the role of chest physiotherapy in prevention of postextubation atelectasis in pediatric patients with neuromuscular diseases

ho w t o cit e thi s article : bila n n , p oorshir i b.th e rol e o f ches t physiotherap y i n preventio n o f postextubatio n atelectasi s i n pediatri c patient s wit h neuromuscula r diseases . ira n j chil d neuro l. 2013 winte r; 7 (1) : 21-24 .   objective there are controversial findings in the literature on the effects of chest physiotherapy on postextubation lung collapse in pediatric age group. therefore, we aimed to investigate the efficacy of chest physiotherapy in prevention of postextubation atelectasis in pediatric patients. material s & methods in a case-control study from march 2007 to march 2011, two groups of patients (35 patients in each group) susceptible to lung collapse were enrolled in the study. the studied patients had neuromuscular diseases such as spinal muscular atrophy, guillain-barre syndrome, critical illness polyneuropathy/myopathy, and cerebral palsy. the patients were randomly divided into two groups (case and control); the case group underwent daily chest physiotherapy through vibrator and chest percussion and the control group was under supervision. in the latter group, the underlying disease was treated and the lung collapse was managed, if occurred. result s the frequency of atelectasis was lower in the case group who received prophylactic chest physiotherapy compared to the control group (16.6% vs. 40%). conclusio n chest physiotherapy as well as appropriate and regular change of position can considerably reduce the rate of pulmonary collapse in pediatric patients. refe r ences jorgensen j, wei jl, sykes kj, klem sa, weatherly ra, bruegger de, latz ad, nicklaus pj. incidence of and risk factors for airway complications following endotracheal intubation for bronchiolitis. otolaryngol head neck surg 2007;137(3):394-9. flenady vj, gray ph. chest physiotherapy for preventing morbidity in babies being extubated from mechanical ventilation. cochrane database syst rev 2002;(2):cd000283. odita jc, kayyali m, ammari a. post-extubation atelectasis in ventilated newborn infants. pediatr radiol 1993;23(3):183-5. balachandran a, shivbalan s, thangavelu s. chest physiotherapy in pediatric practice. indian pediatr 2005;42(6):559-68. finer nn, moriartey rr, boyd j, phillips hj, stewart ar, ulan o. postextubation atelectasis: a retrospective review and a prospective controlled study. j pediatr 1979;94(1):110-3. al-alaiyan s, dyer d, khan b. chest physiotherapy and post-extubation atelectasis in infants. pediatr pulmonol. 1996;21(4):227-30. bloomfield fh, teele rl, voss m, knight db, harding je. the role of neonatal chest physiotherapy in preventing postentubation atelectasis. j pediatr 1998;133(2):269-71. bagley ce, gray ph, tudehope di, flenady v, shearman ad, lamont a. routine neonatal postextubation chest physiotherapy: a randomized controlled trial. j paediatr child health 2005;41(11):592-7. vivian-beresford a, king c, macauley h. neonatal post-extubation complications: the preventive role of physiotherapy. physiother can 1987;39:184-90. bagley c, flenady v, tudehope d, gray p. the role of postextubation chest physiotherapy: a randomised controlled trial. proceedings of the perinatal society of australia and new zealand 4th annual congress. brisbane: 1999. reines hd, sade rm, bradford bf, marshall j. chest physiotherapy fails to prevent postoperative atelectasis in children after cardiac surgery. ann surg 1982;195(4):451-5. cavenaghi s, moura sc, silva th, venturinelli td, marino lh, lamari nm. importance of pre- and postoperative physiotherapy in pediatric cardiac surgery. rev bras cir cardiovasc 2009;24(3):397-400. deakins k, chatburn rl. a comparison of intrapulmonary percussive ventilation and conventional chest physiotherapy for the treatment of atelectasis in the pediatric patient. respir care 2002;47(10):1162-7.