Chest physiotherapy during anesthesia for children with cystic fibrosis: Effects on respiratory function

• Published in: Pediatric pulmonology 2007-12, Vol.42 (12), p.1152-1158
• Main Authors: Tannenbaum, E., Prasad, S.A., Dinwiddie, R., Main, Eleanor
• Format: Article
• Language: English
• Subjects: Adolescent; Anesthesia; Anesthesia, General - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child; Child, Preschool; cystic fibrosis; Cystic Fibrosis - physiopathology; Cystic Fibrosis - rehabilitation; Cystic Fibrosis - surgery; Errors of metabolism; Female; Follow-Up Studies; Forced Expiratory Flow Rates - physiology; general anesthesia; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; General aspects; Humans; Intraoperative Care - methods; Male; Medical sciences; Metabolic diseases; Miscellaneous hereditary metabolic disorders; pediatrics; physical therapy; Physical Therapy Modalities; Pneumology; respiratory function tests; respiratory therapy; Retrospective Studies; Thoracic Surgical Procedures; Thorax; Time Factors; Treatment Outcome
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.20710

Background Physiotherapists sometimes use elective surgical procedures for children with cystic fibrosis as an opportunity to perform physiotherapy treatments during anesthesia. These treatments theoretically facilitate direct endotracheal airway clearance and compensate for any post‐operative respiratory deterioration related to the anaesthetic and surgery. Materials, patients, and methods Children were randomized either to receive physiotherapy or not following anesthesia and intubation. Respiratory mechanics (Crs and Rrs), tidal volume, and peak inspiratory pressure (PIP) were measured immediately before and after physiotherapy. FEV1 was measured before and after surgery and post‐operative physiotherapy requirements were recorded. Results Eighteen patients, mean age 12 years (range 2.8–15 years) were recruited, with nine in each group. Both groups showed a non‐significant decline in FEV1 the day after surgery compared with pre‐operative values (−5.8%: physiotherapy and −7.1%: control). Both PIP and Rrs increased significantly following physiotherapy (within‐ and between‐groups, P