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Routine neonatal postextubation chest physiotherapy: a randomized controlled trial.

C E Bagley1, P H Gray, D I Tudehope

  • 1Department of Physiotherapy, University of Queensland, South Brisbane, Queensland, Australia. 21phymh@mater.org.au

Journal of Paediatrics and Child Health
|January 10, 2006
PubMed
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Routine neonatal chest physiotherapy after extubation does not reduce postextubation collapse. This randomized controlled trial found no significant difference in adverse outcomes for infants receiving physiotherapy compared to standard care.

Area of Science:

  • Neonatal care
  • Pediatric respiratory medicine
  • Clinical trials

Background:

  • Postextubation collapse is a common complication in neonates requiring mechanical ventilation.
  • Chest physiotherapy is sometimes used to prevent or treat respiratory complications in infants.

Purpose of the Study:

  • To evaluate the effectiveness of a neonatal postextubation chest physiotherapy program.
  • To determine if physiotherapy reduces postextubation collapse and adverse outcomes in mechanically ventilated infants.

Main Methods:

  • A randomized controlled trial involving 177 neonates was conducted.
  • Infants were assigned to either a physiotherapy group (chest percussion and suctioning) or a control group (suctioning only).
  • Postextubation collapse was assessed via chest X-ray by a blinded radiologist.

Related Experiment Videos

Main Results:

  • No statistically significant difference in postextubation collapse rates between the physiotherapy group (17.2%) and the control group (19.8%) was observed (P = 0.85).
  • There were no significant differences in apnea, bradycardia, need for oxygen, or re-intubation rates between the groups.
  • The trial was stopped early due to an interim analysis.

Conclusions:

  • Routine neonatal postextubation chest physiotherapy is not indicated for all infants.
  • The study found no evidence that chest physiotherapy is associated with adverse outcomes in this population.