Effect of Thoracic Block Technique on Atelectasis in Children on Mechanical Ventilation

Statement of the problem: • Does the thoracic block technique has effect on atelectasis in Children on Mechanical Ventilation? Null hypothesis: • there is effect of thoracic block technique on atelectasis in children on Mechanical ventilation.

Subjects: The study targets the children from both sexes. Sample size estimation will be carried out to determine the recruited number of children, selected randomly from Cairo University pediatric specialized hospital intensive care units ,Cairo to participate in the study Study design: Randomized controlled clinical trial. A. Inclusion criteria: age range from 6 months to 4 years . diagnosed with pneumonia, receiving Mechanical ventilation. start from second day of admission to intensive care unit. have unilateral mild to moderate atelectasis according to medical referral . should be vitally stable during the session. B. Exclusion criteria: The children will be excluded from the study if they had one of the following: medically unstable ( examples: tachycardia and tachypnea). uncontrolled convulsion. irritable or moderate to sever pain rib fracture pneumothorax Children will be assessed by measuring heart rate, respiratory rate, chest x-ray, arterial blood gases,dynamic compliance, oxygen saturation index before and after ten days of receiving intervention

Manual compression on healthy lung for 20 seconds and rest for 20 seconds, total time 20 minutes and percussion,vibration , postural drainage one session time for 35 minutes every day for ten days

Manual compression of the healthy lung during expiration associated with the use of invasive or non invasive mechanical ventilation

Assessment of change in heart rate and respiratory rate will be carried out by using electro cardiograph electrodes and pulse oximeter.

Assessment of atelectasis in chest x ray will be carried out by comparing presence, extent and distribution of atelectasis in x ray film before and intervention

Assessment of change in arterial blood gases test will be carried out by comparing results before and after intervention

Inclusion Criteria: age range from 6 months to 4 years . diagnosed with pneumonia, receiving Mechanical ventilation. start from second day of admission to intensive care unit. have unilateral mild to moderate atelectasis according to medical referral. should be vitally stable during the session. B. Exclusion criteria: The children were excluded from the study if they had one of the following: Exclusion Criteria: The children were excluded from the study if they had one of the following: medically unstable ( examples: tachycardia and tachypnea). uncontrolled convulsion. irritable or moderate to sever pain rib fracture pneumothorax