Short-Term Effects of Conventional Chest Physiotherapy and Expiratory Flow Increase Technique on Respiratory Parameters, Heart Rate, and Pain in Mechanically Ventilated Premature Neonates: A Randomized Controlled Trial.

Abstract

Background/Objectives: Prematurity is a leading cause of infant mortality and mechanical ventilation increases respiratory complication risk. The effects of secretion removal techniques in premature infants remain a topic of ongoing debate. The aim of the study is to compare two secretion removal techniques in premature infants on mechanical ventilation; Methods: The participants were randomized into conventional chest physiotherapy (CPT; n = 22) or expiratory flow increase technique (EFIT; n = 21) groups. Each participant completed four sessions on consecutive days with a minimum of one and a maximum of two sessions per day. We assessed peripheral oxygen saturation (SpO₂), heart (HR) and respiratory rates (RR), tidal volume (VT), and pain levels at specific time points: before the intervention, immediately after the intervention, 5 min after the intervention, and 10 min after the intervention. The partial Eta squared (ŋ_p²) was reported to measure the effect size; Results: HR and RR increased post-intervention in both groups (p < 0.001; HR ŋ_p² = 0.51; RR ŋ_p² = 0.38); post hoc comparisons showed EFIT group decreased RR from the first to last session (p = 0.045). Both groups exhibited increased VT and SpO₂ in all sessions (p < 0.001; VT ŋ_p² = 0.40; SpO₂ ŋ_p² = 0.50). The EFIT group had higher SpO₂ values (p = 0.013; ŋ_p² = 0.15) and lower pain scores (p < 0.001; ŋ_p² = 0.46) post-intervention compared to CPT; Conclusions: CPT and EFIT resulted in similar effects on short-term respiratory parameters and heart rate; however, EFIT had advantages, including lower RR, higher SpO₂, and reduced pain, suggesting it may be a more effective, comfortable neonatal respiratory treatment.