This study aims to gather and present scientific evidence on the role of a physiotherapist in the pre, peri and postoperative of pediatric cardiac surgery. This professional is able to prevent, minimize or reverse possible respiratory dysfunction and motor sequelae resulting from these interventions. Studies discuss the involvement of respiratory system, specifically the clearance of bronchial secretions and ventilatory adequacy, as a result of surgical procedure. Scientific evidences suggest the effectiveness of physiotherapy in reducing indices of: pneumonia, atelectasis, hospitalization, sequelae deleterious, and length of bed restriction, beyond clinical improvement. These data confirm positive contribution of physiotherapeutic intervention in these surgeries.Descriptors: Physical Therapy Modalities. Cardiac Surgical Procedures. Heart Defects, Congenital. ResumoO objetivo deste estudo é reunir e apresentar evidências científicas sobre a atuação do fisioterapeuta nos períodos pré, peri e pós-operatório da cirurgia cardíaca pediátrica. Esse profissional está habilitado a prevenir, minimizar e reverter possíveis disfunções respiratórias e sequelas motoras decorrentes dessas intervenções. Estudos discutem o comprometimento do sistema respiratório, especificamente do clearance de secreção brônquica e da adequação ventilatória, resultantes do procedimento cirúrgico, havendo evidências científicas quanto à eficácia da fisioterapia na redução: dos índices de pneumonias, atelectasias, período de internação, sequelas deletérias, tempo de restrição ao leito, além da melhora clínica. Esses dados atestam a contribuição positiva da intervenção fisioterapêutica nessas cirurgias. Rev Bras Cir Cardiovasc 2011;26(2):264-72 Descritores

Obese children showed increased oscillometry parameters values representative of airway obstruction, compared to normal-weight children. Changes in some oscillometry parameters can already be observed in overweight school-aged children.

Background Among the many consequences of loss of CFTR protein function, a significant reduction of the secretion of bicarbonate (HCO 3 −) in cystic fibrosis (CF) is a major pathogenic feature. Loss of HCO 3 − leads to abnormally low pH and impaired mucus clearance in airways and other exocrine organs, which suggests that NaHCO 3 inhalation may be a low-cost, easily accessible therapy for CF. Objective To evaluate the safety, tolerability, and effects of inhaled aerosols of NaHCO 3 solutions (4.2% and 8.4%). Methods An experimental, prospective, open-label, pilot, clinical study was conducted with 12 CF volunteer participants over 18 years of age with bronchiectasis and pulmonary functions classified as mildly to severely depressed. Sputum rheology, pH, and microbiology were examined as well as spirometry, exercise performance, quality-of-life assessments, dyspnea, blood count, and venous blood gas levels. Results Sputum pH increased immediately after inhalation of NaHCO 3 at each clinical visit and was inversely correlated with rheology when all parameters were evaluated: [G′ (elasticity of the mucus) = − 0.241; G″ (viscosity of the mucus) = − 0.287; G* (viscoelasticity of the mucus) = − 0.275]. G* and G′ were slightly correlated with peak flow, forced expiratory volume in 1 s (FEV 1), and quality of life; G″ was correlated with quality of life; sputum pH was correlated with oxygen consumption (VO 2) and vitality score in quality of life. No changes were observed in blood count, venous blood gas, respiratory rate, heart rate, peripheral oxygen saturation of hemoglobin (SpO 2), body temperature, or incidence of dyspnea. No adverse events associated with the study were observed. Conclusion Nebulized NaHCO 3 inhalation appears to be a safe and well tolerated potential therapeutic agent in the management of CF. Nebulized NaHCO 3 inhalation temporarily elevates airway liquid pH and reduces sputum viscosity and viscoelasticity.

Introduction. The index of ventilatory efficiency (VE/VCO2) obtained by the progressive exercise test has been considered the gold standard in the prognosis of adults with heart failure, but few studies have evaluated this approach in children. Objective. To verify the scientific evidence about the VE/VCO2 in pediatric and adolescents patients. Methods. A systematic literature review was carried out using the key words VE/VCO2, children, and adolescents using the PEDro and PubMed/MedLine databases. Clinical trials published from 1987 to 2014, including children, adolescents, and young adults up to 25 years, addressing the VE/VCO2 index as a method of evaluation, monitoring, and prognosis were considered. Results. Initially, 95 articles were found; 12 were excluded as the title/abstract did not contain the VE/VCO2 index or because they included patients greater than 25 years of age. From the remaining 83, 58 were repeated between the databases. The final sample consisted of 32 studies including healthy children and children with respiratory and other diseases. Conclusion. There are few studies involving cardiorespiratory assessment by ventilatory efficiency. The studies highlight the fact that high VE/VCO2 values are associated with a worse prognosis of patients due to the relationship with the decrease in pulmonary perfusion and cardiac output.