Chest Physiotherapy in the Neonate With Respiratory Distress

Abstract

Chest physiotherapy is a frequently practiced but poorly documented form of therapy. Twenty neonates (mean age43 hr) were studied with a variety of respiratory disorders to assess the effect of complete chest physiotherapy on arterial blood cases. This was compared to the alteration of blood gases following suctioning of the airway. Nine were receivin~ added oxygen alone, six were receiving continuous distending pressure and five were intubated receiving mechanical ventilation. Complete chest physie therapy treatment consisted of postural drainage with percussions and vibrations in each drainage position followed by suctioning of the airway. The treatment was performed for a specific area of lung involvement if present. For generalized lung disorders, drainage was performed with an emphasis on the basal segments of the lower lobes. Each infant had arterial blood gases performed five minutes prior to and twenty minutes fdllowing suctioning, and similarly before and after physiotherapy (average interval between the two pairs=1.8 hr) There was a mean increase of 20.8 mm Hg in the pO following physiotherapy. (p(0.01) with no sipificant change zbserved following suctioning. There was no significant change in the pH or pCO with either procedure. Analysis of covariance revealed no signihcant correlations between p02 and sex, age, body weight, gestation, inspired oxygen concentration, or the order of receiving the procedures. In neonates with respiratory distress, oxygenation is improved following physiotherapy. VT were unchanged. Two hour followup values f o r a l l parameters studied were s i m i l a r t o control values except f o r a trend toward increased compl lance. There were no s i g n i f i c a n t d i f f e rences a t any stage o f the study f o r PaC02, pH, base excess. VT. o r minute ventilation. This studv indicates t h a t there i s a j i g n i f i c a n t de rease i n Pa02 a f t e s t v b t i o n nd suc toning n rease i n pa82 a f t e r hy erventPFa€!on but Feiese ceianges f o not appear t o be related t o ayterations i n lung volume. 190 E"%N,EBfvTef F k E E S~~a X F f l % e f R P T~i t i t u t eFACTORS AFFECTING LUNG VOLUME IN POST EXTUBATED NEONATES. William W. Fox, Jacob G. Schwartz. Thomas The Hospital for Sick Children, Toronto, Canada. It has been well established that slowly adapting vagal The failure to elicit a deflation reflex in all infants, and the absence of response to mucosal stimulation in sane infants suggasta that vagal irritant reflexes are weak or absent in human newborns. This may be one reason why aspiration is common in this age group. s~e c i a l 06biems. since neonatal CT tdbes are'uniuffed they Perm i t leakege o f gas around the tube during respiration and, therefore, introduce errors i n FRC determination. The present study evaluates a new 60 second closed c i r c u i t helium (He) d i l u t i o n technique f o r determination o f FRC independent o f small ga: leaks. By a n a l y t i c a l l y r e l a t i n q the f a l l i n lie concentration due LO mixi n g w i t h that due ...

Chest physiotherapy and porencephalic brain lesions in very preterm infants

“…Chest physiotherapy on preterm infants has been shown to improve oxygenation, aid removal of secretions and lessen postextubation atelectasis 3–5 . The technique of percussion with a facemask resulted in a more consistent improvement in oxygenation and was as well tolerated as other techniques 6 .…”

Airway lavage with exogenous surfactant in an animal model of meconium aspiration syndrome

“…Chest physiotherapy (CPT) is performed in the NICU to improve airway clearance and prevent atelectasis 8–10 . It is also considered to promote the discharge of debris in the trachea and improve respiratory function in MAS.…”

Pulmonary Rehabilitation in Newborns

“…Respiratuar distres sendromlu bebeklerde postüral drenaj ve göğüs perküsyonları kullanılan bir çalışmada, bu iki girişim PO2'yi önemli ölçüde arttırmıştır (28). Belirtilen gelişme, tedavi ortasında küçük bir yük-selme ile başlayıp dereceli artmıştır.…”

“…Kollaps gelişti ise ilave oksijen, CPAP re-entübasyon destekleri, solunum fizyoterapisi ve sık aspirasyon gerekir. 70'li yılların sonunda sağ üst lobun drenajını sağlayan pozisyonlama, perküsyon ve aspirasyonu içe-ren koruyucu göğüs fizyoterapisinin postekstübasyon atelektazisini önemli ölçüde azalltığını bildirilmiştir (28). Bazı otörler de kollapstan korumak üzere ekstübasyon öncesinde de göğüs fizyoterapisine dikkat çekmişler-dir.…”