Effects of Chest Physiotherapy in Preterm Infants with Respiratory Distress Syndrome: A Systematic Review (original) (raw)
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Effect of chest physiotherapy on lung function in preterm infants
Preterm infants are at an increased risk of lung damage due to the adverse effects of the ventilatory assistance which is required to support their respiration. Chest physiotherapy (CPT) has been proposed as one intervention which can be used to help improve ventilation by assisting in the removal of excess tracheobronchial secretions. The package of CPT used in the preterm infant consists of a variety of techniques which include postural drainage and positioning, active techniques such as percussion and vibrations, and suction. The use of these techniques, in varying combinations, has become traditional treatment for a variety of acute and chronic pulmonary conditions. There has been some attempt in the past to ascertain which techniques produced the most clinically relevant results however study results are equivocal due to the variations in techniques investigated and outcomes measured. In the absence of clear clinical guidelines, techniques used tend to depend on the experience ...
Chest physiotherapy in preterm infants with lung diseases
Italian Journal of Pediatrics, 2010
Background In neonatology the role of chest physiotherapy is still uncertain because of the controversial outcomes. Methods The aim of this study was to test the applicability in preterm infants of 'reflex rolling', from the Vojta method, in preterm neonates with lung pathology, with particular attention to the effects on blood gases and oxygen saturation, on the spontaneous breathing, on the onset of stress or pain. The study included 34 preterm newborns with mean gestational age of 30.5 (1.6) weeks - mean (DS) - and birth weight of 1430 (423) g - mean (DS) -, who suffered from hyaline membrane disease, under treatment with nasal CPAP (continuous positive airways pressure), or from pneumonia, under treatment with oxygen-therapy. The neonates underwent phase 1 of 'reflex rolling' according to Vojta method three times daily. Respiratory rate, SatO2, transcutaneous PtcCO2 e PtcO2 were monitored; in order to evaluate the onset of stress or pain following the stimulation...
Background: Tactile maneuvers stimulating spontaneous respiratory activity in preterm infants are recommended since birth, but data on how and how often these maneuvers are applied in clinical practice are unknown. In the last years, most preterm newborns with respiratory failure are preferentially managed with non-invasive respiratory support and by stimulating spontaneous respiratory activity from the delivery room and in Neonatal Intensive Care Unit (NICU), in order to avoid the risks of intubation and prolonged mechanical ventilation.Methods: Preterm infants with gestational age ≤ 30 weeks not intubated in the delivery room and requiring non-invasive respiratory support at birth will be eligible for the study. They will be randomized and allocated to one of two treatment groups: 1) the Study Group infants will be subject to the technique of respiratory facilitation within the first 24 h of life, according to the reflex stimulations, by the physiotherapist. The newborn is placed ...
South African Journal of …, 2010
Respiratory distress syndrome (RDS), caused by surfactant deficiency, is a common cause of respiratory failure in preterm infants. RDS is treated by administration of exogenous surfactant and ventilatory support as needed, in the form of intermittent positive-pressure ventilation (IPPV) or continuous distending pressure (CDP). Bronchopulmonary dysplasia (BPD) remains a problem, despite improvements in the technique of conventional positive-pressure ventilation, so non-invasive forms of ventilation such as nasal continuous positive airways pressure (NCPAP) are of interest. 1 NCPAP together with permissive hypercapnia appears to decrease the incidence of BPD significantly. 2 NCPAP is currently widely used in the management of RDS in preterm infants. 2-5 Surfactant therapy with early extubation to NCPAP decreases the need for intubation and ventilation, 6-8 shortens the duration of mechanical ventilation, decreases the need for subsequent surfactant therapy 9 and decreases BPD in extremely low-birth-weight (ELBW) infants. Whether NCPAP should be started immediately at birth or delayed until the baby has signs of RDS is still unclear 10-13 and is currently under evaluation. 14 The application of NCPAP immediately after birth may reduce the need for subsequent surfactant therapy. 13 NCPAP is also useful in facilitating extubation and managing the apnoea of prematurity. While highly effective, NCPAP is not always successful 15 and may be associated with complications such as pneumothorax, 13 a greater risk of early-onset sepsis in ELBW infants 16 and the development of nasal trauma. Continuous negative airways pressure (CNEP) is another way of delivering CDP. CNEP was found to be physiologically equivalent to positive end-expiratory pressure (PEEP) in an animal model of acute lung injury 19 and is effective in the management of RDS in preterm infants. 20,21 However, while NCPAP has gained favour, CNEP has remained largely un-utilised. The systems used to apply CNEP are often Daynia E Ballot, MB BCh, FCP (Paed), PhD Peter A Cooper, MB ChB, DCH, FCP (Paed), PhD Barbara J Cory, RN, DNEd Sithembiso Velaphi, MB BCH, FCP (Paed), MMed (Paed), Fellowship Neonatology A pilot study to determine whether external stabilisation of the chest wall reduces the need for mechanical ventilation in preterm infants S S A J o u r n a l of C h i l d H e al th
BMJ (Clinical research ed.), 2013
To assess the role of nasal continuous positive airway pressure (CPAP) initiated at birth for prevention of death and bronchopulmonary dysplasia in very preterm infants. Systematic review. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and online Pediatric Academic Society abstracts from the year of inception to June 2013. Randomised controlled trials evaluating the effect of nasal CPAP compared with intubation in preterm infants born at less than 32 weeks' gestation and presenting the outcomes of either death or bronchopulmonary dysplasia, or both (defined as the need for oxygen support or mechanical ventilation at 36 weeks corrected gestation), during hospital stay. Four randomised controlled trials (2782 participants) met the inclusion criteria, with 1296 infants in the nasal CPAP group and 1486 in the intubation group. All the trials reported bronchopulmonary dysplasia independently at 36 weeks corrected gestation, with borderline significance in favour ...
Respiratory support strategies for the preterm newborns — National Survey 2008
Early Human Development, 2008
Introdução: As estratégias de suporte ventilatório utilizadas no recém -nascido têm sido motivo de grande investigação. Objectivos: Avaliar as práticas de suporte ventilatório nas unidades de neonatologia nacionais utilizadas na assistência ao recém -nascido de extremo baixo peso e avaliar se estão em conformidade com a prática baseada na evidência. Métodos: Foi enviado, por via electrónica, a 31 unidades de neonatologia nacionais, um inquérito sobre Abstract Background: Respiratory support strategies for the preterm newborn have been the subject of intense research. Aim: To survey neonatal respiratory support practices in Portugal and to determine whether they reflect evidence from randomised trials. Methods: Questionnaires were given out to 31 Portuguese neonatal units to determine the types of ventilators, modes of ventilation, lung function monitoring, use of exogenous surfactant, oxygen saturation
Respiratory support strategies for the preterm newborn – National survey 2008
2009
Introdução: As estratégias de suporte ventilatório utilizadas no recém -nascido têm sido motivo de grande investigação. Objectivos: Avaliar as práticas de suporte ventilatório nas unidades de neonatologia nacionais utilizadas na assistência ao recém -nascido de extremo baixo peso e avaliar se estão em conformidade com a prática baseada na evidência. Métodos: Foi enviado, por via electrónica, a 31 unidades de neonatologia nacionais, um inquérito sobre Abstract Background: Respiratory support strategies for the preterm newborn have been the subject of intense research. Aim: To survey neonatal respiratory support practices in Portugal and to determine whether they reflect evidence from randomised trials. Methods: Questionnaires were given out to 31 Portuguese neonatal units to determine the types of ventilators, modes of ventilation, lung function monitoring, use of exogenous surfactant, oxygen saturation
BMJ Open
IntroductionAlthough respiratory physiotherapy techniques may reduce respiratory load in newborns, manual contact with the ribcage may interfere with pulmonary mechanics. Therefore, this systematic review aims to evaluate the effects of conventional and non-conventional respiratory physiotherapies on pulmonary mechanics of newborns.Methods and analysisWe will search PubMed, LILACS, SciELO, ScienceDirect, Cochrane Central and Web of Science databases. Searches will be conducted from September 2022. We will include randomised clinical trials reporting thoracoabdominal synchrony, lung volumes and capacities, respiratory discomfort and pain in newborns aged between 1 hour and 28 days and admitted to neonatal intensive care units. We will exclude studies not fully available or incomplete and studies conducted with newborns presenting structural alterations. Two independent researchers will perform the study selection, data extraction and quality assessment. After consensus, one reviewer ...