Chest Physiotherapy in Mechanically Ventilated Infants: a Narrative Literature Review

Chest physiotherapy is well supported for the treatment of respiratory complications in adults undergoing mechanical ventilation in intensive care. This narrative literature review aims to establish the current evidence available regarding chest physiotherapy in paediatric intensive care populations, specifically infants. Due to anatomical and physiological differences infants have greater incidence of respiratory complications when ventilated. Search methods: a search of the databases MEDLINE and CINHAL was undertaken. Search terms used related to physiotherapy in paediatric populations and new chest physiotherapy techniques ‘chest squeezing’ and ‘ventilator hyperinflation’. Limits were articles in English, published between 2000-2014. Only three articles were found relating to chest squeezing in children and no literature related to Ventilator Hyperinflation (VHI) and paediatrics. Consequently adult literature has also been included. Results: This review identified that chest physiotherapy may be more advantageous when combined with hyperinflation, yet, failed to identify any significant differences between VHI and Manual Hyperinflation (MHI) as an adjunct. This finding however likely reflects insufficient evidence rather than real equivalence between techniques, thus, identifying a need for further research to investigate how chest squeezing works and whether VHI is more effective than MHI for ventilated infants.