Pulmonary physiotherapy in neonates: physiologic changes and respiratory management.

Area of Science:

• Neonatal Physiology
• Respiratory Medicine
• Pediatric Critical Care

Background:

• Chest physiotherapy is commonly used in neonates with respiratory compromise.
• The physiological effects of specific physiotherapy techniques, such as suctioning and hyperventilation, require careful evaluation.

Purpose of the Study:

• To investigate the impact of chest physiotherapy, including suctioning and hyperventilation, on respiratory function in neonates.
• To assess changes in arterial blood gases, respiratory patterns, lung mechanics, and functional residual capacity.

Main Methods:

• Measurements were taken in 13 neonates (1.25-3.20 kg) during a control period, after chest vibration and suctioning, after hyperventilation, and 2 hours post-suctioning.
• Parameters included arterial blood gases (PO2, PCO2), respiratory rate, lung mechanics (resistance, compliance), tidal volume, and functional residual capacity.

Main Results:

• Mean PO2 significantly decreased after suctioning (to 43 mm Hg) and increased after hyperventilation (to 78 mm Hg).
• Inspiratory resistance significantly decreased post-suctioning, returning to baseline after hyperventilation. Respiratory rate increased significantly after suctioning.
• Functional residual capacity, dynamic lung compliance, tidal volume, PCO2, and base excess showed no significant changes.

Conclusions:

• Suctioning and hyperventilation can lead to significant hypoxemia and altered respiratory mechanics in neonates.
• Routine use of suctioning and hyperventilation in infants recovering from respiratory diseases is not supported due to the risk of severe hypoxemia.