University Polyclinic Foundation A. Gemelli IRCCS, Rome, Italy.
Department of Geriatrics, Neurosciences and Orthopedics, Sacred Heart Catholic University, Rome, Italy -
Eur J Phys Rehabil Med. 2023 Jun;59(3):436-439. doi: 10.23736/S1973-9087.23.07599-8. Epub 2023 May 9.
Preterm infants can develop many complications related to organs underdevelopment. Respiratory distress syndrome (RDS) is considered the most important cause of morbidity and mortality in these patients. Traditional therapies for severe RDS, such as mechanical ventilation, come with a potential risk for pneumothorax and bronchopulmonary dysplasia while evidence on chest physiotherapy in preterm infants are controversial in terms of feasibility, tolerability and safety. The use of the positive expiratory pressure (PEP) mask is known in the pediatric field especially in cystic fibrosis for the removal of secretions and lung re-expansion. However, no literature exists on the application and effectiveness of this treatment modality for the respiratory rehabilitation of preterm infants. In this study, we aimed to assess the efficacy of a respiratory rehabilitation protocol based on PEP mask in a preterm infant with respiratory distress syndrome.
A Caucasian girl born at 26 + 5 weeks of gestational age with respiratory distress syndrome was treated with mechanical ventilation, oxygen therapy and PEP-mask.
Three weeks of PEP mask led to a significant clinical and radiological improvement of the lung's function with progressive reduction of the oxygen supplement and mechanical ventilation until complete weaning off. Given the absence of literature on this subject, further studies should be conducted to confirm these preliminary observations.
早产儿可能会出现许多与器官发育不全相关的并发症。呼吸窘迫综合征(RDS)被认为是这些患者发病率和死亡率的最重要原因。对于严重 RDS 的传统治疗方法,例如机械通气,存在气胸和支气管肺发育不良的潜在风险,而关于早产儿胸部物理治疗的证据在可行性、耐受性和安全性方面存在争议。正压呼气(PEP)面罩在儿科领域,尤其是在囊性纤维化中,用于清除分泌物和肺复张,这是众所周知的。然而,对于早产儿呼吸康复的这种治疗方式的应用和效果,尚无文献记载。在本研究中,我们旨在评估基于 PEP 面罩的呼吸康复方案在患有呼吸窘迫综合征的早产儿中的疗效。
一名白人女孩,胎龄 26+5 周,患有呼吸窘迫综合征,接受了机械通气、氧疗和 PEP 面罩治疗。
使用 PEP 面罩治疗 3 周后,肺功能的临床和影像学改善显著,氧补充和机械通气逐渐减少,直至完全脱机。鉴于该主题缺乏文献,应进行进一步的研究以确认这些初步观察结果。