Análise dos sintomas, sinais clínicos e suporte de oxigênio em pacientes com bronquiolite antes e após fisioterapia respiratória durante a internação hospitalar

Castro, Giselle de; Remondini, Renata; Santos, Alba; Prado, Cristiane do

doi:10.1590/s0103-05822011000400020

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…An important mechanical problem that directly influences the use of compressive techniques is that in newborns, the process of passive expiration occurs in very low volumes due to resistive properties of the pulmonary parenchyma, especially regarding alveolar surface tension, that is, techniques of pulmonary emptying may increase the risk of alveolar collapse (22). This neonatal characteristic may occasionally contraindicate this technique in spontaneously breathing (20), and it may also justify the need for objective assessments, at the bedside, of thoracoabdominal mobility during respiratory physical therapy maneuvers, such as the one presented in this study.…”

Section: Discussionmentioning

confidence: 99%

Thoracoabdominal mobility evaluation by photogrammetry in newborns after expiratory flow increase technique

et al. 2017

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Introduction: Expiratory flow increase is a maneuver of respiratory physical therapy that promotes flow direction to the upper airways however, when applied in newborns, it may result in changes of thoracoabdominal mobility. Objective: To evaluate the thoracoabdominal mobility by photogrammetry in newborns after expiratory flow increase technique. Methods: Experimental blind study performed with newborns in supine position on a support table with upper limbs flexed, abducted and externally rotated and hip flexed at 110°. Adhesive markers were allocated for geometric delimitation of the thoracoabdominal compartment and expiratory flow increase technique was performed for 5 minutes with the therapist's hands on the thorax and abdomen. Newborns were filmed before and after the maneuver and the frames were analyzed in AutoCAD ® software by a blinded investigator at the time of the procedure. The largest and the smallest thoracoabdominal area were expressed in cm 2 and the mean values were compared between two moments (pre and post maneuver) by paired t test. Results: Twenty newborns with a mean age of 39 weeks were included. Before the maneuver, thoracoabdominal area was 56.1 cm 2 during expiration and 59.7 cm 2 during inspiration, and after the maneuver the value was 56.2 cm 2 during expiration and 59.8 cm 2 during inspiration,

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Section: Discussionmentioning

confidence: 99%

Thoracoabdominal mobility evaluation by photogrammetry in newborns after expiratory flow increase technique

et al. 2017

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“…We believe it is also important to note that the literature on the field focuses almost entirely on studies involving children with AVB who have been hospitalized. 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 Although we have previously demonstrated the clinical effects and safety of the use of high-frequency chest wall oscillation (HFCW) 31 and ACT for non-hospitalized infants with mild to moderate AVB, this appears to be the first study conducted in an outpatient setting with children diagnosed with recurrent wheezing. One of the factors contributing to this scarce literature may be the differential diagnosis between recurrent wheezing and asthma.…”

Section: Discussionmentioning

confidence: 96%

Effects and safety of hypertonic saline combined with airway clearance in non-hospitalized children with recurrent wheezing

González-Bellido¹,

Veláz-Baza²,

Rama-Suárez³

et al. 2023

Hong Kong Physiother. J.

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Background: The International Study of Wheezing in Infants defines recurrent wheezing as the presence of three or more medically documented episodes of wheezing within one year. To date, there is no evidence on the use of hypertonic saline (HS) combined with airway clearance techniques (ACT) for children with recurrent wheezing treated in an outpatient setting. Therefore, this is the first study to explore the use of such interventions in infants with recurrent wheezing. Objectives: To evaluate the effects and safety of a three-month protocol including HS and ACT for non-hospitalized infants with recurrent wheezing. Methods: Randomized, double-blind, controlled trial, including outpatient infants with recurrent wheezing. Children were randomized to either 3% HS or 0.9% saline groups and were treated with bronchodilator and nebulized with the respective solutions before ACT. The primary outcome was the Wang score. Secondary outcomes included the number of hospitalizations and respiratory crisis, need for rescue medication, and school absences. All variables were measured during the three previous months from inclusion and during intervention period. The study protocol was registered at ClinicalTrials.gov (NCT04331496) on March, 31, 2020. Results: Forty children were included. Regarding immediate effects, significant differences ([Formula: see text]) were found for time, but not for group or interaction (group [Formula: see text] time), in all outcome variables (increase in SpO2, decrease in heart and respiratory rate, wheezing episodes, retraction, and Wang score). Comparing the previous three months with the study period, there were significant differences in both groups for the severity of crisis ([Formula: see text]) and medication steps ([Formula: see text]). Conclusion: A three-month protocol including HS and ACT for outpatient infants with recurrent wheezing was safe and reduced morbidity. No differences were found between the use of HS and 0.9% saline.

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“…Foi observado que 83% de toda amostra do presente estudo não utilizou qualquer tipo de suporte ventilatório, sendo apenas necessário em 3 lactentes, no qual foram avaliados no período de inverno por ser tratar de uma doença sazonal. No estudo de Castro et al [18] No grupo da FT a FC antes do manuseio era 126,1 (± 19,96) e após o manuseio foi encontrado 131,6 (± 20,76), na FR antes do manuseio era 51,75 (± 8,86) e após 52,08 (± 5,7). Já no RTA a FC era 121,6 (± 16,83) e após o manuseio foi para 110,8 (± 21,61) e a FR antes 47,33 (± 10,82) e após 39,75 (± 7,7).…”

Section: Discussionunclassified

Efeito agudo do método reequilíbrio toracoabdominal em lactentes com diagnóstico de bronquiolite

Oliveira¹,

Ferraz

Maia³

et al. 2022

Fisioter Bras

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Introdução: Nos lactentes, o sistema imunológico ainda é imaturo, o que torna as crianças mais suscetíveis ao vírus sincicial respiratório, o principal causador da bronquiolite. O Reequilíbrio Toraco-abdominal (RTA) é um método de terapia manual que atua sobre o sistema respiratório por meio de uma leitura global em situações de doenças. Objetivos: Avaliar os efeitos do método RTA, comparado à fisioterapia tradicional (FT) em lactentes com bronquiolite. Metodologia: Pesquisa experimental e prospectiva, na qual 24 lactentes foram divididos em dois grupos, FT (n = 12) e RTA (n = 12). Parâmetros fisiológicos (frequência respiratória, frequência cardíaca, saturação de pulso de oxigênio e ausculta pulmonar), desconforto respiratório e desequilíbrio da biomecânica respiratória foram avaliados antes e após os manuseios. Resultados: A idade média foi de 13 (± 11,07) semanas no grupo FT e no grupo RTA 13,3 (± 8,41) semanas. Após os manuseios, obteve diferença estatística no grupo do RTA comparado ao da FT nos seguintes parâmetros: observamos uma diminuição significativa da frequência cardíaca (p = 0,02) e da frequência respiratória (p = 0,0002), no quesito esforço respiratório em tórax superior (p = 0,004) e tórax inferior (p = 0,017) e no escore de Wood-Downes em moderada com (p = 0,0001). Conclusão: O RTA mostrou-se mais eficaz que as técnicas da FT em relação aos benefícios ao lactente.

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Análise dos sintomas, sinais clínicos e suporte de oxigênio em pacientes com bronquiolite antes e após fisioterapia respiratória durante a internação hospitalar

Cited by 8 publications

References 12 publications

Thoracoabdominal mobility evaluation by photogrammetry in newborns after expiratory flow increase technique

Thoracoabdominal mobility evaluation by photogrammetry in newborns after expiratory flow increase technique

Effects and safety of hypertonic saline combined with airway clearance in non-hospitalized children with recurrent wheezing

Efeito agudo do método reequilíbrio toracoabdominal em lactentes com diagnóstico de bronquiolite

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