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?:abstract
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Background: Little is known about the prescription, frequency and nature of airway clearance therapy (ACT) in children hospitalised with lower respiratory tract infections (LRTIs) Objectives: To describe the characteristics and outcomes of children hospitalised with LRTIs at a tertiary paediatric hospital in South Africa and to investigate the role and impact of ACT in these children Method: A retrospective folder review of children hospitalised with LRTI between January and June 2015 was conducted, extracting data on demographic characteristics, health condition, ACT interventions and patient outcomes Results: A total of 1208 individual cases (median [IQR] age 7 6 (2 8-19 0) months), in 1440 hospitalisations, were included The majority of children were hospitalised primarily for the management of bronchiolitis Comorbidities were present in 52 6% of patients during at least one of their hospitalisations Airway clearance therapy was administered in 5 9% (n = 85) of admissions, most commonly conventional (manual) ACT Transient oxyhaemoglobin desaturation was reported in six children, and one child developed lobar collapse an hour post-treatment No other adverse events were reported The median (IQR) duration of hospitalisation was 2 3 (1 5-5 0) days, and the overall mortality rate was 0 7% Children hospitalised for presumed nosocomial infections and pneumonia had the longest length of stay, were more likely to receive ACT and had the highest mortality rate Conclusion: Airway clearance therapy was infrequently used in this population and was more commonly applied in those with nosocomial LRTI and pneumonia Clinical implications: Although ACT was generally well tolerated, safety has not been ascertained, and oxygen saturation should be carefully monitored during therapy
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