Effect of chest physiotherapy on blood gases of neonates treated by intermittent positive pressure respiration

Holloway, R.; Adams, E. B.; Desai, Sonya; Thambiran, Aesen

doi:10.1136/thx.24.4.421

Cited by 31 publications

(11 citation statements)

References 15 publications

(15 reference statements)

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“…Authors found that chest physiotherapy and suction did not improve oxygen pressure, but caused decreased paCo 2 and paO 2 . 17 Limitations of this study were that the cause of illness was not similar among patients and the physiotherapy procedure was not conducted by the same therapist. In conclusion, in mechanicallyventilated children in the pICU, mechanical ventilation parameters and blood gas analysis values are not significantly different between patients who received chest physiotherapy and suctioning, compared to those who received suctioning alone.…”

Section: Discussionmentioning

confidence: 97%

Comparison of ventilation parameters and blood gas analysis in mechanically-ventilated children who received chest physiotherapy and suctioning vs. suctioning alone

Elizabeth

Yoel

Ali

et al. 2017

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Background Chest physiotherapy and suctioning are routine methods for airway clearance in mechanically-ventilated children. However, chest physiotherapy has not been confirmed to affect ventilation parameters, such as tidal volume (TV), peak inflation pressure (pIp), peak inspiratory flow (pIF), and peak expiratory flow (pEF), as well as blood gas analysis (BGA) values in pediatric intensive care unit (pICU) patients. Objective To determine the efficacy of chest physiotherapy and suctioning vs. suctioning alone for improving the mechanical ventilation and BGA parameters. Methods This randomized, single-blind, clinical trial was conducted from November 2012 to June 2013 in the pICU at Haji Adam Malik Hospital, Medan. A total of 40 mechanicallyventilated pediatric patients were enrolled and divided into either the chest physiotherapy and suctioning group (24 subjects) or the suctioning alone group (16 subjects). Subjects underwent treatment, followed by monitoring of their ventilation parameters and blood gas analyses. Data were analyzed by independent T-test and Mann-Whitney test. Results Subjects comprised of 23 boys and 17 girls, with an age range of 1-204 months. After the respective treatments (chest physiotherapy and suctioning vs. suctioning alone), the ventilation parameters were as follows: median TV (60.0 vs. 56.5 mL, respectively; p=0.838), median pEF (10.4 vs. 10.8 I/s, respectively; p=0.838), median pIF (7.4 vs. 8.2 I/s, respectively; p=0.469), and mean pIp (17.3 vs. 15.6 cmH2O, respectively; p=0.23). The BGA values were: median pH (7.4 vs. 7.3, respectively; p=0.838), median pCO2 (38.4 vs. 36.2 mmHg, respectively; p=1.000), mean pO2 (136.6 vs. 139.2 mmHg, respectively; p=0.834), median HCO3 (20.4 vs. 22.7 mmol/L, respectively; p=0.594), median TCO2 (22.0 vs. 23.7 mmol/L, respectively; p=0.672), mean BE (-4.3 vs. -3.1 mmol/L, respectively; p=0.629), and median O2 saturation (98.5 vs. 98.3 %, respectively; p=0.967). Conclusion In mechanically-ventilated children in the pICU, ventilation parameters and BGA values are not significantly

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Section: Discussionmentioning

confidence: 97%

Comparison of ventilation parameters and blood gas analysis in mechanically-ventilated children who received chest physiotherapy and suctioning vs. suctioning alone

Elizabeth

Yoel

Ali

et al. 2017

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“…(25) However, a significant SpO 2 reduction was found during the BS technique, and was not for the MZ technique. The literature (17,(26)(27)(28) with respect to SpO 2 during the BS maneuver is controversial.…”

Section: Discussionmentioning

confidence: 99%

Aplicabilidade das técnicas de bag squeezing e manobra zeep em pacientes submetidos à ventilação mecânica

Lobo¹,

Cavalcante²,

Mont’Alverne³

2010

Rev. bras. ter. intensiva

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Objectives:To evaluate the applicability of the bag squeezing and zeep maneuvers in mechanically ventilated patients.Methods: Twenty stable mechanically ventilated patients were studied. All patients were randomly allocated to either bag squeezing technique followed by zeep maneuver, or the reversed sequence. Each group crossed to the other sequence four hours later. Heart rate, respiratory rate, peripheral oxygen saturation and blood pressure were measured before, during and after each technique use. The suctioned secretions were collected and measured. The data were analyzed by pairwise statistical analysis for inter-group comparisons, and ANOVA for each group results analysis.Results: The heart rate was sig-nificantly increased, from 92.6 ± 18.3 bpm to 99.8 ± 18.5 bpm and the peripheral oxygen saturation significantly decreased from 96.9 ± 3.0% to 94.5 ± 4.3% during the bag squeezing maneuver, although the values remained within the normal range. No significant changes were seen for the zeep maneuver. Peripheral oxygen saturation during the maneuvers was found to change when the techniques were compared. No differences were found for the suctioned secretions amounts. Conclusion:The results suggest that both techniques are feasible as they cause few hemodynamic changes, and both are effective for bronchial secretions removal.

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“…In most studies evaluating the effect of CPT on Pao 2 or TCPO 2 chest percussion was manually applied. 34,39,42,43 Two studies combined percussion and vibration over each lung area drained. 42,43 Holloway and associates reported a drop in Pao 2 and Paco 2 and a wider alveolar-arterial (A-a) oxygen gradient after CPT and suctioning.…”

Section: Percussion and Vibrationmentioning

confidence: 99%

“…34,39,42,43 Two studies combined percussion and vibration over each lung area drained. 42,43 Holloway and associates reported a drop in Pao 2 and Paco 2 and a wider alveolar-arterial (A-a) oxygen gradient after CPT and suctioning. 42 The suction procedure used did not include hyperventilation and hyperoxygenation.…”

Section: Percussion and Vibrationmentioning

confidence: 99%

Physical Therapy for Neonates with Respiratory Dysfunction

Crane

1981

Physical Therapy

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Chest physical therapy for neonates with pulmonary dysfunction is a growing specialty of physical therapy practice. The purpose of this article is to provide physical therapists current information regarding chest physical therapy for the newborn infant. The neonatal diagnoses for which chest physical therapy is useful or has good rationale are discussed. Common complications are reviewed that affect physical therapy and medical treatment for infants with respiratory diseases and prematurity. Specific indications, contraindications, and precautions for physical therapy techniques are listed. Chest physical therapy evaluation and treatment are described and rationale for the application of various techniques is provided. Literature is reviewed dealing with the effects of chest physical therapy on neonates with pulmonary dysfunction. The strengths and weaknesses of each reviewed study are analyzed and suggestions for direction of future research for physical therapists are provided.

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Effect of chest physiotherapy on blood gases of neonates treated by intermittent positive pressure respiration

Cited by 31 publications

References 15 publications

Comparison of ventilation parameters and blood gas analysis in mechanically-ventilated children who received chest physiotherapy and suctioning vs. suctioning alone

Comparison of ventilation parameters and blood gas analysis in mechanically-ventilated children who received chest physiotherapy and suctioning vs. suctioning alone

Aplicabilidade das técnicas de bag squeezing e manobra zeep em pacientes submetidos à ventilação mecânica

Physical Therapy for Neonates with Respiratory Dysfunction

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