Influence of Patient Positioning During Nasal Lavage (nasal lavage)
Influence of Patient Positioning During Nasal Lavage in Pediatric Patients: A Randomized Controlled Trial
Acute upper respiratory tract infections are the primary cause of pediatric visits and hospitalizations in young children. Nasal congestion and mucus accumulation often cause discomfort, feeding difficulties, and respiratory distress in infants. Nasal lavage using normal saline solution is widely recommended to clear upper airways; however, there is limited evidence regarding the optimal patient posture during irrigation.
This study aims to determine whether patient position-supine (lying on the back) versus sitting (tilted 10 degrees forward)-improves the effectiveness of nasal cavity clearance in children aged 0 to 2 years.
A randomized, parallel, age-stratified clinical trial will be conducted at Pediatric Emergency Department and in Pediatric Hospitalization at Universitary La Paz hospital. Participants will be pediatric patients with mild-to-moderate upper respiratory symptoms requiring nasal lavage as part of their routine care.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Ana Martínez-Serrano, phD pediatric nurse
- Telefonnummer: +34675115169
- E-mail: ana.martinez.serrano@salud.madrid.org
Studiesteder
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-
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Madrid, Spanien
- Universitary La Paz Hospital
-
Kontakt:
- Ana Martínez-Serrano
- Telefonnummer: +34675115169
- E-mail: ana.martinez.serrano@salud.madrid.org
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Pediatric patients aged 0 to 2 years requiring nasal lavage in emergency or hospitalization settings for symptoms related to upper respiratory tract infections
- Modified TAL score <= 8 points (mild to moderate)
- Stable Pediatric Assessment Triangle (PAT), or if unstable, attributable exclusively to respiratory distress while maintaining adequate coloration and normal appearance
- Informed consent signed by parents
Exclusion Criteria:
- Absolute contraindications for nasal lavage (recent unstabilized nasal fractures, acute traumatic brain injury, swallowing disorders, ineffective cough or inability to cough, severe active nasal hemorrhage, unresolved tympanic membrane perforation, severe craniofacial anomalies)
- Post-operative period following recent nasal surgery (< 6 months since the surgical intervention)
- Chronic respiratory pathologies or chronic congenital pulmonary diseases (such as cystic fibrosis)
- Severe physical limitations preventing the safe adoption of any of the studied postures, or severe alteration of consciousness level/cognitive impairment preventing comprehension of instructions and collaboration.
- Patients who do not fully participate in the intervention.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Aktiv komparator: Group A: Supine Position
Patients placed in supine position with the headboard flat and head turned to the side during normal saline nasal irrigation |
Lying position nasal irrigation |
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Eksperimentel: Group B: Semi-sitting Position
Patients placed in a semi-sitting position, tilted 10 degrees forward and swaddled in a sheet during normal saline nasal irrigation |
Seated nasal irrigation 10 degrees forward |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Effectiveness of nasal cavity cleaning according to the investigator
Tidsramme: Periprocedural
|
Visible expulsion of mucus or normal saline solution through nostril after irrigation |
Periprocedural
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Physiological parameters: Oxygen saturation
Tidsramme: Periprocedural
|
Changes in pulse oximetry oxygen saturation percentage |
Periprocedural
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Clinical severity assessed by the modified TAL score
Tidsramme: Baseline and immediately after the intervention
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Evaluation of respiratory distress using the validated modified TAL score (ranging from 0 to 12 points) |
Baseline and immediately after the intervention
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Incidence and type of adverse effects
Tidsramme: Periprocedural
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Occurrence and classification of adverse effects experienced during or immediately after the technique, such as nasal bleeding (epistaxis), transient apnea, cyanosis, vomiting, or coughing. |
Periprocedural
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Physiological parameters: heart rate
Tidsramme: Baseline and immediately after the intervention
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Changes in patient heart rate |
Baseline and immediately after the intervention
|
|
Physiological parameters: respiratory rate
Tidsramme: Baseline and immediately after the intervention
|
Changes in patient respiratory rate |
Baseline and immediately after the intervention
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Publikationer og nyttige links
Generelle publikationer
- Schmidt MN, Daugberg R, Nygaard U, Nielsen XC, Chawes B, Rytter MH, Schoos AM. Normal saline for children with bronchiolitis: study protocol for a randomised controlled non-inferiority trial. BMJ Paediatr Open. 2024 Jan 17;8(1):e002273. doi: 10.1136/bmjpo-2023-002273.
- Martinez-Serrano A, Martinez-Campos P, Seijoso-Gonzalez L, Ruiz-Rojo H. Literature review of nasal lavage technique in paediatrics. Enferm Clin (Engl Ed). 2021 May-Jun;31(3):189-194. doi: 10.1016/j.enfcli.2021.01.005. Epub 2021 Feb 23. English, Spanish.
- Cabaillot A, Vorilhon P, Roca M, Boussageon R, Eschalier B, Pereirad B. Saline nasal irrigation for acute upper respiratory tract infections in infants and children: A systematic review and meta-analysis. Paediatr Respir Rev. 2020 Nov;36:151-158. doi: 10.1016/j.prrv.2019.11.003. Epub 2020 Feb 21.
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 2025.1018
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