Effects of Physiotherapy in Hemodynamics and Childrens Respiratory Mechanics

Respiratory Mechanics and Hemodynamics in Children With Respiratory Failure: Comparison of Two Techniques of Respiratory Physiotherapy

The hypothesis of this study is that respiratory physiotherapy can promote improvement in respiratory mechanics in children with respiratory failure and the bag squeezing maneuver is more effective in improving respiratory mechanics in childrens and does not alter the hemodynamic proved safe

20% increase in FiO2 Inflation pressure of 30 cm H2O + 10l O2/min 0.5 ml saline 0.9% 10 Manual Hyperinflation 10 vibrocompression Aspiration Tracheal

20% increase in FiO2 0.5 ml saline 10 vibrocompression toracica on the right and left Aspiration Tracheal

To perform the BS technique, we used a Protec® manual inflation bag with a flow of 10 L / min and 100% oxygen. A Commercial Medical® manometer was adapted between the orotracheal tube and the inflation bag to monitor the inflation pressure which was recommendedat 30 cmH2O for all children of the BS group. Initially we instilled at most 0.5 ml saline solution(SS) at 0.9% followed by 10 manual hyperinflation maneuvers interspersed with 10 vibrocompression maneuvers and as a last procedure, we performed an aspiration of the orotracheal tube airways and mouth. Between the aspirations the child was re-connected to the ventilator.

To perform the TVC technique, we applied 10 vibrocompression maneuvers on the chest of the children during the expiratory phase of the respiratory cycle, on each of the lateral decubitus position, totaling 20 maneuvers, followed by aspiration in the dorsal decubitus position. All measurements in both study groups were performed with the child connected to the ventilator. Before starting the maneuver BS or TVC the child received an increase of 20% fraction of inspired oxygen (FiO2) from what was received previously in MV and after data collection FiO2 returned to baseline values.

Effects of Bag Squeezing and vibrocompression chest in hemodynamic, resistance and respiratory system compliance

All variables were assessed prior to the proposed technique (pre-maneuver), immediately after the execution of the technique randomly chosen (post-maneuver), 30, 60 and 120 after the end of the technique randomly chosen. The mean of three readings was used as the representative value for each variable. All children were ventilated with the same mechanical Dixtal® DX3020 Brazil ventilator

Inclusion Criteria: children aged between one and 60 months diagnosed with respiratory failure undergoing mechanical ventilation Exclusion Criteria: had traumatic brain injury severe thrombocytopenia (<20,000 pl/mm³) hypovolemia and cyanogenic congenital heart defects pneumothorax, hemothorax and/or pleural effusion without previous drainage