Abstract
Objectives To evaluate the incidence of post-extubation atelectasia (PEA) and brain injury in newborns treated with the expiratory flow increase (EFI) method of chest physiotherapy, the most common chest physiotherapy technique in France. Design Retrospective study. Setting A large level-3 regional neonatal intensive care unit. Population A cohort of all consecutive neonates admitted over a 17-month period who developed acute or chronic lung disease and required conventional mechanical ventilation. Intervention Chest physiotherapy using the EFI technique, initiated early after birth, and performed three times daily until at least 24 hours after extubation. Outcome measures PEA and brain lesions (intraventricular haemorrhage and cystic periventricular leukomalacia). Chest X-rays were taken 24 hours after extubation and routine head ultrasounds were performed during the course of hospitalization. Results Among the 362 infants submitted to chest physiotherapy, nine developed PEA (2%; 95% CI = 1–4.0%). PEA was highly predictive of extubation failure since six of the nine infants with PEA were reintubated (67%), whereas only 33 among the 353 infants without PEA required reintubation (9%). Intraventricular haemorrhage and cystic periventricular leukomalacia were documented in 59 (16%) and 5 (1%) infants, respectively. In 54 of the 59 infants (92%) with intraventricular haemorrhage and all infants with periventricular leukomalacia, brain lesions existed prior to the initiation of chest physiotherapy. Conclusion The incidence of PEA in babies treated with the EFI technique is low and chest physiotherapy does not appear to increase the incidence of brain lesions above the percentage normally seen in newborns with respiratory failure. A randomized controlled trial is urgently needed to further study the efficacy and safety of the EFI method in the prevention of neonatal post-extubation atelectasis and extubation failure.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
