Physiotherapy on Pneumonia in Childrens
Condition: Pneumonia
MeSH terms: Pneumonia
Study type: Interventional

Summary: 
      The children's susceptibility to respiratory problems is due to their anatomical and
      physiological characteristics; therefore, children with more severe clinical conditions may
      undergo invasive mechanical ventilation (IMV). However, its prolonged use favors tracheal
      injury, barotrauma and / or volutrauma, decreased cardiac output and oxygen toxicity, and
      especially the accumulation of respiratory secretions due to ineffective cough due to
      non-closure of the glottis and damage in the transport of mucus by the presence of the
      tracheal tube. Thus, triggering the development of mechanical ventilation-associated
      pneumonia (VAP), which is defined as a pulmonary infection that arises 48 to 72 hours after
      endotracheal intubation and the institution of invasive mechanical ventilation. As a
      consequence, respiratory work is performed by IMV, reducing the work exerted by spontaneous
      ventilation, causing neuromuscular disorders after 5 to 7 days of IMV, changes in muscle
      mechanics, reducing the capacity of the diaphragm to generate force, thus contributing to
      changes in modulation autonomic heart rate, changes in muscular trophism, generating physical
      deconditioning due to weakness and, finally, an increase in the length of hospitalization and
      immobilism. From this perspective, early mobilization emerges as a rehabilitation mechanism
      to improve muscle strength and joint mobility, as well as to improve lung function and
      respiratory system performance, as well as improved autonomic heart rate modulation. It can
      facilitate the weaning of IMV, reducing hospitalization time and promoting quality of life
      after discharge.
    

Detailed description: 
      We will select 40 volunteers of both sexes and between the ages of 1 and 8 years, with
      clinical diagnosis of VAP hospitalized in an intensive care unit, which will be submitted,
      together with the hospital protocol, the protocol of early mobilization. For these patients
      will be performed physical therapy evaluation in the pre-protocol period, on the second and
      fourth day of application of the protocol and 1 week at the end of the proposed protocol. For
      statistical analysis will be compared the pre and post-treatment data found in the
      evaluations and tabulated in a Microsoft Excel worksheet. BioStat 5.2 software will be used
      to analyze the results, and the choice of tests for this will depend on the types of
      distributions found and the homogeneity of the variables.
    

Intervention name(s): Rehabilitation; Chest physical therapy
Intervention type(s): Other; Other
Intervention description(s): physical therapy exercise; chest physical therapy exercise
Other intervention name(s): physical therapy
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: randomized clinical trial
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Other
Keywords: Pneumonia, Ventilator-Associated; Mechanical ventilation; Physical therapy