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Published on: September 16, 2019
Short-Term Effects of Conventional Chest Physiotherapy and Expiratory Flow Increase Technique on Respiratory
Jacqueline Carla de Macedo1,2, Clarice Rosa Olivo1,2,3,4, Viviani Barnabé1,2
1Instituto de Assistência Médica Ao Servidor Público Estadual, Hospital do Servidor Público do Estado de São Paulo, São Paulo 04039-000, Brazil.
Insights
The expiratory flow increase technique (EFIT) may be a more effective and comfortable respiratory treatment for premature infants on mechanical ventilation than conventional chest physiotherapy (CPT). EFIT demonstrated advantages in reducing respiratory rate and pain while increasing oxygen saturation.
Area of Science:
- Neonatal Medicine
- Respiratory Therapy
- Pediatric Critical Care
Background:
- Prematurity is a significant cause of infant mortality.
- Mechanical ventilation in premature infants increases the risk of respiratory complications.
- Secretion removal techniques for premature infants require further investigation.
Purpose of the Study:
- To compare the efficacy of two secretion removal techniques in premature infants receiving mechanical ventilation.
- To evaluate the impact of conventional chest physiotherapy (CPT) versus the expiratory flow increase technique (EFIT) on respiratory parameters and pain.
Main Methods:
- Randomized controlled trial comparing CPT (n=22) and EFIT (n=21) in premature infants on mechanical ventilation.
- Four intervention sessions were administered over consecutive days.
- Assessed peripheral oxygen saturation (SpO2), heart rate (HR), respiratory rate (RR), tidal volume (VT), and pain levels pre- and post-intervention.
Main Results:
- Both CPT and EFIT increased HR and RR post-intervention.
- The EFIT group showed a decrease in RR from the first to the last session.
- Both techniques improved VT and SpO2; however, EFIT resulted in higher SpO2 and lower pain scores compared to CPT.
Conclusions:
- CPT and EFIT have similar short-term effects on respiratory parameters and heart rate in premature infants.
- EFIT offers advantages over CPT, including reduced respiratory rate, enhanced SpO2, and decreased pain.
- EFIT may represent a more effective and comfortable neonatal respiratory treatment option.
Abstract:
Background/Objectives: Prematurity is a leading cause of infant mortality and mechanical ventilation increases respiratory complication risk. The effects of secretion removal techniques in premature infants remain a topic of ongoing debate. The aim of the study is to compare two secretion removal techniques in premature infants on mechanical ventilation; Methods: The participants were randomized into conventional chest physiotherapy (CPT; n = 22) or expiratory flow increase technique (EFIT; n = 21) groups. Each participant completed four sessions on consecutive days with a minimum of one and a maximum of two sessions per day. We assessed peripheral oxygen saturation (SpO2), heart (HR) and respiratory rates (RR), tidal volume (VT), and pain levels at specific time points: before the intervention, immediately after the intervention, 5 min after the intervention, and 10 min after the intervention. The partial Eta squared (ŋp2) was reported to measure the effect size; Results: HR and RR increased post-intervention in both groups (p < 0.001; HR ŋp2 = 0.51; RR ŋp2 = 0.38); post hoc comparisons showed EFIT group decreased RR from the first to last session (p = 0.045). Both groups exhibited increased VT and SpO2 in all sessions (p < 0.001; VT ŋp2 = 0.40; SpO2 ŋp2 = 0.50). The EFIT group had higher SpO2 values (p = 0.013; ŋp2 = 0.15) and lower pain scores (p < 0.001; ŋp2 = 0.46) post-intervention compared to CPT; Conclusions: CPT and EFIT resulted in similar effects on short-term respiratory parameters and heart rate; however, EFIT had advantages, including lower RR, higher SpO2, and reduced pain, suggesting it may be a more effective, comfortable neonatal respiratory treatment.
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