Purpose: This study aimed to investigate the effectiveness of different physical therapy protocols on the autonomic modulation of heart rate, time of invasive mechanical ventilation (IMV), and length of hospital stay. Methods: This was a randomized clinical study with 20 children on IMV in an intensive care unit (ICU), between July 2018 and September 2019. The control group (n = 10) performed the hospital's physical therapy protocol and the experimental group (n = 10) performed the physical therapy protocol based on physical exercise. Results: Higher values of heart rate variability were found in the experimental group, both in individual and intergroup analyses. There was a significant reduction in the time of IMV and ICU stay. Conclusion: There was an improvement in heart rate variability, reduced time on mechanical ventilation and length of stay in the ICU in individuals who performed the study protocol.

Background: Electrical impedance tomography (EIT) is widely used in the practice of patients with respiratory distress syndrome (ARDS), but little is known about the determination of adequate positive end-expiratory pressure (PEEP) in the pediatric intensive care unit. Aim: Evaluating the effects of titration of PEEP with EIT after alveolar recruitment in children with ARDS on ventilatory variables and blood gas analysis. Methods: This is a longitudinal analytical study carried out in the pediatric intensive care unit. The study included 5 patients diagnosed with ARDS, aged between 6 and 11 years and had an indication for alveolar recruitment maneuver (RM). The EIT belt was posicionated around the sternum and the ventilatory variables were collected (compliance, regional ventilation, driving pressure, alveolar overdistension, alveolar collapse and PEEP titration) and blood gas analysis. The RM was performed in steps, then PEEP titration was performed with the help of the EIT. Results: There was a significant improvement in the ventilatory variables and blood gas analysis of the participants after PEEP titration. The parameters that most changed the pre-and posttitration values were pulmonary compliance (p<0.05), alveolar overdistension (p<0.05), partial pressure of carbon dioxide (p<0.01), blood pressure of oxygen and arterial oxygen saturation (p<0.05). Conclusion: Titration of PEEP with the aid of EIT is safety, improving ventilation and basic acid balance in children with ARDS.