title: Evaluation of respiratory conditions in early phase of hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  To investigate the effectiveness of respiratory physiotherapy based on clinical evidence and analyze the improvement in respiratory parameters.
  
  
  METHODS
  A prospective study was carried out in the Bone Marrow Transplant Unit of the Universidade Estadual de Campinas (UNICAMP). Two different previously established respiratory physiotherapy protocols were applied from days D-1 to D+7 that aimed to improve airway clearance, pulmonary re-expansion and the strengthening of respiratory muscles. Group A were subjected to diaphragmatic proprioceptive stimulation, breathing exercises, incentive spirometry with Respiron(®), inspiratory muscle training with the Threshold(®) Inspiratory Muscle Training device, bronchial hygienization with Shaker(®) and cough stimulation. Group B performed a protocol that only used incentive spirometry. The parameters analyzed were: tidal volume, minute volume, maximal inspiratory pressure, maximal expiratory pressure, oxygen saturation, heart rate and respiratory frequency.
  
  
  RESULTS
  Sixty-seven patients submitted to myeloablative hematopoietic stem cell transplantation were included in this study. Among these, thirty-nine were evaluated and randomized in the two groups. There were significant differences between the groups for tidal volume at D+2 (p-value = 0.007) and maximal inspiratory pressure (p-value = 0.03), maximal expiratory pressure (p-value = 0.03) and tidal volume (p-value = 0.004) at D+7.
  
  
  CONCLUSIONS
  On comparing Group A with Group B, the authors concluded that the protocol of respiratory physiotherapy applied in this study resulted in an improvement in ventilation and in respiratory muscle strength of patients submitted to hematopoietic stem cell transplantation.
authors.affiliation: Universidade Estadual de Campinas - UNICAMP, SP, Brazil.
authors.forename: Eliane Aparecida
authors.initials: EA
authors.lastname: Bom
authors.forename: Clarissa Vasconcelos
authors.initials: CV
authors.lastname: de Souza
authors.forename: Rosana Almeida da Silva
authors.initials: RA
authors.lastname: Thiesen
authors.forename: Eliana Cristina Martins
authors.initials: EC
authors.lastname: Miranda
authors.forename: Carmino Antonio
authors.initials: CA
authors.lastname: de Souza