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[Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase
Mariana Almada Bassani1, Jamil Pedro Siqueira Caldas1, Abimael Aranha Netto2
1Hospital da Mulher Professor Doutor José Aristodemo Pinotti, Centro de Atenção Integral à Saúde da Mulher (Caism), Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
Insights
Respiratory physical therapy using the expiratory flow increase technique did not significantly alter cerebral blood flow in stable preterm infants. This study assessed cerebral hemodynamics in premature newborns undergoing this specific respiratory intervention.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Care
- Cerebral Hemodynamics
Background:
- Premature infants often experience altered cerebral blood flow.
- Respiratory therapies are crucial for managing cardiorespiratory stability in neonates.
- The impact of specific techniques like expiratory flow increase on cerebral hemodynamics requires investigation.
Purpose of the Study:
- To evaluate the effect of the expiratory flow increase technique in respiratory therapy on cerebral hemodynamics in preterm infants.
- To assess changes in cerebral blood flow velocity and resistance indices during and after the intervention.
Main Methods:
- An intervention study involving 40 clinically stable preterm infants (≤34 weeks gestation).
- Cerebral hemodynamics were assessed using transcranial Doppler flowmetry, measuring flow velocity, resistance index, and pulsatility index in the pericallosal artery.
- Measurements were taken before, during, and after a 5-minute expiratory flow increase session.
Main Results:
- No statistically significant changes were observed in systolic peak flow velocity, end-diastolic flow velocity, or mean flow velocity.
- The resistance index and pulsatility index in the pericallosal artery also showed no significant alterations over time.
- These findings indicate that the intervention did not induce significant changes in cerebral blood flow parameters.
Conclusions:
- The expiratory flow increase technique, as applied in this study, did not demonstrate a significant impact on cerebral blood flow in clinically stable preterm infants.
- Further research may be needed to explore potential long-term effects or impacts in different infant populations.
Objective:
To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns.
Methods:
This is an intervention study, which included 40 preterm infants (≤34 weeks) aged 8-15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded. Ultrasonographic assessments with transcranial Doppler flowmetry were performed before, during and after the increase in expiratory flow session, which lasted 5minutes. Cerebral blood flow velocity and resistance and pulsatility indices in the pericallosal artery were assessed.
Results:
Respiratory physical therapy did not significantly alter flow velocity at the systolic peak (p=0.50), the end diastolic flow velocity (p=0.17), the mean flow velocity (p=0.07), the resistance index (p=0.41) and the pulsatility index (p=0.67) over time.
Conclusions:
The expiratory flow increase technique did not affect cerebral blood flow in clinically-stable preterm infants.
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