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Structured respiratory physiotherapy protocol for resolution of atelectasis in pediatric intensive care.
Camassuti, Patrícia Aparecida Silva; Johnston, Cíntia; de Carvalho, Werther Brunow; Luglio, Michele; de Araújo, Orlei Ribeiro; Morrow, Brenda.
Afiliação
  • Camassuti PAS; Postgraduate Program in Pediatrics, Department of Pediatrics, Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: patriciascamassuti@gmail.com.
  • Johnston C; Postgraduate Program in Pediatrics, Department of Pediatrics, Universidade de São Paulo, São Paulo, SP, Brazil.
  • de Carvalho WB; Department of Pediatrics, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Luglio M; Children's Institute, Universidade de São Paulo, São Paulo, SP, Braziil.
  • de Araújo OR; Institute of Pediatric Oncology, Support Group for Adolescents and Children with Cancer (GRAACC), Universidade Federal de São Paulo, São Paulo, SP, Brazil.
  • Morrow B; Department of Paediatrics and Child Health, University of Cape Town: Rondebosch, Western Cape, ZA, South Africa.
Clinics (Sao Paulo) ; 79: 100494, 2024.
Article em En | MEDLINE | ID: mdl-39306956
ABSTRACT
Children are at higher risk of atelectasis due to their anatomical and physiological particularities. Several physiotherapy techniques are used to treat atelectasis, but only four studies cite methods in pediatric patients undergoing Invasive Mechanical Ventilation (IMV). The objective of this study was to evaluate the Structured Respiratory Physiotherapy Protocol (SRPP) for airway clearance and lung reexpansion for infants on IMV with atelectasis. This is a prospective study including 30 infants (mean ± standard deviation age 8.9 ± 8.0 months; weight 7.5 ± 3.0 kg; BMI 15.8 ± 1.6 kg/cm2 and IMV duration 7.7 ± 4.3 days). The sample was randomized into a Control Group (CG), which received routine physiotherapy, and an Intervention Group (IG), submitted to SRPP (postural drainage, mechanical thoracic vibration, manual hyperinflation, stretching of the accessory respiratory muscles, and functional positioning). Both groups were evaluated before and after physiotherapy for respiratory effort using the Wood Downes Score (WD) and pulmonary aeration using lung ultrasonography (Lung Ultrasound Score ‒ LUS). The outcome of the intervention was evaluated by the magnitude of the effect by the Hedges' g test [(small (0.2 < Hedges' g < 0.5), moderate (0.5 < Hedges' g < 0.8) and large (Hedges' g > 0.8) effects]. There were large within-group effects on the reduction of WD in the CG after intervention in both the CG (Hedges' g = -1.53) and IG (Hedges' g = -2.2). There was a moderate effect on LUS reduction in the CG (Hedges' g = -0.64) and a large effect on IG (Hedges' g = -1.88). This study has shown that the SRPP appears to be safe and may be effective in improving airway clearance and lung reexpansion in children on IMV with atelectasis.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Respiração Artificial / Terapia Respiratória / Atelectasia Pulmonar Limite: Female / Humans / Infant / Male Idioma: En Revista: Clinics (Sao Paulo) Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Respiração Artificial / Terapia Respiratória / Atelectasia Pulmonar Limite: Female / Humans / Infant / Male Idioma: En Revista: Clinics (Sao Paulo) Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Estados Unidos