Chest physiotherapy may be associated with brain damage in extremely premature infants

Harding, Jane E.; Miles, Fiona K.I.; Becroft, D. M. O.; Allen, Bruce C.; Knight, David B.

doi:10.1016/s0022-3476(98)70017-4

Cited by 83 publications

(66 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[19][20][21][22] Disagreements stem from the use of techniques developed for adults, which do not take into consideration the particularities of the infant respiratory system. New chest physiotherapy techniques especially developed for infants have been employed in recent years.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

View full text Add to dashboard Cite

BACKGROUND: Prolonged slow expiration (PSE) is a physiotherapy technique often applied in infants to reduce pulmonary obstruction and clear secretions, but there have been few studies of PSE's effects on the respiratory system. OBJECTIVE: To describe PSE's effects on respiratory mechanics in infants. METHODS: We conducted a cross-sectional study with 18 infants who had histories of recurrent wheezing. The infants were sedated for lung-function testing, which was followed by PSE. The PSE consisted of 3 sequences of prolonged manual thoraco-abdominal compressions during the expiratory phase. We measured peak expiratory flow (PEF), tidal volume (V T ), and the frequency of sighs during and immediately after PSE. We described the exhaled volume during PSE as a fraction of expiratory reserve volume (%ERV). We quantified ERV with the raised-volume rapid-thoracic-compression technique. RESULTS: The cohort's mean age was 32.2 weeks, and they had an average of 4.8 previous wheezing episodes. During PSE there was significant V T reduction (80 ؎ 17 mL vs 49 ؎ 11 mL, P < .001), no significant change in PEF (149 ؎ 32 mL/s vs 150 ؎ 32 mL/s, P ‫؍‬ .54), and more frequent sighs (40% vs 5%, P ‫؍‬ .03), compared to immediately after PSE. The exhaled volume increased in each PSE sequence (32 ؎ 18% of ERV, 41 ؎ 24% of ERV, and 53 ؎ 20% of ERV, P ‫؍‬ .03). CONCLUSIONS: It was possible to confirm and quantify that PSE deflates the lung to ERV. PSE caused no changes in PEF, induced sigh breaths, and decreased V T , which is probably the main mechanical feature for mucus clearance.

show abstract

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

View full text Add to dashboard Cite

show abstract

“…[27][28][29] No wonder that conventional CPT gives poor results and is poorly tolerated, with side effects such as esophageal reflux, tachypnea, tachycardia, hypoxemia, rib fracture, and severe central nervous system complications, especially in newborns. [30][31][32][33][34] The 2012 Cochrane review showed no significant benefit from conventional CPT on clinical score or hospital stay, and conventional CPT in acute viral bronchiolitis is no longer recommended. [35][36][37] In France, increased-exhalation technique has been widely used in various ways since the 1970s.…”

Section: Chest Physical Therapymentioning

confidence: 99%

Chest Physical Therapy in Acute Viral Bronchiolitis: An Updated Review

2013

View full text Add to dashboard Cite

“…Through the studies of the incidence of PIVH in the different neonatal intensive care units, it is possible to obtain a profile of the disease and to propose control measures. Even though the factors implied in the genesis of PIVH are obscure with regard to providing data that would enable interventions for the reduction of its occurrence 5,6 , the literature begins to infer that the precocious treatment of some conditions related to the pathology is a differential in the reported incidence 19 . The established diagnosis makes possible the verification of the related problems, thus enabling interventions for improvement of the quality of life of these children 20 .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, fluctuations in the cerebral blood flow were described as being capable of causing the rupture of these vessels, thus favoring the appearance of PIVH 5 . Therefore, several factors have been related to PIVH in premature newborns weighing less than 1500 grams, since PIVH could be caused by changes in the cerebral blood flow induced by factors such as vaginal delivery, the use of assisted ventilation in respiratory insufficiency, apnea, pneumothorax, asphyxia, hypercapnia, convulsions, cardiopathies, sepsis with shock, and rapid fluid infusions, as well as stressful invasive procedures, including the manipulation of the newborn, venoclysis, and respiratory physical therapy [5][6][7][8] . Measures such as the use of antenatal corticosteroids can prevent the occurrence of PIVH by contributing to the occurrence of fewer severe respiratory conditions as well as by acting directly in the maturation of the cerebral vessels 5 .…”

mentioning

confidence: 99%

Peri-intraventricular hemorrhage in newborns weighing less than 1500 grams: comparative analysis between 2 institutions

Ponte

Marba

2003

Rev. Hosp. Clin.

View full text Add to dashboard Cite

PURPOSE:This study aims to characterize the peri-intraventricular hemorrhages in the neonatal period in very low birth weight newborns in 2 institutions that provide neonatal tertiary assistance.METHOD: This was a comparative and observational study in 2 neonatal intensive care units, the Maternity Hospital of Campinas and the "Centro de Atenção Integrada à Saúde da Mulher" of the State University of Campinas, from December 01, 1998 to November 30, 1999. We examined 187 newborns for peri-intraventricular hemorrhages, using transfontanel ultrasound (76 and 11 respectively at the first and second unit), and classified them into 4 grades. We observed their gender, intrauterine growth, weight, and gestational age at birth. RESULTS:We diagnosed 34 cases of peri-intraventricular hemorrhages (13 and 21, respectively), and both groups differed as to the birth weight and the adequacy of weight to the gestational age at birth. There was no difference in the prevalence or extent of peri-intraventricular hemorrhages among cases. There was a statistically significant occurrence of lower birth weight at gestational ages of less than 30 weeks.CONCLUSIONS: The prevalence of peri-intraventricular hemorrhages in our study was compared to that reported in the world literature. Although the cases of the second institution had a smaller mean birth weight, the prevalence of periintraventricular hemorrhages was similar to that at the first institution, probably because in the first one, 69% of the gestational ages of the neonates with hemorrhage were less than 30 weeks as compared to 48% in the second one. We stress the importance of the ultrasonographic method for diagnosing peri-intraventricular hemorrhages in very low birth weight newborns.

show abstract

Chest physiotherapy may be associated with brain damage in extremely premature infants

Cited by 83 publications

References 15 publications

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

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

Chest Physical Therapy in Acute Viral Bronchiolitis: An Updated Review

Peri-intraventricular hemorrhage in newborns weighing less than 1500 grams: comparative analysis between 2 institutions

Contact Info

Product

Resources

About