CHEST PHYSIOTHERAPY IN THE NEONATE WITH RESPIRATORY DISTRESS

Abstract

Chest physiotherapy is a frequently practiced but poorly documented form of therapy. Twenty neonates (mean age=43 hr) were studied with a variety of respiratory disorders to assess the effect of complete chest physiotherapy on arterial blood gases. This was compared to the alteration of blood gases following suctioning of the airway. Nine were receiving added oxygen alone, six were receiving continuous distending pressure and five were intubated receiving mechanical ventilation. Complete chest physiotherapy treatment consisted of postural drainage with percussions and vibrations in each drainage position followed by suctioning of the airway. The treatment was performed for a specific area of lung involvement if present. For generalized lung disorders, drainage was performed with an emphasis on the basal segments of the lower lobes. Each infant had arterial blood gases performed five minutes prior to and twenty minutes following suctioning, and similarly before and after physiotherapy (average interval between the two pairs=1.8 hr) There was a mean increase of 20.8 mm Hg in the pOg following physiotherapy, (p<0.01) with no significant change observed following suctioning. There was no significant change in the pH or pCO₂ with either procedure. Analysis of covariance revealed no significant correlations between pO₂, and sex, age, body weight, gestation, inspired oxygen concentration, or the order of receiving the procedures. In neonates with respiratory distress, oxygenation is improved following physiotherapy.

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