Airway clearance techniques have no effect on 24-hour food intake in children hospitalised for moderate bronchiolitis: a randomised controlled trial

<bold>Introduction:</bold> Airway clearance techniques (ACT) could slightly and transiently improve respiratory symptoms in children with bronchiolitis, but the clinical significance of this change is unknown. We investigated whether ACT would impact the 24-hour food intake of these children. <bold>Methods:</bold> We conducted a two-arm parallel-group randomised controlled trial. Allocation was concealed; and assessors and parents were blinded. Hospitalised children aged from 1 to 12 months, bottle-fed or diversified and referred for ACT were included. Both groups received standard treatment: upper airway clearance at inclusion and before each feeding during the 24 hours of follow-up. The experimental group underwent a 10-minute PSE session with rhinopharyngeal retrograde clearance (RRC) and targeted unprovoked cough. The primary outcome was the 24-hour food intake. Secondary outcomes were clinical severity, respiratory rate, heart rate, pulsed oxygen saturation, the number of vomit episodes and sleep quality. <bold>Results:</bold> Forty-two children were randomised with a 1:1 (mean age: 5.0 (±2.9) months). Food intake did not differ between groups (estimate: 1.8% (95%CI -7.0 to 10.6); p=0.68). ACT had no effect on SpO2 at the follow-up assessments (5 minutes, 30 minutes and 24 hours after intervention) or during sleep, or on the number of vomit episodes and total sleep time; and an uncertain effect on RR and HR. <bold>Conclusions:</bold> ACT did not affect food intake or the 24-hour course of bronchiolitis more than standard treatment in children hospitalised for moderate bronchiolitis.