Macedo Jacqueline Carla de, Olivo Clarice Rosa, Barnabé Viviani, Dias Eduardo Dati, Moraes Íbis Ariana Peña de, Tibério Iolanda de Fátima Lopes Calvo, Carvalho Celso Ricardo Fernandes de, Saraiva-Romanholo Beatriz Mangueira
Instituto de Assistência Médica Ao Servidor Público Estadual, Hospital do Servidor Público do Estado de São Paulo, São Paulo 04039-000, Brazil.
Faculty of Medicine, University City of São Paulo, São Paulo 03071-000, Brazil.
Healthcare (Basel). 2024 Nov 30;12(23):2408. doi: 10.3390/healthcare12232408.
: Prematurity is a leading cause of infant mortality and mechanical ventilation increases respiratory complication risk. The effects of secretion removal techniques in premature infants remain a topic of ongoing debate. The aim of the study is to compare two secretion removal techniques in premature infants on mechanical ventilation; : The participants were randomized into conventional chest physiotherapy (CPT; = 22) or expiratory flow increase technique (EFIT; = 21) groups. Each participant completed four sessions on consecutive days with a minimum of one and a maximum of two sessions per day. We assessed peripheral oxygen saturation (SpO), heart (HR) and respiratory rates (RR), tidal volume (VT), and pain levels at specific time points: before the intervention, immediately after the intervention, 5 min after the intervention, and 10 min after the intervention. The partial Eta squared (ŋ) was reported to measure the effect size; : HR and RR increased post-intervention in both groups ( < 0.001; HR ŋ = 0.51; RR ŋ = 0.38); post hoc comparisons showed EFIT group decreased RR from the first to last session ( = 0.045). Both groups exhibited increased VT and SpO in all sessions ( < 0.001; VT ŋ = 0.40; SpO ŋ = 0.50). The EFIT group had higher SpO values ( = 0.013; ŋ = 0.15) and lower pain scores ( < 0.001; ŋ = 0.46) post-intervention compared to CPT; : CPT and EFIT resulted in similar effects on short-term respiratory parameters and heart rate; however, EFIT had advantages, including lower RR, higher SpO, and reduced pain, suggesting it may be a more effective, comfortable neonatal respiratory treatment.
早产是婴儿死亡的主要原因，机械通气会增加呼吸并发症的风险。分泌物清除技术对早产儿的影响仍是一个持续争论的话题。本研究的目的是比较两种分泌物清除技术对接受机械通气的早产儿的效果；研究对象被随机分为传统胸部物理治疗（CPT；n = 22）或呼气流量增加技术（EFIT；n = 21）组。每位参与者连续四天完成四个疗程，每天最少一个疗程，最多两个疗程。我们在特定时间点评估外周血氧饱和度（SpO）、心率（HR）和呼吸频率（RR）、潮气量（VT）以及疼痛程度：干预前、干预后即刻、干预后5分钟和干预后10分钟。报告了偏η²（ŋ）以测量效应大小；两组干预后HR和RR均增加（P < 0.001；HR ŋ = 0.51；RR ŋ = 0.38）；事后比较显示EFIT组从第一个疗程到最后一个疗程RR下降（P = 0.045）。两组在所有疗程中VT和SpO均增加（P < 0.001；VT ŋ = 0.40；SpO ŋ = 0.50）。与CPT组相比，EFIT组干预后SpO值更高（P = 0.013；ŋ = 0.15）且疼痛评分更低（P < 0.001；ŋ = 0.46）；CPT和EFIT对短期呼吸参数和心率产生相似的影响；然而，EFIT具有优势，包括更低的RR、更高的SpO和减轻的疼痛，表明它可能是一种更有效、更舒适的新生儿呼吸治疗方法。
