Tuesday , September 22 2020

What to do in case of newborn bronchiolitis?



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HEALTH – Physiotherapists did not appreciate the new guidelines of the Haute Autorité de Santé (HAS), nor the interpretation that was made in the media.

FAS explained in its latest guidelines for infants under 12 months that in the case of bronchiolitis, "non-curative therapies are not recommended". Among them, "respiratory physiotherapy of bronchial decongestion". She adds: "Traditional techniques such as clapping (shaking the rib cage affected by the flat arm) or vibration for example are contraindicated."

In order to explain this FAS decision, several media outlets, including HuffPostThe AFP's explanations came from the health authority: "the studies did not provide scientific evidence of its efficacy against bronchiolitis."

This sentence has angered the world of kinesiotherapy.

Specifically on Instagram, "influential" physiotherapists ask their followers to testify in favor of the respiratory physiotherapist. And favorable testimonies gather dozens.

Other accounts criticize journalists for taking this argument from scientific studies without confirming exactly what it was. Thus, the Great Movement explains why there are so few studies on this issue and why this fact cannot be used as a demonstration of the inefficiency of respiratory physiotherapy.

"Imagine bronchiolitis is a puzzle," writes the Great Movement. Every study done on bronchiolitis is a piece of the puzzle. Whenever a study is published, we understand a little more about what the puzzle looks like. To date, we have very few puzzles. “

For its part, the Brain Muscle account makes the same remark: "Absence of evidence is not evidence of absence: this sentence must be banned. The FAS and science are clear: when we have evidence we can decide scientifically.

Despite these arguments, the vice president of the French Society of Pediatrics, Professor Robert Cohen, contaminated with CHI Créteil (Val-de-Marne) infection, agrees with HAS. He specifies HuffPost: "It's been eight years since I say and repeat, the respiratory physio is useless. Look what other countries do, no one prescribes more infant sessions. We are the only one in Belgium to continue on this path. This is a real indicator that must be taken into account. "

This is an argument that the pediatrician already mentioned in 2015 on Europe's microphone1: “In Northern Europe, we are doing more. In Germany, not even in the countries of the South. It's just a thrill that hurts infants. "

So, without a respiratory physiotherapist, how to treat bronchiolitis in newborns?

"They're not healing," Professor Cohen cut. These are natural remedies. Minimum support required. For years we have wanted to cure all diseases, it is a mistake. You have to know how to be patient, be careful, especially in the first two days and check the quality of the child's breathing. "

The Haute Autorité de Santé says nothing in its recommendations for good practice. Depending on the general condition of the child, his respiratory and heart rate, different protocols need to be established. First of all, there is disrespect for the respiratory airways, which is nothing but a nose wash.

• Wash your nose

"All nasal infants infected with bronchiolitis are clogged. You have to clean them, says Professor Cohen. All washing regimes are good, with saline and normal or hypertonic seawater. I don't say no to baby mites, as long as they are soap-free, as best they can because they are microbial nests. "

• Split meals

"Look at the two-month-old newborn, the doctor continues, eating is his sport of the day. He will take 5 meals of 150 ml. Go 90ml and 6 times daily. He will be less uncomfortable.

• Place the oxygen

This is the most important part, even if it only applies to a small proportion of cases of bronchiolitis. If arterial oxygen saturation falls below 92%, then oxygenation is considered in the hospital.

"I am in charge of the infant unit and when they come to us, we just do it, put them under oxygen and break their meals. We keep them for a day or two if it improves their comfort. "

It takes ten days to see bronchiolitis. So much goodbye to physio, ventolin, bronchial fluids and healthy patience?

Look it up HuffPost:

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