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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.
Studie Overzicht
Toestand
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Ana Martínez-Serrano, phD pediatric nurse
- Telefoonnummer: +34675115169
- E-mail: ana.martinez.serrano@salud.madrid.org
Studie Locaties
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Madrid, Spanje
- Universitary La Paz Hospital
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Contact:
- Ana Martínez-Serrano
- Telefoonnummer: +34675115169
- E-mail: ana.martinez.serrano@salud.madrid.org
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Actieve vergelijker: 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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Experimenteel: 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 |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Effectiveness of nasal cavity cleaning according to the investigator
Tijdsspanne: Periprocedural
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Visible expulsion of mucus or normal saline solution through nostril after irrigation |
Periprocedural
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Physiological parameters: Oxygen saturation
Tijdsspanne: Periprocedural
|
Changes in pulse oximetry oxygen saturation percentage |
Periprocedural
|
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Clinical severity assessed by the modified TAL score
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: Baseline and immediately after the intervention
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Changes in patient heart rate |
Baseline and immediately after the intervention
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Physiological parameters: respiratory rate
Tijdsspanne: Baseline and immediately after the intervention
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Changes in patient respiratory rate |
Baseline and immediately after the intervention
|
Medewerkers en onderzoekers
Sponsor
Publicaties en nuttige links
Algemene publicaties
- 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.
Studie record data
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Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
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Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 2025.1018
Plan Individuele Deelnemersgegevens (IPD)
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