| Chest physiotherapy for reducing respiratory morbidity in infants requiring ventilatory support. | |
| | |
MedLine Citation:
|
PMID: 18646156 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Chest physiotherapy (CPT) has been used in many neonatal nurseries around the world to improve airway clearance and treat lung collapse; however, the evidence to support its use has been conflicting. Despite the large number of studies there is very little evidence of sufficiently good quality on which to base current practice. OBJECTIVES: To assess the effects of active CPT techniques, such as percussion and vibration followed by suction compared with suction alone, on the respiratory system in infants receiving mechanical ventilation. Additionally, differences between types of active CPT techniques were assessed. SEARCH STRATEGY: Our search included The Cochrane Library (Issue 2, 2007), MEDLINE (1966 to 2007), EMBASE (1988 to 2007), CINAHL, Science Citation Index, previous reviews including cross-references, abstracts, conference proceedings and grey literature. SELECTION CRITERIA: Trials in which ventilated newborn infants up to four weeks of age were randomly or quasi-randomly assigned to receive active CPT or suction alone. Infants receiving CPT for the extubation period were excluded. DATA COLLECTION AND ANALYSIS: Two review authors independently conducted quality assessments and data extraction for included trials. We analysed data for individual trial results using relative risk (RR) and mean difference (MD). Results are presented with 95% confidence intervals (CI). Due to insufficient data, we could not undertake meta-analysis. MAIN RESULTS: Three trials involving 106 infants were included in this review. In one trial (n = 20) CPT was no better than standard care in clearing secretions. No increase in the risk of intraventricular haemorrhage was noted. Two trials compared different types of active CPT. One trial (n = 56) showed that non-resolved atelectasis was reduced in more neonates receiving the lung squeezing technique (LST) when compared to postural drainage, percussion and vibration (PDPV) (RR 0.25; 95% CI 0.11 to 0.57). No difference in secretion clearance or in the rate of intraventricular haemorrhage or periventricular leucomalacia was demonstrated. The other trial (n = 30) showed that the use of percussion or 'cupping' resulted in an increased incidence of hypoxaemia (RR 0.53; 95% CI 0.28 to 0.99) and increased oxygen requirements (MD -9.68; 95% CI -14.16 to -5.20) when compared with contact heel percussion. There was insufficient information to adequately assess important short and longer-term outcomes, including adverse effects. AUTHORS' CONCLUSIONS: The results of this review do not provide sufficient evidence on which to base clinical practice. There is a need for larger randomised controlled trials to address these issues. |
| | |
Authors:
|
Judith L Hough; Vicki Flenady; Leanne Johnston; Paul G Woodgate |
Related Documents
:
|
17763276 - Chorioamnionitis and brain damage in the preterm newborn. 15805376 - Improved survival rates with increased neurodevelopmental disability for extremely low ... 19533856 - Influence of antenatal care, placental weight and genetic variation on low birth weight... 19647236 - Infant outcome of 957 singletons born after frozen embryo replacement: the danish natio... 14645976 - Relationship between birth weight and adult lung function: controlling for maternal fac... 20022416 - Delivery room resuscitation of near-term infants: role of the laryngeal mask airway. |
Publication Detail:
|
Type: Journal Article; Review Date: 2008-07-16 |
Journal Detail:
|
Title: Cochrane database of systematic reviews (Online) Volume: - ISSN: 1469-493X ISO Abbreviation: Cochrane Database Syst Rev Publication Date: 2008 |
Date Detail:
|
Created Date: 2008-07-22 Completed Date: 2008-10-15 Revised Date: 2008-11-21 |
Medline Journal Info:
|
Nlm Unique ID: 100909747 Medline TA: Cochrane Database Syst Rev Country: England |
Other Details:
|
Languages: eng Pagination: CD006445 Citation Subset: IM |
Affiliation:
|
Physiotherapy Department, Mater Hospital, Raymond Terrace, South Brisbane, Queensland, Australia, 4101. judyhough@optusnet.com.au |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Humans Infant Infant, Newborn Mucus / secretion* Percussion / methods Pulmonary Atelectasis / therapy* Randomized Controlled Trials as Topic Respiration, Artificial / adverse effects* Respiratory Therapy / methods* Suction Vibration / therapeutic use |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Open surgical procedures for incisional hernias.
Next Document: Risk assessment tools for the prevention of pressure ulcers.