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Elinaldo Da Conceicao Dos Santos - One of the best experts on this subject based on the ideXlab platform.
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effect of positive airway pressure added to conventional Chest Physiotherapy in resolution of pleural effusion after drainage a randomised controlled trial
European Respiratory Journal, 2015Co-Authors: Elinaldo Da Conceicao Dos Santos, Joao Silva, Fernanda Melo, Marcus Titus Trindade De Assis Filho, Marcela Brito Vidal, Juliana De Souza Da Silva, Marcia Novais, Franklin Barbosa, Islla MarreirosAbstract:Chest Physiotherapy (CPT) is widely used in cases of pleural effusion treated by Chest drainage but there are few data about which approach is effective. Hypothesis: The non-invasive positive pressure accelerates the reabsorption of pleural effusion. Aim: To test the effects of non-invasive positive airway pressure added to CPT on resolution of pleural effusions after drainage. Methods: This trial enrolled 43 patients with pleural effusion and Chest drainage in situ for Results: Group I presented shorter Chest tube drainage and hospital stay of 2 days (p Conclusion: Non-invasive positive airway pressure added to conventional CPT promotes a faster resolution of pleural effusion in patients with Chest drainage.
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efficacy of the addition of positive airway pressure to conventional Chest Physiotherapy in resolution of pleural effusion after drainage protocol for a randomised controlled trial
Journal of Physiotherapy, 2015Co-Authors: Elinaldo Da Conceicao Dos Santos, Adriana Claudia LunardiAbstract:Abstract Introduction Chest drainage for pleural effusion can cause pain and changes in respiratory function. It can also increase the risk of pulmonary complications and impair functional ability, which may increase length of hospital stay and the associated costs. For these reasons, surgical and clinical strategies have been adopted to reduce the duration of Chest drainage. Objectives To evaluate the efficacy of the addition of intermittent positive airway pressure applied by the Muller reanimator via a rubber facial mask versus conventional Physiotherapy on the duration of Chest drainage (primary objective), and its effect on the recovery of respiratory function, length of hospital stay and incidence of pulmonary complications (secondary objectives). Design Randomised, controlled trial. Participants and setting Inpatients with pleural effusion, aged over 18 years, who have had Chest drainage in situ for Intervention and control groups After initial assessments of lung function, 156 patients will be randomised into a positive airway pressure group (positive airway pressure at 15 cmH 2 O plus conventional Chest Physiotherapy), a conventional Chest Physiotherapy group (conventional Chest Physiotherapy plus non-therapeutic positive airway pressure at 4 cmH 2 O) or a control group (non-therapeutic positive airway pressure at 4 cmH 2 O). All groups will receive treatment three times per day for 7 consecutive days. Measurements A blinded assessor will conduct all assessments. Peripheral oxygenation and Chest drainage output will be measured over 7 consecutive days. Lung function will be re-assessed on Day 4 and Day 8. The criteria for removal of the Chest drain will be a transudate output ≤ 200ml over 24hours and full lung expansion on Chest radiography, as assessed by a blinded physician. Duration of Chest drainage, length of hospital stay, and any pulmonary complications diagnosed during hospitalisation will be recorded. Analysis Intention to treat using: survival analysis for duration of Chest drainage, and length of hospital stay; analysis of variance for Chest-tube output, lung function and peripheral oxygen saturation; and chi-square tests for comparing the incidence of pulmonary complications between groups. Discussion Conventional Chest Physiotherapy and intermittent positive airway pressure breathing are widely indicated for people with pleural effusion and Chest drains; however, no studies have evaluated the real benefit of this type of treatment. Our hypothesis is that optimised lung expansion achieved through the application of intermittent positive airway pressure will accelerate the reabsorption of pleural effusion, decrease the duration of Chest drainage and respiratory system impairment, reduce the length of hospital stay, and reduce the incidence of pulmonary complications.
Adriana Claudia Lunardi - One of the best experts on this subject based on the ideXlab platform.
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efficacy of the addition of positive airway pressure to conventional Chest Physiotherapy in resolution of pleural effusion after drainage protocol for a randomised controlled trial
Journal of Physiotherapy, 2015Co-Authors: Elinaldo Da Conceicao Dos Santos, Adriana Claudia LunardiAbstract:Abstract Introduction Chest drainage for pleural effusion can cause pain and changes in respiratory function. It can also increase the risk of pulmonary complications and impair functional ability, which may increase length of hospital stay and the associated costs. For these reasons, surgical and clinical strategies have been adopted to reduce the duration of Chest drainage. Objectives To evaluate the efficacy of the addition of intermittent positive airway pressure applied by the Muller reanimator via a rubber facial mask versus conventional Physiotherapy on the duration of Chest drainage (primary objective), and its effect on the recovery of respiratory function, length of hospital stay and incidence of pulmonary complications (secondary objectives). Design Randomised, controlled trial. Participants and setting Inpatients with pleural effusion, aged over 18 years, who have had Chest drainage in situ for Intervention and control groups After initial assessments of lung function, 156 patients will be randomised into a positive airway pressure group (positive airway pressure at 15 cmH 2 O plus conventional Chest Physiotherapy), a conventional Chest Physiotherapy group (conventional Chest Physiotherapy plus non-therapeutic positive airway pressure at 4 cmH 2 O) or a control group (non-therapeutic positive airway pressure at 4 cmH 2 O). All groups will receive treatment three times per day for 7 consecutive days. Measurements A blinded assessor will conduct all assessments. Peripheral oxygenation and Chest drainage output will be measured over 7 consecutive days. Lung function will be re-assessed on Day 4 and Day 8. The criteria for removal of the Chest drain will be a transudate output ≤ 200ml over 24hours and full lung expansion on Chest radiography, as assessed by a blinded physician. Duration of Chest drainage, length of hospital stay, and any pulmonary complications diagnosed during hospitalisation will be recorded. Analysis Intention to treat using: survival analysis for duration of Chest drainage, and length of hospital stay; analysis of variance for Chest-tube output, lung function and peripheral oxygen saturation; and chi-square tests for comparing the incidence of pulmonary complications between groups. Discussion Conventional Chest Physiotherapy and intermittent positive airway pressure breathing are widely indicated for people with pleural effusion and Chest drains; however, no studies have evaluated the real benefit of this type of treatment. Our hypothesis is that optimised lung expansion achieved through the application of intermittent positive airway pressure will accelerate the reabsorption of pleural effusion, decrease the duration of Chest drainage and respiratory system impairment, reduce the length of hospital stay, and reduce the incidence of pulmonary complications.
Brenda M Button - One of the best experts on this subject based on the ideXlab platform.
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Chest Physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
Archives of Disease in Childhood, 2004Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony OlinskyAbstract:Background: Postural drainage Chest Physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. Aims: To compare standard postural drainage Chest Physiotherapy (SPT) and a modified Physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. Methods: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four Chest Physiotherapy sessions were administered (day 1: MPT–SPT; day 2: SPT–MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the Physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30° head-down tilt). Results: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. Conclusions: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.
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Chest Physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
Archives of Disease in Childhood-education and Practice Edition, 2004Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony OlinskyAbstract:BACKGROUND: Postural drainage Chest Physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. AIMS: To compare standard postural drainage Chest Physiotherapy (SPT) and a modified Physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. METHODS: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four Chest Physiotherapy sessions were administered (day 1: MPT-SPT; day 2: SPT-MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the Physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30 degrees head-down tilt). RESULTS: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. CONCLUSIONS: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.
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Chest Physiotherapy in infants with cystic fibrosis to tip or not a five year study
Pediatric Pulmonology, 2003Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky, Michael Ditchfield, Ian StoryAbstract:There is controversy about the need for postural drainage Physiotherapy in asymptomatic infants with cystic fibrosis (CF). We aimed to compare the effectiveness of standard postural drainage Chest Physiotherapy (SPT) with a modified Physiotherapy regimen without head-down tilt (MPT) in young infants with CF. Twenty newly diagnosed infants with CF (mean age, 2.1 months; range, 1–4) were randomized to SPT or MPT. Parents kept a detailed symptom and treatment diary for the following 12 months. Serial Chest radiographs, taken at diagnosis, 12 months, 2½ years, and 5 years after diagnosis, were assessed using the Brasfield score. Pulmonary function tests were compared between groups after 5 years. Of the 20 infants, 16 (80%) completed the review at 12 months, and 14 (70%) at 2½ and 5 years. Patients receiving SPT had more days with upper respiratory tract symptoms than those on MPT (70 ± 32.8 vs. 37 ± 24.9 days; P = 0.04) and required longer courses of antibiotics (23 ± 28.5 vs. 14 ± 11.2 days; P = 0.05). Chest x-ray scores were similar at diagnosis but were worse at 2½ years for those receiving SPT (P = 0.03). Forced vital capacity and forced expired volume in 1 sec (FEV1) at 5–6 years was lower for SPT than for MPT (P < 0.05). In conclusion, MPT was associated with fewer respiratory complications than SPT in infants with CF. Pediatr Pulmonol. 2003; 35:208–213. © 2003 Wiley-Liss, Inc.
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benefits of music therapy as an adjunct to Chest Physiotherapy in infants and toddlers with cystic fibrosis
Pediatric Pulmonology, 2000Co-Authors: Melissa C Grasso, Brenda M Button, Dianne J Allison, Susan M SawyerAbstract:Routine Chest Physiotherapy (CPT) is an important component of prophylactic therapy in children with cystic fibrosis (CF) and requires a significant commitment of time and energy. It is important, therefore, to establish CPT as a positive experience. In this study, we evaluated the effect of recorded music as an adjunct to CPT. Specifically, we compared the use of newly composed music, familiar music, and the family's usual routine on children's and parents' enjoyment of CPT and the parents' perception of time taken to complete CPT. Enjoyment and perception of time were evaluated via questionnaires designed specifically for this study. Participants were caregivers of one or more children with CF who were aged between 4(1/2) months and 24 months at the commencement of the clinical trial and required CPT on a daily basis. Participants were randomly allocated into control and treatment groups. Control group participants experienced two conditions consecutively: no audiotape (NT; control) and familiar music tape (FT; placebo control). Treatment group participants were given the treatment music tape (TT), which was composed and compiled by a music therapist. After baseline assessment, evaluation occurred at two 6-weekly intervals. Children's enjoyment increased significantly after use of the TT (+1. 25 units) compared to NT (-0.5 units; P = 0.03), as did parents' enjoyment (+1.0 vs. 0.0 units, P = 0.02). Children's enjoyment did not change significantly after use of the FT (+0.75 units) compared to NT (n.s.). Likewise, parents' enjoyment did not change significantly after use of the FT (+1.0 units, n.s.). There was no change in perception of time after use of the TT (-4.5 vs. +0.2 min, n.s.) or the FT (+3.3 min, n.s.). These results indicate that children's and parents' enjoyment of CPT significantly increased after the use of specifically composed and recorded music as an adjunct. We therefore recommend that recorded music, such as that provided in this study, be given to parents to use as an adjunct to CPT when their young children are diagnosed with CF, in order to assist the establishment of a positive routine.
Anthony Olinsky - One of the best experts on this subject based on the ideXlab platform.
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Chest Physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
Archives of Disease in Childhood, 2004Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony OlinskyAbstract:Background: Postural drainage Chest Physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. Aims: To compare standard postural drainage Chest Physiotherapy (SPT) and a modified Physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. Methods: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four Chest Physiotherapy sessions were administered (day 1: MPT–SPT; day 2: SPT–MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the Physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30° head-down tilt). Results: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. Conclusions: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.
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Chest Physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
Archives of Disease in Childhood-education and Practice Edition, 2004Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony OlinskyAbstract:BACKGROUND: Postural drainage Chest Physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. AIMS: To compare standard postural drainage Chest Physiotherapy (SPT) and a modified Physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. METHODS: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four Chest Physiotherapy sessions were administered (day 1: MPT-SPT; day 2: SPT-MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the Physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30 degrees head-down tilt). RESULTS: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. CONCLUSIONS: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.
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Chest Physiotherapy in infants with cystic fibrosis to tip or not a five year study
Pediatric Pulmonology, 2003Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky, Michael Ditchfield, Ian StoryAbstract:There is controversy about the need for postural drainage Physiotherapy in asymptomatic infants with cystic fibrosis (CF). We aimed to compare the effectiveness of standard postural drainage Chest Physiotherapy (SPT) with a modified Physiotherapy regimen without head-down tilt (MPT) in young infants with CF. Twenty newly diagnosed infants with CF (mean age, 2.1 months; range, 1–4) were randomized to SPT or MPT. Parents kept a detailed symptom and treatment diary for the following 12 months. Serial Chest radiographs, taken at diagnosis, 12 months, 2½ years, and 5 years after diagnosis, were assessed using the Brasfield score. Pulmonary function tests were compared between groups after 5 years. Of the 20 infants, 16 (80%) completed the review at 12 months, and 14 (70%) at 2½ and 5 years. Patients receiving SPT had more days with upper respiratory tract symptoms than those on MPT (70 ± 32.8 vs. 37 ± 24.9 days; P = 0.04) and required longer courses of antibiotics (23 ± 28.5 vs. 14 ± 11.2 days; P = 0.05). Chest x-ray scores were similar at diagnosis but were worse at 2½ years for those receiving SPT (P = 0.03). Forced vital capacity and forced expired volume in 1 sec (FEV1) at 5–6 years was lower for SPT than for MPT (P < 0.05). In conclusion, MPT was associated with fewer respiratory complications than SPT in infants with CF. Pediatr Pulmonol. 2003; 35:208–213. © 2003 Wiley-Liss, Inc.
Islla Marreiros - One of the best experts on this subject based on the ideXlab platform.
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effect of positive airway pressure added to conventional Chest Physiotherapy in resolution of pleural effusion after drainage a randomised controlled trial
European Respiratory Journal, 2015Co-Authors: Elinaldo Da Conceicao Dos Santos, Joao Silva, Fernanda Melo, Marcus Titus Trindade De Assis Filho, Marcela Brito Vidal, Juliana De Souza Da Silva, Marcia Novais, Franklin Barbosa, Islla MarreirosAbstract:Chest Physiotherapy (CPT) is widely used in cases of pleural effusion treated by Chest drainage but there are few data about which approach is effective. Hypothesis: The non-invasive positive pressure accelerates the reabsorption of pleural effusion. Aim: To test the effects of non-invasive positive airway pressure added to CPT on resolution of pleural effusions after drainage. Methods: This trial enrolled 43 patients with pleural effusion and Chest drainage in situ for Results: Group I presented shorter Chest tube drainage and hospital stay of 2 days (p Conclusion: Non-invasive positive airway pressure added to conventional CPT promotes a faster resolution of pleural effusion in patients with Chest drainage.