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Respiratory physiotherapy in acute viral bronchiolitis in the newborn. Pro/con arguments. La kinésithérapie respiratoire dans la bronchiolite virale aiguë du nourrisson. Arguments pour/contre

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Postiaux, G. | Maffei, P. | Villiot-Danger, J. -C. | Dubus, J. -C.

Edité par CCSD ; Elsevier Masson -

International audience. This article reports an exchange of unbiased arguments between Mr Guy Postiaux speaking in favour of respiratory physiotherapy in acute viral bronchiolitis in the newborn and Prof. Jean-Christoph Dubus arguing against. A review of the literature suggests that traditional methods of physiotherapy should be abandoned because they are not validated and because they have harmful side effects. The latest Cochrane revue (2016) suggests the use of slow expiration techniques that have some validated elements and cause no harmful side effects. Large multicentre studies should be undertaken to confirm or refute the results of the five studies in the Cochrane review. Their analysis would allow extraction of objective evidence for the efficacy of slow expiration techniques on the relief of bronchopulmonary obstruction and the reduction of the degree of severity in the short and medium term. Studies of the effect of ambulatory respiratory physiotherapy for bronchiolitis of a moderate degree not requiring hospitalisation are not available. An evaluation is needed which is based on the pathophysiology of multifactorial bronchial obstruction and on the physical signs, of which auscultation is the cornerstone. (C) 2018 SPLF. Published by Elsevier Masson SAS. All rights reserved. . Cet article rapporte un échange d'arguments objectifs entre Mr Guy Postiaux plai-dant pour la kinésithérapie respiratoire dans la bronchiolite vitale aiguë du nourrisson et le Pr Jean-Christophe Dubus plaidant contre. Il ressort de la revue de la littérature que les méthodes usuelles de kinésithérapie doivent être abandonnées parce qu'elles ne sont pas validées et peuvent présenter des effets secondaires délétères. La plus récente révision Cochrane (2016) suggère l'utilisation des techniques expiratoires lentes qui possèdent des éléments de validation et qui ne présentent aucun effet secondaire délétère. De larges études multicentriques doivent

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