Respiratory Therapy and Newborn Pain: Comparison Between Techniques
Condition: Newborn Pain; Respiratory Therapy Techniques
Study type: Interventional

Summary: 
      This study intend to assess the pain intensity of newborns in neonatal intensive care unit
      (NICU) undergoing different techniques of respiratory therapy and compare these procedures. A
      randomized controlled clinical trial and blind trial with newborns admitted to NICU. The
      babies were categorized according to gestational age , age, weight, diagnosis, support and
      signs of respiratory distress. Then, they were allocated by lot to come from one of 3 groups:
      G1 - control, G2 - undergoing physical therapy; G3 - received the thoracoabdominal
      rebalancing. Each newborn received just one physical therapy session in that they were
      assessed before one of the three procedures (T1), immediately after (T2) and after 15 minutes
      (T3). This evaluation found cardiorespiratory parameters (oxygen saturation, heart and
      respiratory rate) and three specific scales for pain assessment (NIPS, NFCS and PIPP). The
      hypothesis is that newborns hospitalized in intensive care unit did not show pain when
      undergoing respiratory therapy.
    


Intervention name(s): Thoracoabdominal rebalancing; Physical Therapy
Intervention type(s): Procedure; Procedure
Intervention description(s): In this group the infants received four handlings thoracoabdominal rebalancing, in order: 1) 5min support thoracoabdominal, in which the therapist leaned one hand on the lower chest and upper abdomen of the newborn, with some of its fingers on the ribs, pulling them gently down and keeping them in that position during inspiration, 2) more than 5 minutes of abdominal support, carried by hand in the lower abdomen of the newborn, applying light pressure during inspiration enough to be beaten by the diaphragm of the newborn and not to increase the use of accessory muscles of inspiration, 3) 5min support ileo-costal, by a slight manual pressure of the physiotherapist on the lateral chest and abdomen of the newborn, maintained throughout inspiration and 4) finally ran up 5min ginga thoracic maneuver slight manual pressure on the lower chest of newborns, directing the costal movement during expiration, now an then the other hemithorax.; In this group the newborns were first submitted to the mechanical vibrator applied over a diaper, on the chest of newborns for 5 min, as follows: 1min 1min right hemithorax and the left hemithorax, both previously, followed 30 seconds in the lateral aspect of each hemithorax; more than 1min in each hemithorax in the posterior region. The mechanical vibrator was performed subsequent to manual chest compression, using light hand pressure on the chest of newborns, respecting the compliance of the chest. The chest compression was applied for 2min 2min in the right hemithorax and left-sided chest, above, and 1 minute on each side, another 2 minutes on the back of each hemithorax, totaling 10 minutes of compression. Next to chest compression, mechanical vibration was applied for 5 min in the same topographical sequence described.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Newborn Pain; Respiratory Physiotherapy; Neonatal intensive care unit