title: Chest physiotherapy is not clinically indicated for infants receiving outpatient care for acute wheezing episodes.
abstract: OBJECTIVE
  To evaluate the effectiveness of chest physiotherapy (CPT), which provides slow and long expiratory flow and assisted cough techniques, in infants receiving outpatient care for acute wheezing episodes.
  
  
  METHODS
  Forty-eight infants with moderate acute wheezing episodes were randomised to receive either salbutamol MDI with CPT (n = 25) or without CPT (n = 23). The clinical score and SpO2 levels were recorded, before and after treatment, in a blinded design. The primary outcome was discharge after the first hour of treatment: clinical score ≤5/12 and SpO2 ≥ 93%. Secondary outcomes were the number of admissions to hospital after the second hour, use of oral corticosteroid bursts and admissions to hospital on day seven.
  
  
  RESULTS
  There were no differences between children with and without CPT in discharge rate (92% vs. 87%), clinical score (median [IQR]: 2.8 [2.2-3.3] vs. 3.4 [2.8-4.1]) and SpO2 = (96.4 [95.7-97.1] vs. 96.0 [94.9-96.5]) after the first hour of treatment or in the number of hospital admissions after the second hour. No differences were observed at days seven and 28 following treatment.
  
  
  CONCLUSIONS
  There was no evidence of clinical benefits from these specific CPT techniques for infants receiving outpatient care for acute wheezing episodes.
authors.affiliation: Department of Paediatrics, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile; Department of Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Castro-Rodriguez
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Silva
authors.forename: Patricio
authors.initials: P
authors.lastname: Tapia
authors.forename: Pamela
authors.initials: P
authors.lastname: Salinas
authors.forename: Alvaro
authors.initials: A
authors.lastname: Tellez
authors.forename: Thomas
authors.initials: T
authors.lastname: Leisewitz
authors.forename: Ignacio
authors.initials: I
authors.lastname: Sanchez
mesh_terms: D000208:Acute Disease; D000420:Albuterol / Q000627:therapeutic use*; D000553:Ambulatory Care / Q000379:methods*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D026741:Physical Therapy Modalities; D012135:Respiratory Sounds; D012140:Respiratory Tract Diseases / Q000628:therapy*; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol
keywords: Acute wheezing episode; Chest physiotherapy; Infants; Outpatient