早产儿手动胸腔稳定术后膈超声:临床试验

Q4 Medicine Fisioterapia em Movimento Pub Date : 2023-01-01 DOI:10.1590/fm.2023.36132
Marimar Goretti Andreazza, Cristiane Nogueira Binotto, Regina Paula Guimarãens Vieira Cavalcante da Silva, Silvia Valderramas, Monica Nunes Lima
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引用次数: 0

摘要

手动胸腔稳定操作(MRCSM)是一种物理治疗干预,促进膈肌相邻区域的稳定,促进该肌肉的收缩和呼吸工作。目的通过横膈膜超声评价早产儿MRCSM前后膈肌移位情况。方法临床试验前后用膈超声评价MRCSM对膈移位幅度的影响。结果48例平均胎龄为33.0±2.8周,平均出生体重为1904.1±708.9 g的早产儿。新生儿分为三组:无呼吸窘迫综合征(RDS);n = 26), RDS (n = 15)和呼吸暂停(n = 7)作为入院新生儿重症监护病房(NICU)的原因。无RDS或呼吸暂停的新生儿膈移位和增厚的测量结果相似,MRCSM后膈移位幅度显著增加(p <0.001;效应量>0.68),呼气时膈肌增厚较少。隔膜增厚分数为0.50(0.33 ~ 0.72),隔膜增厚率为0.04(0.03 ~ 0.07)。这些测量结果显示,RDS或呼吸暂停的存在与否没有显著差异(p >0.05)。与基线相比,心率(p = 0.30)、呼吸频率(p = 0.79)和外周血氧饱和度(p = 0.17)均无显著变化。结论MRCSM有效、安全,可增加1周龄早产儿膈肌偏移幅度和厚度,无论是否存在RDS或呼吸暂停作为入院NICU的原因。
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Diaphragm ultrasound after manual rib cage stabilization maneuver in premature newborns: clinical trial
Abstract Introduction The manual rib cage stabilization maneu-ver (MRCSM) is a physical therapy intervention that promotes stabilization of the zone of apposition of the diaphragm, facilitating the contraction of this muscle and the work of breathing. Objective To evaluate by diaphragm ultrasound the diaphragmatic excursion in premature newborns before and after MRCSM. Methods Before-after clinical trial assessing by diaphragm ultra-sound the effectiveness of MRCSM in the amplitude of diaphragmatic excursions. Results The study sample consisted of 48 premature newborns born at a mean gestational age of 33.0 ± 2.8 weeks with a mean birth weight of 1,904.1 ± 708.9 grams. The newborns were classified in three groups: without respiratory distress syndrome (RDS; n = 26), with RDS (n = 15) and with apnea (n = 7) as a cause of admission to the neonatal intensive care unit (NICU). The measurements of diaphragmatic excursion and thickening were similar in newborns without or with RDS or apnea and there was a significant increase in the amplitude of diaphragmatic excursions after MRCSM (p < 0.001; effect size > 0.68) and less diaphragmatic thickening at exhalation in all of them. The diaphragm thickening fraction was 0.50 (0.33 - 0.72), and the diaphragm thickening rate was 0.04 (0.03 - 0.07). These measurements showed no significant variation with the presence or absence of RDS or apnea (p > 0.05). No significant variations in heart rate (p = 0.30), respiratory rate (p = 0.79), and peripheral oxygen saturation, consid-ering newborns in ambient air (p = 0.17) compared with baseline. Conclusion The MRCSM was effective, safe, and increased the amplitude of diaphragmatic excursion and thickness in premature newborns at one week of age, regardless of the presence or absence of RDS or apnea as a cause of admission to the NICU.
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来源期刊
Fisioterapia em Movimento
Fisioterapia em Movimento Health Professions-Complementary and Manual Therapy
CiteScore
0.40
自引率
0.00%
发文量
78
审稿时长
13 weeks
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