Effect of expiratory flow increase technique on pulmonary function of infants on mechanical ventilation

Abstract

There was a short-term improvement in the oxygenation of infants who were submitted to the EFIT. Additional studies are necessary to establish the efficacy and effectiveness of this technique.

Prolonged Slow Expiration Technique in Infants: Effects on Tidal Volume, Peak Expiratory Flow, and Expiratory Reserve Volume

“…13 Although PSE is used in several countries, mainly in Europe, in the 20 years since the first description of PSE there has not been a detailed description of PSE in the literature. It is assumed that PSE deflates the lung to expiratory reserve volume (ERV), induces sigh breaths, and does not increase peak expiratory flow (PEF), because it is a slow technique, 9,12,13 but these assumptions are unproven, and PSE's effects on infant respiratory mechanics are unknown.…”

“…6,7 New chest physiotherapy techniques were developed specifically for infants, in accordance with their physiological characteristics. 8,9 Prolonged slow expiration (PSE) is one of these new techniques, employed in clinical practice in infants with bronchial obstruction and hypersecretion. 10 In PSE, pressure is exerted on the thorax and abdomen to prolong the expiratory phase and thus promote secretion clearance.…”

Atelectasias em pediatria: mecanismos, diagnóstico e tratamento

“…Desta forma, a compressão torácica bilateral é contra-indicada para recém-nascidos e lactentes, pois ao comprimir-se bilateralmente o tórax conseqüentemente reduz-se temporariamente o recuo elástico pulmonar e, como nesta faixa etária a criança apresenta menor VC, ela não é capaz de gerar espontaneamente um fluxo inspiratório suficiente para retornar ao VC basal, o que provavelmente poderá predispor ao colapso de unidades alveolares 39 . Nesta faixa etária estão indicadas as técnicas de aumento do fluxo expiratório (AFE) sem compressão tóracoabdominal, associada ou não à vibração manual [39][40][41][42][43] . A VPM não-invasiva pode ser utilizada para o tratamento da atelectasia.…”

Comparação dos efeitos de duas técnicas fisioterapêuticas respiratórias em parâmetros cardiorrespiratórios de lactentes com bronquiolite viral aguda

“…(10,13) Patients were placed in the supine position, with the head of the bed slightly elevated, as a safeguard against gastroesophageal reflux and aspiration. The physical therapist stood at the side of the bed, with elbows in a semiflexed position, performing the technique without using body weight.…”

“…In cases in which the patient presented tachypnea, the ratio was one compression for every two or three breaths. (13) Vibration consisted of quick rhythmic movements, with enough intensity to cause vibration of the airway. Such vibrations are repeated isometric contractions of the chest wall during the expiratory phase.…”