Acute Viral Bronchiolitis (AVB) is one of the leading causes of respiratory illness and hospitalization among infants during the first year of life, generating a substantial burden on healthcare services and public health expenditures. Despite the widespread use of respiratory physiotherapy in clinical practice, there is limited evidence regarding its effectiveness in preventing hospital admissions when provided in an outpatient setting.
This quasi-experimental study aims to evaluate the impact of an outpatient respiratory physiotherapy protocol on hospitalization rates among infants up to 12 months of age diagnosed with mild to moderate acute viral bronchiolitis in the public healthcare system of Sorocaba, Brazil. Infants referred for respiratory physiotherapy will be compared with a similar group of infants who receive standard medical care without physiotherapy referral.
The physiotherapy protocol includes slow expiratory techniques, rhinopharyngeal retrograde clearance, cough stimulation, and continuous positive airway pressure (CPAP) when clinically indicated. Participants will be followed through medical records and telephone monitoring.
The primary outcome is hospital admission due to bronchiolitis. Secondary outcomes include length of hospital stay, healthcare costs, and clinical evolution. The findings may provide evidence on whether outpatient respiratory physiotherapy can reduce hospitalizations and optimize healthcare resource utilization in infants with acute viral bronchiolitis.
Infants aged 12 months or younger.
Clinical diagnosis of acute viral bronchiolitis.
Mild or moderate bronchiolitis according to clinical assessment and Wang Bronchiolitis Severity Score.
Initial evaluation performed at a participating emergency care unit (UPA).
Severe bronchiolitis requiring immediate hospitalization or emergency medical intervention.
Infants who did not follow the predefined clinical care pathway (e.g., no initial evaluation at a participating emergency care unit).
Absence of a clinical diagnosis of acute viral bronchiolitis by the attending pediatrician.
Any medical condition that, in the opinion of the clinical team, would make participation inappropriate or interfere with study procedures.