Renata Maba Gonçalves

Manual vibrocompression and nasotracheal suctioning in post-operative period of infants with heart deffects

OBJETIVO: Verificar a repercussao da vibrocompressao manual e da aspiracao nasotraqueal sobre os parâmetros cardiorrespiratorios de frequencia cardiaca (fc) e respiratoria (fr), saturacao periferica de oxigenio (SpO2), dor e desconforto respiratorio, em lactentes no pos-operatorio de cirurgias cardiacas. METODOS: Estudo controlado e randomizado, com as avaliacoes realizadas pela mesma fisioterapeuta, em dois momentos: antes e apos o procedimento. Dividiu-se o total de lactentes, por sorteio simples, em dois grupos: Intervencao (GI), com vibrocompressao manual toracica, aspiracao nasotraqueal e repouso; e Controle (GC), com 30 minutos de repouso. Avaliaram-se os dados cardiorrespiratorios (SpO2; fc; fr), aplicando-se as escalas: Neonatal Infant Pain Scale (NIPS), para analisar a dor, e Boletim de Silvermann-Andersen (BSA), para verificar o desconforto respiratorio. Os dados foram tratados por meio de analise de variância (ANOVA) para medidas repetidas, sendo significante p<0,05. RESULTADOS: Avaliaram-se 20 lactentes cardiopatas, dez em cada grupo (sete acianoticos e tres cianoticos), com idades de zero a 12 meses. Para analisar a interacao entre o grupo e o tempo, observou-se diferenca significativa na variacao da SpO2 (p=0,016), sem alteracao nas demais variaveis. Ja o comportamento dos parâmetros nos tempos apresentou diferenca significativa apenas na variacao da fr (p=0,001). Quanto a avaliacao do efeito no grupo, nao houve diferenca estatistica em nenhum dos dados (SpO2 - p=0,77; fc - p=0,14; fr - p=0,17; NIPS - p=0,49 e BSA - p=0,51). CONCLUSOES: A vibrocompressao manual e a aspiracao nasotraqueal aplicadas em lactentes no pos-operatorio de cirurgias cardiacas nao prejudicaram a SpO2 e a fr, alem de nao desencadearem dor e desconforto respiratorio. [Registro Brasileiro de Ensaios Clinicos (ReBEC): REQ: 1467].OBJECTIVE: To evaluate the impact of manual vibrocompression and nasotracheal suctioning on heart (hr) and respiratory (rr) rates, peripheral oxygen saturation (SpO2), pain and respiratory distress in infants in the postoperative period of a cardiac surgery. METHODS: Randomized controlled trial, in which the assessments were performed by the same physiotherapist in two moments: before and after the procedure. The infants were randomly divided into two groups: Intervention (IG), with manual chest vibrocompression, nasotracheal suctioning and resting; and Control CG), with 30 minutes of rest. Cardiorespiratory data (SpO2; hr; rr) were monitored and the following scales were used: Neonatal Infant Pain Scale (NIPS), for pain evaluation, and Bulletin of Silverman-Andersen (BSA), for respiratory distress assessment. The data were verified by analysis of variance (ANOVA) for repeated measures, being significant p<0.05. RESULTS: 20 infants with heart disease, ten in each group (seven acyanotic and three cyanotic) were enrolled, with ages ranging from zero to 12 months. In the analysis of the interaction between group and time, there was a significant difference in the variation of SpO2 (p=0.016), without changes in the other variables. Considering the main effect on time, only rr showed a significant difference (p=0.001). As for the group main effect, there were no statistical differences (SpO2 - p=0.77, hr - p=0.14, rr - p=0.17, NIPS - p=0.49 and BSA - p=0.51 ). CONCLUSIONS: The manual vibrocompression and the nasotracheal suctioning applied to infants in postoperative of cardiac surgery did not altered SpO2 and rr, and did not trigger pain and respiratory distress. [Brazilian Registry of Clinical Trials (ReBEC): REQ: 1467].

Diaphragmatic Breathing Exercise in Children

Objective: to present scientific evidence about diaphragmatic breathing exercise as in children´s affections. Sources of data: Science Direct, MEDLINE, SciELO, Portal CAPES , PubMed and Bireme, considering the published articles from 1956 to 2016, searched through the descriptors Ciencias da Saude (DeCS):“physical therapy”, “pediatric”, “children”, “breathing” and “diaphragmatic breathing”. Was also consulted the bibliographic Universidade do Estado de Santa Catarina (UDESC). There was included the texts related to treatments and trials about diaphragmatic breathign exercise as a therapeutic strategy in pediatrics. Synthesis of data: Were selected eleven journal articles and one dissertation of course compatible with the established criteria. Conclusions: The publications board the diaphragmatic breathing exercise in premature children, cystic fibrosis, asthma, mouth breathing syndrome, neuromuscular diseases, chronic functional constipation and dysfunctional voiding. This resource has presented positive results in some clinic situations, but are required more investigations about the effects of this therapeutic strategy in children.

A influência da postura corporal nos parâmetros do sistema de oscilometria de impulso em crianças

Impulse oscillometry (IOS) is an alternative and supplementary method for evaluating respiratory mechanics, but whose performance technique still requires standardization. Objective: This study sought to analyze and compare the results of IOS parameters when done with schoolchildren in standing (orthostatic) and sitting positions. Method: Analytical cross-sectional study. Healthy school children of 6 to 12 years were submitted to spirometry and two exams with IOS (randomized sitting and standing). Data were analyzed with SPSS 20.0. Using the Shapiro-Wilk test and, according to the normality of the data, applying the Wilcoxon or Student T-tests, the postures were compared. In correlating between the anthropometric data and the oscillometric variables, the Pearson or Spearman test was used, with p ≤ 0.05. Results: Participating were 72 children with a mean age of 8.42 ± 1.26. There was no difference between the oscillometric variables in the two postures. In the sitting position, there was low negative correlation between trunk height (Hetrunk) and the following variables: resistance to 20Hz (R20) (p = 0.034) and 5Hz (R5) (p = 0.041), central resistance (Rescent) (p = 0.018), and impedance (Z) (p = 0.030). In the standing position there was low negative correlation between age and peripheral resistance (Resper) (p = 0.011), R5 (p = 0.014), and Z (p = 0.009). Conclusion: There was no difference noted in comparing the oscillometric variables in the two postures. However, the airway resistance was influenced by Hetrunk, height, and age. The orthostatic position seems to be the best position to analyze Resper.

Teste de caminhada de seis minutos em crianças com doença respiratória crônica

Introduction: the six-minute walk test (6MWT) is widely used to assess functional capacity in children because of its easy administration and low cost. Objective: to evaluate and compare the performance of healthy children (CG), cystic fibrosis (CFG) and syndrome of mouth breathing (MBG) the 6MWT. Method: controlled comparative cross-sectional study. There were two 6MWT (6MWT1 and 6MWT2) as recommended by the American Thoracic Society. The Shapiro-Wilk normality test was used and for comparison of the two 6MWT in each group, there was the paired t-test and ANOVA later post-hoc Bonferroni for the distances (D6MWT). Results: 51 children participated (8 to 12 years), 17 per group. In comparing the D6MWT, only the CFG got underperformed the CG in both 6MWT (p = 0.001). Conclusion: the lowest performance by CFG strengthens the 6MWT as a sensitive instrument for assessing exercise capacity of children with chronic lung disease.

Vibrocompresión manual y aspiración nasotraqueal en el post-operatorio de lactantes cardiópatas

OBJETIVO: Verificar a repercussao da vibrocompressao manual e da aspiracao nasotraqueal sobre os parâmetros cardiorrespiratorios de frequencia cardiaca (fc) e respiratoria (fr), saturacao periferica de oxigenio (SpO2), dor e desconforto respiratorio, em lactentes no pos-operatorio de cirurgias cardiacas. METODOS: Estudo controlado e randomizado, com as avaliacoes realizadas pela mesma fisioterapeuta, em dois momentos: antes e apos o procedimento. Dividiu-se o total de lactentes, por sorteio simples, em dois grupos: Intervencao (GI), com vibrocompressao manual toracica, aspiracao nasotraqueal e repouso; e Controle (GC), com 30 minutos de repouso. Avaliaram-se os dados cardiorrespiratorios (SpO2; fc; fr), aplicando-se as escalas: Neonatal Infant Pain Scale (NIPS), para analisar a dor, e Boletim de Silvermann-Andersen (BSA), para verificar o desconforto respiratorio. Os dados foram tratados por meio de analise de variância (ANOVA) para medidas repetidas, sendo significante p<0,05. RESULTADOS: Avaliaram-se 20 lactentes cardiopatas, dez em cada grupo (sete acianoticos e tres cianoticos), com idades de zero a 12 meses. Para analisar a interacao entre o grupo e o tempo, observou-se diferenca significativa na variacao da SpO2 (p=0,016), sem alteracao nas demais variaveis. Ja o comportamento dos parâmetros nos tempos apresentou diferenca significativa apenas na variacao da fr (p=0,001). Quanto a avaliacao do efeito no grupo, nao houve diferenca estatistica em nenhum dos dados (SpO2 - p=0,77; fc - p=0,14; fr - p=0,17; NIPS - p=0,49 e BSA - p=0,51). CONCLUSOES: A vibrocompressao manual e a aspiracao nasotraqueal aplicadas em lactentes no pos-operatorio de cirurgias cardiacas nao prejudicaram a SpO2 e a fr, alem de nao desencadearem dor e desconforto respiratorio. [Registro Brasileiro de Ensaios Clinicos (ReBEC): REQ: 1467].OBJECTIVE: To evaluate the impact of manual vibrocompression and nasotracheal suctioning on heart (hr) and respiratory (rr) rates, peripheral oxygen saturation (SpO2), pain and respiratory distress in infants in the postoperative period of a cardiac surgery. METHODS: Randomized controlled trial, in which the assessments were performed by the same physiotherapist in two moments: before and after the procedure. The infants were randomly divided into two groups: Intervention (IG), with manual chest vibrocompression, nasotracheal suctioning and resting; and Control CG), with 30 minutes of rest. Cardiorespiratory data (SpO2; hr; rr) were monitored and the following scales were used: Neonatal Infant Pain Scale (NIPS), for pain evaluation, and Bulletin of Silverman-Andersen (BSA), for respiratory distress assessment. The data were verified by analysis of variance (ANOVA) for repeated measures, being significant p<0.05. RESULTS: 20 infants with heart disease, ten in each group (seven acyanotic and three cyanotic) were enrolled, with ages ranging from zero to 12 months. In the analysis of the interaction between group and time, there was a significant difference in the variation of SpO2 (p=0.016), without changes in the other variables. Considering the main effect on time, only rr showed a significant difference (p=0.001). As for the group main effect, there were no statistical differences (SpO2 - p=0.77, hr - p=0.14, rr - p=0.17, NIPS - p=0.49 and BSA - p=0.51 ). CONCLUSIONS: The manual vibrocompression and the nasotracheal suctioning applied to infants in postoperative of cardiac surgery did not altered SpO2 and rr, and did not trigger pain and respiratory distress. [Brazilian Registry of Clinical Trials (ReBEC): REQ: 1467].

Vibrocompressão manual e aspiração nasotraqueal no pós-operatório de lactentes cardiopatas

OBJETIVO: Verificar a repercussao da vibrocompressao manual e da aspiracao nasotraqueal sobre os parâmetros cardiorrespiratorios de frequencia cardiaca (fc) e respiratoria (fr), saturacao periferica de oxigenio (SpO2), dor e desconforto respiratorio, em lactentes no pos-operatorio de cirurgias cardiacas. METODOS: Estudo controlado e randomizado, com as avaliacoes realizadas pela mesma fisioterapeuta, em dois momentos: antes e apos o procedimento. Dividiu-se o total de lactentes, por sorteio simples, em dois grupos: Intervencao (GI), com vibrocompressao manual toracica, aspiracao nasotraqueal e repouso; e Controle (GC), com 30 minutos de repouso. Avaliaram-se os dados cardiorrespiratorios (SpO2; fc; fr), aplicando-se as escalas: Neonatal Infant Pain Scale (NIPS), para analisar a dor, e Boletim de Silvermann-Andersen (BSA), para verificar o desconforto respiratorio. Os dados foram tratados por meio de analise de variância (ANOVA) para medidas repetidas, sendo significante p<0,05. RESULTADOS: Avaliaram-se 20 lactentes cardiopatas, dez em cada grupo (sete acianoticos e tres cianoticos), com idades de zero a 12 meses. Para analisar a interacao entre o grupo e o tempo, observou-se diferenca significativa na variacao da SpO2 (p=0,016), sem alteracao nas demais variaveis. Ja o comportamento dos parâmetros nos tempos apresentou diferenca significativa apenas na variacao da fr (p=0,001). Quanto a avaliacao do efeito no grupo, nao houve diferenca estatistica em nenhum dos dados (SpO2 - p=0,77; fc - p=0,14; fr - p=0,17; NIPS - p=0,49 e BSA - p=0,51). CONCLUSOES: A vibrocompressao manual e a aspiracao nasotraqueal aplicadas em lactentes no pos-operatorio de cirurgias cardiacas nao prejudicaram a SpO2 e a fr, alem de nao desencadearem dor e desconforto respiratorio. [Registro Brasileiro de Ensaios Clinicos (ReBEC): REQ: 1467].OBJECTIVE: To evaluate the impact of manual vibrocompression and nasotracheal suctioning on heart (hr) and respiratory (rr) rates, peripheral oxygen saturation (SpO2), pain and respiratory distress in infants in the postoperative period of a cardiac surgery. METHODS: Randomized controlled trial, in which the assessments were performed by the same physiotherapist in two moments: before and after the procedure. The infants were randomly divided into two groups: Intervention (IG), with manual chest vibrocompression, nasotracheal suctioning and resting; and Control CG), with 30 minutes of rest. Cardiorespiratory data (SpO2; hr; rr) were monitored and the following scales were used: Neonatal Infant Pain Scale (NIPS), for pain evaluation, and Bulletin of Silverman-Andersen (BSA), for respiratory distress assessment. The data were verified by analysis of variance (ANOVA) for repeated measures, being significant p<0.05. RESULTS: 20 infants with heart disease, ten in each group (seven acyanotic and three cyanotic) were enrolled, with ages ranging from zero to 12 months. In the analysis of the interaction between group and time, there was a significant difference in the variation of SpO2 (p=0.016), without changes in the other variables. Considering the main effect on time, only rr showed a significant difference (p=0.001). As for the group main effect, there were no statistical differences (SpO2 - p=0.77, hr - p=0.14, rr - p=0.17, NIPS - p=0.49 and BSA - p=0.51 ). CONCLUSIONS: The manual vibrocompression and the nasotracheal suctioning applied to infants in postoperative of cardiac surgery did not altered SpO2 and rr, and did not trigger pain and respiratory distress. [Brazilian Registry of Clinical Trials (ReBEC): REQ: 1467].