The Efficiency of Chest Physiotherapy Applied in a Different Order
Condition: Respiratory Disease
MeSH terms: Respiratory Tract Diseases; Respiration Disorders
Study type: Interventional

Summary: 
      This study intends to compare the impact of chest physiotherapy applied with two different
      methods on physiologic parameters in children hospitalized in the intensive care unit. In the
      intensive care unit where the study was conducted, the patients who have a respiratory
      disorder and receive supplemental oxygen therapy with non-invasive mechanical ventilation or
      an oxygen mask are first administered an inhaler drug therapy placed in the physician's
      order. It is followed by chest physiotherapy and then oropharyngeal and nasopharyngeal
      aspiration. However, in practice rendered by the researcher, it is suggested that when chest
      physiotherapy and aspiration are administered in the first place and then followed by an
      inhaler drug therapy, it might have a more positive impact on the patient's physiologic
      parameters. For this reason, it is intended to compare the efficiency of chest physiotherapy
      applied in a different order.
    

Detailed description: 
      42 children who complied with the inclusion criteria will be included in the study. The
      mother or father of the children hospitalized in the pediatric intensive care unit of the
      hospital where the study is conducted will be given information about the study and asked to
      sign the "Informed Voluntary Consent Form". After the family's approval, they will be asked
      to fill out the "Parent Introductory Information Form".

      The randomization method will be used to create the control group and the study group.
      Children to be included in the study will be placed in the groups with the randomized
      controlled method with 21 children in each group. The randomization of the study will be made
      with the online program available at the URL address https://www.randomizer.org/. Before
      entering the sample size in the program, lots will be drawn, and the 1st set will be assigned
      to the control group, and the 2nd set will be assigned to the study group. In order to
      determine in which group the children involved in the study will be placed, numbers from 1 to
      42 will be entered into the program without repetition. Children that will constitute the
      study group through the program will be randomly distributed into 2 groups.

      The control group (n=21) will be administered the inhaler drug routinely administered in the
      intensive care unit where the study is conducted and then receive chest physiotherapy
      (tapotement or vibration), then nasopharyngeal and oropharyngeal aspiration. The study group
      (n=21) will first receive chest physiotherapy (tapotement or vibration) and aspiration,
      followed by inhaler drug therapy.

      The "Patient Data Collection Forms" of both groups will be filled out. Chest physiotherapy
      will follow the "Tapotement and Vibration Application Procedure," and aspiration will follow
      the "Nasopharyngeal and Oropharyngeal Aspiration Application Procedure". The "Patient
      Physiologic Parameter Assessment Form" information will be recorded before the application
      and 30 minutes after the application. It is known that the stress hormones epinephrine and
      norepinephrine half-life is 1-3 minutes, and it is believed that after a stressful invasive
      intervention, the release of stress hormones increases but turns back to their normal levels
      in 15-20 minutes (Puntillo et al. 2001). Based on this information, vital findings will be
      recorded in the "Patient Physiologic Parameter Assessment Form" after 30 minutes.

      Obtained data will be evaluated using necessary statistical tests in the computer
      environment. Evaluation methods will be selected considering if data is distributed
      homogenously. If it has a homogenous distribution, parametric tests will be used. If it does
      not have a homogenous distribution, non-parametric methods will be used.
    

Intervention name(s): Chest Physiotherapy- Aspiration- Inhaler drugs group
Intervention type(s): Other
Intervention description(s): In the intensive care unit where the study was conducted, the patients who have a respiratory disorder and receive supplemental oxygen therapy with non-invasive mechanical ventilation or an oxygen mask are first administered an inhaler drug therapy placed in the physician's order. It is followed by chest physiotherapy and then oropharyngeal and nasopharyngeal aspiration. However, in practice rendered by the researcher, it is suggested that when chest physiotherapy and aspiration are administered in the first place and then followed by an inhaler drug therapy, it might have a more positive impact on the patient's physiologic parameters.
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Double (Care Provider, Investigator)
Primary purpose: Supportive Care
Keywords: chest physiotherapy; aspiration; inhaler drugs; child; nurse