Comparative Study of Two Different Approaches for Managing of Mechanically Ventilated Extremely Preterm Newborns

Aim: To compare between the effects of routine suctioning and positioning to that of chest physiotherapy on mechanically ventilated newborns.
Study Design: Prospective, randomized controlled study.
Place and Duration of Study: AL-jahra Hospital, Ministry of Health, Kuwait between January 2012 and April 2013.
Methodology: Sixty extremely preterm neonates with respiratory distress syndrome were enrolled in the study. They were mechanically ventilated. Their ages ranged from 4-6 days. They were divided into two equal groups (control and study). The control group received medical treatment, routine suctioning and positioning while the study group received the same medical treatment given to the control group in addition to the selected chest physical therapy program. Arterial blood gases (PaO2, PaCO2, pH) and vital signs (HR, RR, SAP, DAP) were measured. Cranial ultrasound and chest x-ray were done to diagnose any cerebral injuries or rib fractures. All measurements were recorded at baseline measurement, 2 days and 7 days post inclusion in the study.
Results: Significant improvement was recorded in arterial blood gases (PaO2, PaCO2, pH) and vital signs (HR, RR, SAP, DAP) for the study group after 2 and 7 days (P< 0.05). In addition to significant differences were observed between both groups in (PaO2, PaCO2, pH, HR, RR, SAP, DAP) in favor of the study one (P< 0.05). No adverse effects regarding to the incidence of rib fractures or cerebral injury were recorded in the study group.
Conclusion: Chest physiotherapy is an excellent supplement to the line of treatment of extremely preterm neonates who are mechanically ventilated with respiratory distress syndrome.