Short-Term Effects of Conventional Chest Physiotherapy and Expiratory Flow Increase Technique on Respiratory Parameters, Heart Rate, and Pain in Mechanically Ventilated Premature Neonates: A Randomized Controlled Trial

Author(s)

de Macedo, Jacqueline Carla ; Olivo, Clarice Rosa ; Barnabe, Viviani ; Dias, Eduardo Dati ; de Moraes, ibis Ariana Pena ; Tiberio, Iolanda de Fatima Lopes Calvo ; de Carvalho, Celso Ricardo Fernandes ; Saraiva-Romanholo, Beatriz Mangueira

• Document type: Journal article
• Source: HEALTHCARE; v. 12, n. 23, p. 13-pg., 2024-12-01.

Abstract

Background/Objectives: Prematurity is a leading cause of infant mortality and mechanical ventilation increases respiratory complication risk. The effects of secretion removal techniques in premature infants remain a topic of ongoing debate. The aim of the study is to compare two secretion removal techniques in premature infants on mechanical ventilation; Methods: The participants were randomized into conventional chest physiotherapy (CPT; n = 22) or expiratory flow increase technique (EFIT; n = 21) groups. Each participant completed four sessions on consecutive days with a minimum of one and a maximum of two sessions per day. We assessed peripheral oxygen saturation (SpO(2)), heart (HR) and respiratory rates (RR), tidal volume (VT), and pain levels at specific time points: before the intervention, immediately after the intervention, 5 min after the intervention, and 10 min after the intervention. The partial Eta squared (& eng;(2)(p)) was reported to measure the effect size; Results: HR and RR increased post-intervention in both groups (p < 0.001; HR & eng;(2)(p) = 0.51; RR & eng;(2)(p) = 0.38); post hoc comparisons showed EFIT group decreased RR from the first to last session (p = 0.045). Both groups exhibited increased VT and SpO(2) in all sessions (p < 0.001; VT & eng;(2)(p) = 0.40; SpO(2) & eng;(2)(p) = 0.50). The EFIT group had higher SpO(2) values (p = 0.013; & eng;(2)(p) = 0.15) and lower pain scores (p < 0.001; & eng;(2)(p) = 0.46) post-intervention compared to CPT; Conclusions: CPT and EFIT resulted in similar effects on short-term respiratory parameters and heart rate; however, EFIT had advantages, including lower RR, higher SpO(2), and reduced pain, suggesting it may be a more effective, comfortable neonatal respiratory treatment. (AU)

• FAPESP's process: 14/26829-4 - Clinical, functional and inflammatory assessment in asthmatic patients undergoing an educational intervention
• Grantee: Beatriz Mangueira Saraiva
• Support Opportunities: Regular Research Grants
• FAPESP's process: 18/02537-5 - Characterization of asthma-COPD overlap syndrome (ACOS): experimental and clinical studies
• Grantee: Iolanda de Fátima Lopes Calvo Tibério
• Support Opportunities: Research Projects - Thematic Grants