Randomized Comparison of Two Physiotherapy Regimens for Correcting Atelectasis in Ventilated Pre-term Neonates

Chest therapy using manual physiotherapy techniques is an integral part of treating atelectasis in pre-term ventilated neonates. The lung squeezing technique (LST) is used to restore homogeneous inflation of the lungs by means of small amplitude oscillatory chest wall compressions. We compared the effectiveness and safety of using LST with the conventional percussion and vibration (PDPV) protocol for correcting atelectasis in ventilated neonates. Fifty-six pre-term neonates were randomized into an experimental group (n = 26) treated with the lung squeezing protocol and a control group (n = 30) treated with the conventional percussion and vibration protocol. The groups were pre-stratified according to the mode of ventilation: high frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV). Results showed that LST was more effective for correcting lung atelectasis in pre-term neonates than PDPV. After the first therapy session, full lung re-expansion occurred in 81% of the LST group and in only 23% of the PDPV group (p < 0.001). Subgroup analysis showed the superiority of LST in both the CMV (p = 0.006) and HFOV subgroups (p = 0.006). There was no significant difference in haemodynamic disturbances when the LST group was compared to the PDPV group. LST was more effective than conventional PDPV for re-expansion of lung atelectases among the ventilated pre-term neonates in our study.