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Early Respiratory Physiotherapy versus an Individualized Postural Care Program for Reducing Mechanical Ventilation in

Milena Tana1, Anthea Bottoni1, Francesco Cota1

  • 1Unità Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.

Children (Basel, Switzerland)
|November 25, 2023
PubMed

Insights

Early respiratory physiotherapy in preterm infants stimulated spontaneous breathing and was safe. This intervention showed a significant reduction in hemodynamically significant patent ductus arteriosus (PDA).

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Care
  • Clinical Trials

Background:

  • Tactile stimulation promotes spontaneous breathing in preterm newborns.
  • Preterm infants with respiratory failure often require respiratory support.
  • Early intervention strategies are crucial for improving outcomes in vulnerable neonates.

Purpose of the Study:

  • To evaluate the impact of early respiratory physiotherapy on the need for mechanical ventilation in preterm infants.
  • To assess the safety and efficacy of early respiratory physiotherapy in neonates with respiratory failure.
  • To determine if early physiotherapy reduces the incidence of patent ductus arteriosus (PDA).

Main Methods:

  • A monocentric, randomized controlled trial was conducted.
  • Eligible participants were preterm infants (gestational age ≤ 30 weeks) needing non-invasive respiratory support at birth.
  • The intervention group received early respiratory physiotherapy; the control group received standard daily physiotherapy.

Main Results:

  • 133 preterm infants were studied (68 intervention, 65 control).
  • The intervention group showed a non-statistically significant reduction in mechanical ventilation needs.
  • A statistically significant reduction in hemodynamically significant PDA was observed in the intervention group (28% vs. 54%, p=0.03).

Conclusions:

  • Early respiratory physiotherapy is safe for preterm infants requiring non-invasive respiratory support.
  • This physiotherapy approach is protective against the development of hemodynamically significant PDA.
  • Early physiotherapy may offer benefits beyond respiratory support in preterm neonates.
Abstract

Keywords:
mechanical ventilationpatent ductus arteriosuspreterm infantsrespiratory physiotherapyspontaneous respiratory activity

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