Early respiratory therapy reduces postoperative atelectasis in children undergoing lung resection

Related Experiment Videos

Patrícia Nerys Kaminski1, Luiz Alberto Forgiarini, Cristiano Feijó Andrade

  • 1Department of Thoracic Surgery, Hospital da Criança Santo Antônio/Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.

Respiratory Care
|October 31, 2012
PubMed

Insights

A standardized physiotherapy protocol for pediatric lung resection patients effectively reduces atelectasis and the need for bronchoscopy. However, it does not significantly impact chest tube removal time or hospital stay duration.

Area of Science:

  • Pediatric Surgery
  • Respiratory Physiotherapy
  • Thoracic Surgery

Background:

  • Postoperative pulmonary complications are common after lung resection in adults, with early physiotherapy showing benefits.
  • The effectiveness and specific techniques of postoperative physiotherapy in pediatric lung resection patients remain underexplored.
  • Standardization of physiotherapy protocols is needed for children undergoing lung resection.

Purpose of the Study:

  • To evaluate the effectiveness of a standardized postoperative physiotherapy protocol in pediatric patients after lung resection.
  • To compare outcomes between children receiving a standardized protocol and those receiving non-standardized care.

Main Methods:

  • A retrospective and prospective interventional study involving 123 pediatric subjects undergoing lung resection.
  • The intervention group (52 children) received a standardized protocol including positive expiratory pressure, rib cage compression, coughing, limb elevation, and early ambulation.
  • A historical control group (71 children) received non-standardized physiotherapy techniques.

Main Results:

  • The standardized physiotherapy group showed significantly fewer instances of atelectasis (7.6%) compared to the control group (15.4%).
  • Fewer patients in the standardized group required fiberoptic bronchoscopy for bronchial toilet (9.6%) versus the control group (19.7%).
  • No significant differences were observed in chest tube drainage time or hospital stay duration between the groups.

Conclusions:

  • A standardized physiotherapy protocol in pediatric lung resection patients effectively decreases atelectasis.
  • The protocol reduces the likelihood of requiring bronchoscopy for bronchial toilet.
  • The standardized protocol did not lead to a reduction in chest tube removal time or overall hospital stay.
Abstract

Related Concept Videos

Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Respiratory Assessment: Purpose and Indications01:19

Respiratory Assessment: Purpose and Indications

Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Chest Physiotherapy01:24

Chest Physiotherapy

Chest Physiotherapy (CPT) is a therapeutic technique used in respiratory care to improve ventilation, clear bronchial secretions, and enhance the efficiency of respiratory muscles. This therapy includes three primary procedures: postural drainage, percussion, and vibration. It can be performed on spontaneously breathing patients and those who are intubated and mechanically ventilated.
Purpose
CPT is primarily used for patients with excessive bronchial secretions who have difficulty clearing...