An interventional study of Rhinopharyngeal clearance and Aspiration in Acute Viral Bronchiolitis, sponsored by Pontificia Universidade Católica do Rio Grande do Sul. Completed. Open to participants aged Up to 12 Months. Per ClinicalTrials.gov, last updated 2015-06-03.
Sponsored by Pontificia Universidade Católica do Rio Grande do Sul · Not applicable, Interventional, and Treatment
The purpose of this study is to compare the immediate effects of retrograde rhinopharyngeal clearance with nasopharyngeal aspiration in children admitted with acute viral bronchiolitis. The investigators selected children, up to 12 months old, admitted for acute viral bronchiolitis. Patients were divided in aspiration group (AG), submitted to nasopharyngeal aspiration, and clearance group (CG), submitted to retrograde rhinopharyngeal clearance with physiological solution (0.9%) instillation (RRC) technique. In both groups children were evaluated three times in the same day in order to verify cardiorespiratory parameters, clinical score of respiratory dysfunction and adverse effects.
Children up to 12 months old, admitted for acute viral acute viral bronchiolitis were selected. All children participating in the study should be in the first 48 hours of hospitalization. Patients were divided in aspiration group (AG), submitted to nasopharyngeal aspiration, and clearance group (CG), submitted to retrograde rhinopharyngeal clearance (RRC) technique with physiological solution (0.9%) instillation. In both groups children were evaluated three times in the same day (data collection 1 (C1) - performed early in the morning; data collecting 2 (C2) - performed in the early afternoon; and data collecting 3 (C3) - performed in the evening). In each data collection, cardiorespiratory parameters and clinical score of respiratory dysfunction were evaluated before procedures (T0), 10 minutes after (T1) and 30 minutes after (T2). Adverse effects were evaluated during the whole day of the study.
Exclusion Criteria:
The retrograde rhinopharyngeal clearance (RRC) is based on the inspiratory reflex that follows a slow and prolonged expiration (passive exhalation technique performed using a slow thoracic-abdominal compression that begins at the end of a spontaneous exhalation and continues until the expiratory reserve volume). At the end of the expiratory time, the child's mouth was closed by the hand of the researcher (raising the lower jaw), leading the child to perform a nasal aspiration maneuver. The instillation of saline (0.9%) preceded this step, resulting in the inhalation of the substance during the forced inspiration, contributing to the nasopharyngeal clearance.
Procedure: Rhinopharyngeal clearance · Other: 0.9% saline
Nasopharyngeal aspiration consisted in the introduction of a catheter that, by using negative pressure (vacuum), promotes the suction of secretion from the airways. In order to do that, a sterile aspiration catheter was connected to an extension and carefully introduced into the nasal cavity of the patient. The saline instillation of 0.9% was used for humidification before the procedure.
Procedure: Aspiration · Other: 0.9% saline
At the end of the expiratory time, the child's mouth was closed by the hand of the researcher (raising the lower jaw), leading the child to perform a nasal aspiration maneuver.
A sterile aspiration catheter was connected to an extension and carefully introduced into the nasal cavity of the patient.
0.9% saline consists of physiological solution and was instilled in both experimental groups.
Occurrence of chest retractions as a measure of respiratory distress
Time frame: 30 minutes
Occurrence of wheezing as a measure of respiratory distress
Time frame: 30 minutes
Number of nasal bleeding events as a measure of adverse effects
Time frame: 1 day
Number of vomit episodes as a measure of adverse effects
Time frame: 1 day
Measurement of the heart rate using an oximeter
Time frame: 30 minutes
Measurement of the respiratory rate
Time frame: 30 minutes
Measurement of the oxygen saturation using an oximeter
Time frame: 30 minutes
Severity scores on the Wood clinical score
Time frame: 30 minutes
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Pontificia Universidade Católica do Rio Grande do Sul