Chest physiotherapy in preterm infants with lung diseases.
BACKGROUND
In neonatology the role of chest physiotherapy is still uncertain because of the controversial outcomes.


METHODS
The aim of this study was to test the applicability in preterm infants of 'reflex rolling', from the Vojta method, in preterm neonates with lung pathology, with particular attention to the effects on blood gases and oxygen saturation, on the spontaneous breathing, on the onset of stress or pain. The study included 34 preterm newborns with mean gestational age of 30.5 (1.6) weeks - mean (DS) - and birth weight of 1430 (423) g - mean (DS) -, who suffered from hyaline membrane disease, under treatment with nasal CPAP (continuous positive airways pressure), or from pneumonia, under treatment with oxygen-therapy. The neonates underwent phase 1 of 'reflex rolling' according to Vojta method three times daily. Respiratory rate, SatO2, transcutaneous PtcCO2 e PtcO2 were monitored; in order to evaluate the onset of stress or pain following the stimulations, the NIPS score and the PIPP score were recorded; cerebral ultrasound scans were performed on postnatal days 1-3-5-7, and then weekly.


RESULTS
In this population the first phase of Vojta's 'reflex rolling' caused an increase of PtcO2 and SatO2 values. No negative effects on PtcCO2 and respiratory rate were observed, NIPS and PIPP stress scores remained unmodified during the treatment; in no patient the intraventricular haemorrhage worsened in time and none of the infants developed periventricular leucomalacia.


CONCLUSIONS
Our experience, using the Vojta method, allows to affirm that this method is safe for preterm neonates, but further investigations are necessary to confirm its positive effects and to evaluate long-term respiratory outcomes.
Giannantonio
Carmen
C
Department of Paediatrics, Division of Neonatology, Sacro Cuore Catholic University, Largo Francesco Vito 1, Rome, Italy.
Papacci
Patrizia
P
Ciarniello
Roberta
R
Tesfagabir
Mikael Ghennet
MG
Purcaro
Velia
V
Cota
Francesco
F
Semeraro
Carla Maria
CM
Romagnoli
Costantino
C
D001785:Blood Gas Monitoring, Transcutaneous; D002245:Carbon Dioxide / Q000097:blood; D045422:Continuous Positive Airway Pressure; D005260:Female; D006257:Head; D006801:Humans; D006819:Hyaline Membrane Disease / Q000503:physiopathology / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D010812:Physical Stimulation; D026741:Physical Therapy Modalities; D011014:Pneumonia / Q000503:physiopathology / Q000628:therapy*; D012018:Reflex; D056152:Respiratory Rate; D012399:Rotation
D002245:Carbon Dioxide; D010100:Oxygen