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Published on: March 6, 2019
Chest physiotherapy in preterm infants with lung diseases
Carmen Giannantonio1, Patrizia Papacci, Roberta Ciarniello
1Department of Paediatrics, Division of Neonatology, Sacro Cuore Catholic University, Largo Francesco Vito 1, Rome, Italy.
Insights
The Vojta method's reflex rolling technique appears safe for preterm infants with lung issues, showing improved oxygen levels without adverse effects on breathing or stress. Further research is needed to confirm long-term respiratory benefits.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Developmental Pediatrics
Background:
- The efficacy of chest physiotherapy in neonatology remains debated due to inconsistent outcomes.
- Preterm infants with lung pathologies require specialized respiratory support and therapeutic interventions.
Purpose of the Study:
- To assess the safety and applicability of Vojta method's 'reflex rolling' in preterm neonates with lung conditions.
- To evaluate the impact of this method on blood gases, oxygen saturation, spontaneous breathing, and stress/pain indicators.
- To monitor neurological outcomes through cerebral ultrasound scans.
Main Methods:
- 34 preterm infants (mean gestational age 30.5 weeks) with hyaline membrane disease or pneumonia were included.
- Infants received Vojta method's 'reflex rolling' three times daily.
- Respiratory rate, oxygen saturation (SatO2), transcutaneous PtcCO2, and PtcO2 were monitored. Pain and stress were assessed using NIPS and PIPP scores. Cerebral ultrasounds were performed serially.
Main Results:
- Vojta's 'reflex rolling' led to increased PtcO2 and SatO2 levels.
- No negative effects were observed on PtcCO2 or respiratory rate.
- Stress scores (NIPS, PIPP) remained unchanged, and no adverse neurological events like worsening intraventricular hemorrhage or periventricular leucomalacia occurred.
Conclusions:
- The Vojta method, specifically 'reflex rolling', is demonstrated as safe for preterm neonates with lung pathology.
- While safety is established, further investigation is required to confirm positive respiratory effects and long-term outcomes.
- This study provides preliminary evidence for the safe application of Vojta method in a vulnerable neonatal population.
Background:
In neonatology the role of chest physiotherapy is still uncertain because of the controversial outcomes.
Methods:
The aim of this study was to test the applicability in preterm infants of 'reflex rolling', from the Vojta method, in preterm neonates with lung pathology, with particular attention to the effects on blood gases and oxygen saturation, on the spontaneous breathing, on the onset of stress or pain. The study included 34 preterm newborns with mean gestational age of 30.5 (1.6) weeks - mean (DS) - and birth weight of 1430 (423) g - mean (DS) -, who suffered from hyaline membrane disease, under treatment with nasal CPAP (continuous positive airways pressure), or from pneumonia, under treatment with oxygen-therapy. The neonates underwent phase 1 of 'reflex rolling' according to Vojta method three times daily. Respiratory rate, SatO2, transcutaneous PtcCO2 e PtcO2 were monitored; in order to evaluate the onset of stress or pain following the stimulations, the NIPS score and the PIPP score were recorded; cerebral ultrasound scans were performed on postnatal days 1-3-5-7, and then weekly.
Results:
In this population the first phase of Vojta's 'reflex rolling' caused an increase of PtcO2 and SatO2 values. No negative effects on PtcCO2 and respiratory rate were observed, NIPS and PIPP stress scores remained unmodified during the treatment; in no patient the intraventricular haemorrhage worsened in time and none of the infants developed periventricular leucomalacia.
Conclusions:
Our experience, using the Vojta method, allows to affirm that this method is safe for preterm neonates, but further investigations are necessary to confirm its positive effects and to evaluate long-term respiratory outcomes.
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