchiolitis in Douala, Cameroon

Eposse Ekoube,

Heles Nsang,

Épée

et al. 2024

BMC Pediatr

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Introduction In Cameroon, acute bronchiolitis has been reported as the third commonest lower respiratory infection and is usually associated with low mortality. Nonetheless, respiratory distress associated with non-adherence to management guidelines can prolong hospital stay. This study aimed to explore predictors of prolonged hospital stay (≥ 5 days) and mortality in patients aged < 2years hospitalised for acute bronchiolitis. Methodology We conducted a retrospective cohort study at three paediatric units in the city of Douala, Cameroon. Factors associated with prolonged hospital stay and mortality were determined using multivariable linear regression model. Threshold for significance was set at p ≤ 0.05. Results A total of 215 patients with bronchiolitis were included with mean age of 6.94 ± 5.71 months and M/F sex ratio of 1.39/1. Prolonged hospital stay was reported in 46.98% and mortality in 10.70% of patients hospitalised for bronchiolitis. Factors independently associated with prolonged hospital duration were oxygen administration [b = 0.36, OR = 2.35 (95% CI:1.16–4.74), p = 0.017], abnormal respiratory rate [b = 0.38, OR = 2.13 (1.00-4.55), p = 0.050] and patients presenting with cough [b = 0.33, OR = 2.35 (95% CI: 1.22–4.51), p = 0.011], and diarrhoea [b = 0.71, OR = 6.44 (95% CI: 1.6-25.86), p = 0.009] on admission. On the other hand, factors independently associated with mortality were age of the patient [b= -0.07, OR = 0.84 (95% CI: 0.74–0.97), p = 0.014] and oxygen administration [b = 1.08, OR = 9.64 (95% CI:1.16–79.85), p = 0.036] Conclusion Acute bronchiolitis represented 1.24% of admissions and was common in the rainy season, in males and 3–11-month-old patients. Management guidelines were poorly respected. Prolonged length of stay was reported in half of the patients hospitalized and mortality was high, especially in younger patients and in patients receiving oxygen.

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Effectiveness of palivizumab in children with childhood interstitial lung disease: The French experience

et al. 2015

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Prise en charge de la bronchiolite du nourrisson texte court

Cited by 3 publications

References 0 publications

Chest physiotherapy using passive expiratory techniques does not reduce bronchiolitis severity: a randomised controlled trial

Chest physiotherapy using passive expiratory techniques does not reduce bronchiolitis severity: a randomised controlled trial

Predictors of prolonged length of hospital stay and in-hospital mortality in patients aged 1–24 months with acute bronchiolitis in Douala, Cameroon

Effectiveness of palivizumab in children with childhood interstitial lung disease: The French experience

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