Respiratory Physiotherapy Techniques in Neonatal Intensive Care Units: A Scoping Review

Certain physiological characteristics increase the susceptibility of newborns, particularly preterm infants, to pulmonary collapse. In addition, newborns are prone to the accumulation of airway secretions, which, even in small volumes, can compromise respiratory function. Consequently, breathing therapy plays a crucial role in promoting airway clearance and supporting effective ventilation in this population. This scoping review aimed to map the breathing therapy methods used for newborns admitted to intensive care units and also to identify the clinical outcomes assessed in the studies.

We conducted a scoping review of all clinical studies involving hospitalized newborns of both sexes aged 0-28 days who received conventional or nonconventional respiratory physiotherapy. Exclusion criteria were studies on animals, reviews, protocols, or studies that were unavailable or incomplete. Outcomes analyzed included respiratory distress, cardiorespiratory parameters, thoracoabdominal synchrony, pain, and lung volumes and capacities.

The search yielded 1261 articles. Twelve studies were included for data extraction and synthesis. The main respiratory techniques studied were vibration, percussion, postural drainage, increased expiratory flow, lung squeezing (pulmonary hyperinflation using a manual resuscitator), and muscle synergy techniques.

The included studies reported short-term changes in cardiorespiratory parameters following the interventions, while no consistent evidence of increased pain was observed. However, the available evidence is heterogeneous and predominantly derived from single-session interventions, highlighting the need for well-designed and adequately powered studies to further evaluate the efficacy and safety of these interventions in this population.