Effects of respiratory physiotherapy interventions on pulmonary mechanics of newborns: a protocol for a systematic review (original) (raw)
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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...
INTERNATIONAL JOURNAL OF CLINICAL AND BIOMEDICAL RESEARCH, 2016
Background: A child's risk of dying is highest in the first 28 days of life (the neonatal period). The central function of Chest physiotherapy in ventilated neonates is to assist in the removal of tracheobronchial secretions, remove airway obstruction, reduce airway resistance, enhance gas exchange, and reduce the work of breathing. Positioning is used with the aim to improve of ventilation/perfusion (V/Q) matching, lung volumes and mucociliary clearance and to reduce the work of breathing (WOB). Objective: To find out effectiveness of Chest Physiotherapy in prone Position on Respiratory Functions in Ventilated Neonates. Method: 6 ventilated Neonates (n=6) between day 1-day 28 fitting the inclusion criteria were selected. They received chest physiotherapy in prone position which was given to each participant in for 240 minutes/day in two divided sessions of 120 minutes each with a gap of 6 hours (10am-12 pm & 6pm-8pm) for consecutive three days. (i.e. six intervention sessions). Primary outcomes were Oxygen saturation (SpO2), Partial pressure of arterial oxygen (PaO2) & Peak Inspiratory Pressure (P.I.P.). Outcomes were recorded Pre & Post of Last (6 th) 120 minutes session (0 Min & 120 Mins). Results: On comparison of three parameters in two groups using paired t test we found that there was significant difference (p < 0.05) in SpO2, PaO2 and P.I.P at baseline and post intervention. Conclusion: The study concluded that chest Physiotherapy combined with prone positioning is a cost effective, non-invasive and affordable intervention which has a significant impact on improvement of SpO2, PaO2 and PIP in ventilated neonates. A randomized clinical trial evaluating the efficacy of this intervention seems warranted.
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 ...
Healthcare
Preterm birth carries a higher risk of respiratory problems. The objectives of the study are to summarize the evidence on the effect of chest physiotherapy in the treatment of respiratory difficulties in preterm infants, and to determine the most appropriate technique and whether they are safe. Searches were made in PubMed, WOS, Scopus, Cochrane Library, SciELO, LILACS, MEDLINE, ProQuest, PsycArticle and VHL until 30 April 2022. Eligibility criteria were study type, full text, language, and treatment type. No publication date restrictions were applied. The MINCIR Therapy and PEDro scales were used to measure the methodological quality, and the Cochrane risk of bias and Newcastle Ottawa quality assessment Scale to measure the risk of bias. We analysed 10 studies with 522 participants. The most common interventions were conventional chest physiotherapy and stimulation of the chest zone according to Vojta. Lung compression and increased expiratory flow were also used. Heterogeneities w...
International Journal of Physiotherapy, 2018
Background: Chest physiotherapy (CPT) and positioning of neonates has been used in many developed countries around the world to improve airway clearance and avoid lung complications, but the combined effect of both techniques is less documented. The objective of the study was to compare the effectiveness of chest physiotherapy in prone position versus conventional chest physiotherapy in ventilated neonates on respiratory outcomes. Methods: The study design was randomized controlled pilot study. Participants: 12 ventilated neonates fitting in Inclusion Criteria. They were randomly divided into two groups (n=6 in each group) using simple random sampling i.e. Experimental group (4female and 2male) (Chest Physiotherapy and Prone Positioning) and the Control group (3 females and 3males) (Conventional Chest Physiotherapy). Primary outcome measures were SpO2 saturation, Partial Pressure of Arterial Oxygen (PaO2) & Peak Inspiratory Pressure (P.I.P.). Outcomes were recorded Pre & Post of every 120 minutes session of Intervention twice daily with a gap of 6 hours for consecutive three days for the experimental group while for the control group, parameters were measured at the same time of the day. Result: Total 10 participants completed the study protocol. On comparison of three parameters in two groups using the unpaired t-test we found that there was a significant difference (p< 0.05) in SpO2 and PaO2 in both groups but no difference (p >0.05) in P.I.P. levels. Conclusion: Chest physiotherapy in the prone position for ventilated neonate concluded with a higher oxygen saturation (SpO2) and partial pressure of oxygen in the arterial blood (PaO2) when compared to conventional chest physiotherapy.
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 ...