title: [Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique].
abstract: OBJECTIVE
  To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns.
  
  
  METHODS
  This is an intervention study, which included 40 preterm infants (≤34 weeks) aged 8-15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded. Ultrasonographic assessments with transcranial Doppler flowmetry were performed before, during and after the increase in expiratory flow session, which lasted 5minutes. Cerebral blood flow velocity and resistance and pulsatility indices in the pericallosal artery were assessed.
  
  
  RESULTS
  Respiratory physical therapy did not significantly alter flow velocity at the systolic peak (p=0.50), the end diastolic flow velocity (p=0.17), the mean flow velocity (p=0.07), the resistance index (p=0.41) and the pulsatility index (p=0.67) over time.
  
  
  CONCLUSIONS
  The expiratory flow increase technique did not affect cerebral blood flow in clinically-stable preterm infants.
authors.affiliation: Hospital da Mulher Professor Doutor José Aristodemo Pinotti, Centro de Atenção Integral à Saúde da Mulher (Caism), Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil. Electronic address: bassanimariana@hotmail.com.
authors.forename: Mariana Almada
authors.initials: MA
authors.lastname: Bassani
authors.affiliation: Hospital da Mulher Professor Doutor José Aristodemo Pinotti, Centro de Atenção Integral à Saúde da Mulher (Caism), Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
authors.forename: Jamil Pedro Siqueira
authors.initials: JP
authors.lastname: Caldas
authors.affiliation: Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
authors.forename: Abimael Aranha
authors.initials: AA
authors.lastname: Netto
authors.affiliation: Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
authors.forename: Sérgio Tadeu Martins
authors.initials: ST
authors.lastname: Marba
mesh_terms: D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D008297:Male; D012123:Pulmonary Ventilation; D012138:Respiratory Therapy / Q000379:methods*
keywords: Blood flow velocity; Modalidades de fisioterapia; Newborn; Physical therapy modalities; Prematuro; Preterm; Recém‐nascido; Transcranial Doppler ultrasonography; Ultrassonografia Doppler transcraniana; Velocidade do fluxo sanguíneo