Objectives: To evaluate the effect of manual chest compression (MCC) in the variables of oxygenation, hemodynamic and respiratory effeteness in infants suffering from respiratory diseases with atelectasis. Methods: Controlled clinical trial, in which 38 infants were evaluated, 19 in each study group (group A: atelectasis and group B: control). Data were measured before, immediately after and 10 minutes after the end of the technique's application. Results: The average age was of 5.05 months. There was an increase of RR in group A immediately after the application of the technique and signs of respiratory distress with a decrease in the oxygen saturation. Conclusion: There was a reduction in SpO2, an increase of RR and a worsening of clinical signs of respiratory distress. Given this, one may consider that there is a controversy about the benefits, mechanism of action, physiological and therapeutic effects of MCC when applied to infants.
A preschool four-year-old male patient had been admitted to the Mandaqui Hospital with a diagnosis of lobar pneumonia, pleural effusion, and right lung atelectasis. Treatment consisted of antibiotics and physiotherapy sessions, using a technique described in the literature as Insufflation Technique to Reverse Atelectasis (ITRA), which consists of a thoracic block of healthy lung tissue, leaving only the atelectasis area free, associated with the use of invasive or noninvasive mechanical ventilation with positive airway pressure for reversal of atelectasis. Two physiotherapy sessions were conducted daily. The sessions lasted 20 minutes and were fractionated into four series of five minutes each. Each series bilateral thoracic block was performed for 20 seconds with a pause lasting for the same time. Associated with the thoracic block, a continuous positive airways pressure was used using a facial mask and 7 cm H2O PEEP provided via CPAP. Conclusion. ITRA technique was effective in reversing atelectasis in this patient.
O objetivo deste estudo foi avaliar a eficiência da pressão positiva contínua na via aérea (PPCA) intermitente realizado com máscara facial na reversão de atelectasia em recém-nascido pré-termo (RNPT). Apresentação do caso: RNPT com idade gestacional de 29 semanas, gênero feminino, evoluiu com síndrome do desconforto respiratório do RN, recebeu duas doses de surfactante exógeno e permaneceu em intubação orotraqueal por 7 dias. Evoluiu pós-extubação com atelectasia persistente em hemitorax direito. Foi realizada por duas vezes aspiração seletiva evoluindo em um curto período com recidiva da atelectasia, e associado à fisioterapia convencional o uso da CPAP intermitente com máscara facial, apresentando reversão da mesma e permanecendo sem recorrência por 31 dias, até sua alta hospitalar. O período mais extenso, sem recorrência de atelectasia, foi aquele em que a fisioterapia respiratória associou a CPAP intermitente. Assim, o uso da mesma com máscara facial pode ser um recurso coadjuvante no tratamento de reversão de atelectasia.Palavras-chave: recém-nascido, atelectasia, colapso pulmonar, fisioterapia, intubação, pressão positiva contínua nas vias aéreas.
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