Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique

Abstract

Objective:To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns.Methods:This is an intervention study, which included 40 preterm infants (≤34 weeks) aged 8-15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded. Ultrasonographic assessments with transcranial Doppler flowmetry were performed before, during and after the increase in expiratory flow session, which lasted 5min. Cerebral blood flow velocity and resistance and pulsatility indices in the pericallosal artery were assessed.Results:Respiratory physical therapy did not significantly alter flow velocity at the systolic peak (p=0.50), the end diastolic flow velocity (p=0.17), the mean flow velocity (p=0.07), the resistance index (p=0.41) and the pulsatility index (p=0.67) over time.Conclusions:The expiratory flow increase technique did not affect cerebral blood flow in clinically-stable preterm infants.

Effects of Chest Physiotherapy in Preterm Infants with Respiratory Distress Syndrome: A Systematic Review

“…It concludes that no increase in reflux is observed at the proposed times. In this line, the study proposed by Bassani, et al [ 70 ] in 2016, also defines it as a safe technique, since it did not affect cerebral blood flow in clinically stable premature infants.…”

Atuação da fisioterapia no esforço respiratório em crianças hospitalizadas com infecção respiratória aguda: um estudo comparativo

“…A especialidade da fisioterapia respiratória pediátrica apresenta como principais objetivos minimizar os efeitos das complicações pulmonares e de melhorar a função respiratória das crianças [25][26][27]. Sabe-se que a fisioterapia pediátrica no âmbito hospitalar é imprescindível para reabilitação e prevenção da saúde de forma a detectar possíveis disfunções do desenvolvimento neuropsicomotor e prevenir problemas respiratórios, reduzindo os índices de morbidade, o tempo de internação e os custos hospitalares [28].…”

Early rehabilitation of newborns moved by perinatal hypoxia

“…Проведение физиотерапии возможно у недоношенных детей, находящихся на искусственной вентиляции легких (ИВЛ). Основными задачами респираторной физиотерапии являются нормализация оксигенационной функции легких, улучшение реологии мокроты, что способствует снижению отрицательных эффектов и осложнений ИВЛ, сокращению сроков госпитализации [52,53]. Адаптированными методами для недоношенных пациентов, находящихся на ИВЛ, являются позиционирование, прон-позиция (положение ребенка на животе) и метод медленного увеличения скорости выдоха.…”

“…Другая рука физиотерапевта помещается на нижние ребра без приложения силы, таким образом избегают контакт с брюшной полостью ребенка, а подвижность нижних ребер ограничена, что позволяет улучшить экскурсию диафрагмы и предотвратить повышение внутрибрюшного давления. В результате маневра происходит удлинение выдоха [52].…”