Abstract

Studies done in the past on cardiopulmonary physiotherapy in neonates, have not fully laid enough evidence, and several limitations have been quoted. The main purpose of this study was to evaluate the effect of chest physiotherapy, including suctioning on lung dynamics and lobar atelectasis. The secondary objectives were to explore sessions required to resolve collapse and the use of a detailed and replicable protocol of chest physiotherapy for ventilated neonates. Single group non-randomized blinded study design was used. Consecutive 42 mechanically ventilated neonates, consisting of 16 male and 26 female participants from a tertiary care hospital, with neonatal intensive care unit, was used for this study. Eleven babies were premature with 30 ± 3 weeks of gestational age whereas other babies had age of 15 ± 7 days after full term delivery. Techniques of cardiopulmonary physiotherapy, including humidification, positioning, postural drainage, percussion, vibration and endotracheal suctioning were applied. Dynamic compliance, inspiratory and expiratory resistance, reinflation of collapsed lung on chest x-ray were observed. The results found were statistically significant (p < 0.0001) for improvement in lung compliance, reduction in inspiratory and expiratory resistances, along with re-expansion of collapsed lobes. A carefully laid protocol of cardiopulmonary physiotherapy, individualized and when administered by an experienced and well trained cardiopulmonary physiotherapist, in association with multidisciplinary approach shows improvement in lung dynamics of ventilated neonates.

Key words:  Neonates, mechanical ventilation, cardiopulmonary physiotherapy