Fisioterapia respiratória no manejo da bronquiolite viral aguda em crianças: revisão da literatura

Acute viral bronchiolitis is one of the leading causes of infant hospitalization and its treatment remains supportive, which keeps the role of respiratory physiotherapy under debate. Objective: To analyze, through a literature review, the role and effectiveness of respiratory physiotherapy in the management of acute viral bronchiolitis in children, identifying the techniques used and their effects on respiratory symptoms, lung function and clinical recovery. Methodology: Descriptive literature review with a qualitative approach, with searches conducted in 2026 in PubMed, PMC, SciELO, ScienceDirect, SpringerLink, Cochrane Library and Google Scholar. Full articles published between 2019 and 2026, in Portuguese or English, on respiratory physiotherapy in infants and children with acute viral bronchiolitis were included; abstracts, editorials, duplicates and studies unrelated to the topic were excluded. Results: Seven studies made up Table 1: one Cochrane meta-analysis, one systematic review, three randomized clinical trials, one retrospective cohort and one survey of physiotherapists. Conventional percussion, vibration and postural drainage techniques did not change outcomes in the trials pooled by the Cochrane synthesis, whereas slow expiratory techniques, especially in outpatient settings and in mild to moderate cases, reduced severity scores and improved respiratory rate and oxygen saturation. Discussion: The contrast between the null result of conventional techniques in the Cochrane synthesis and the benefits observed in outpatient trials suggests that the effect depends on disease severity, timing of the intervention and the chosen technique. The heterogeneity of protocols and the predominance of subjective assessment measures limit comparison between studies. Final considerations: Respiratory physiotherapy proved safe and potentially useful in mild to moderate cases, with no demonstrated benefit on length of stay. Trials with standardized protocols and validated clinical outcomes are recommended.