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58 APPENDICES Physiotherapy KCE reports vol. 40 5. NATIONAL GUIDELINE CLEARINGHOUSE (MAY 2006) Search for bronchiolitis in the main search window. Twenty references found. Only one relevant: the practice guideline on bronchiolitis in the infant from the Cincinnati Children s Hospital Medical Center (aleready found). 6. ADDITIONAL SEARCH ON ANAES, SSMG, WVVH WEBSITES (MAY 2006) ANAES Search for bronchiolitis in the search window of the main Publications page. One reference found: Prise en charge de la bronchiolite du nourrisson, conference de consensus, 2000 (7). SSMG, WvvH : no records found 7. ADDITIONAL SEARCH IN EMBASE (JUNE 2006) No new relevant reference found.
KCE reports vol.40 APPENDICES Physiotherapy 59 References retrieved from the literature on physiotherapy for bronchiolitis in the infant Reference Type of reference General description Critical appraisal Evidence based clinical practice Practice guideline from de Cincinnati Practice guideline addressing prevention, diagnosis Agree total score: 76/92 guideline for infant with bronchiolitis Children s Hospital Medical Center, and medical management. (3) US No specific section on physiotherapy but states that Cochrane Va form: First published in 1996, last revision in routine respiratory care therapy other than suction The answers to most questions 2005 (i.e., chest physiotherapy, cool mist therapy, aerosol included in this form are positive. with saline) should not be used as not helpful. Some questions are not relevant for Based on 85 references. this guideline. The main recommendations of this guideline seem valid, well documented and applicable in most rehabilitation facilities at most levels of practice. Chest physiotherapy for acute Cochrane Review Systematic review of RCTs on traditional chest Not to be rated bronchiolitis in paediatric patients physical therapy modalities such as: postural between 0 and 24 months old (5) drainage, chest percussion, vibration, chest shaking, directed coughing or forced exhalation techniques. Conclusions based on only 3 RCTs as no other study met the inclusion criteria. Continuous negative extrathoracic Cochrane Review Systematic review of RCTs on CNEP and non Not to be rated pressure (CNEP) or continuous invasive CPAP. positive airway pressure (CPAP) for acute hypoxemic respiratory failure in children (6) Conclusions based on only one RCT on CNEP in children as no other study met the inclusion criteria. Management of bronchiolitis in infants Evidence Report/Technology from Evidence reports that focuses only on prevention, Not rated as not relevant. and children (8) the Assessment Agency for Health diagnosis and efficacy or effectiveness of medical This report has been excluded from Care Research and Quality, US Gov treatment (pharmaceutical agents: corticosteroids, further analysis. bronchodilatators, antimicrobial and antiviral Prise en charge de la bronchiolite du Conférence de consensus d experts agents) of bronchiolitis. Physiotherapy is not addressed in this report. Expert consensus that addresses natural history, Not to be rated nourrisson (7) hospital admission criterias, medical treatments, chest physiotherapy, organisation of care and prevention of bronchiolitis.
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