Influence of Techniques of Chest Physiotherapy in the Pediatric Intensive Care

Study Overview
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Brief Summary
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The purpose of this study is to compare the effect of the autogenic drainage and the intrapulmonary percussive ventilation on the levying of the lung atelectasis, by means of the thoracic imaging (thoracic ultrasound and radiography), at the intubated or extubated child with the ventilatory support.

Official Title
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Influence of Techniques of Chest Physiotherapy on the Respiratory Status and the Hemodynamic Impact in the Pediatric Intensive Care

Conditions
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Atelectasis

Intervention / Treatment
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* Device: Autogenic drainage
* Device: Intrapulmonary percussive ventilation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Child < 10 kg Hospitalization in the pediatric intensive care Presence of an atelectasis to the radiography and/or to the lung ultrasound Presence of an invasive ventilation or a non-invasive ventilation Criteria of cardio-respiratory stability met Exclusion Criteria: Absence of the physiotherapist and the radiologist referents (by ex: at night) Prematurity Neuromuscular disease Ventilation by high-frequency oscillation Extraphysical Assistance Patient cardiac post-surgery with closure postponed from the thorax. In the closure of the thorax, the patient becomes eligible Intracranial pressure > 20 mmHg or clinical signs of intracranial high blood pressure

Ages Eligible for Study
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Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intubated infant<br> | Device: Autogenic drainage<br>* The manual technique of the chest physiotherapy to move the secretions<br>Device: Intrapulmonary percussive ventilation<br>* The instrumental technique of the chest physiotherapy to move the secretions<br>|
| Experimental: Extubated infant<br> | Device: Autogenic drainage<br>* The manual technique of the chest physiotherapy to move the secretions<br>Device: Intrapulmonary percussive ventilation<br>* The instrumental technique of the chest physiotherapy to move the secretions<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline Atelectasis scores at 20 min | Each atelectasis has a thoracic ultrasound | Baseline and at 20 min | 
| Change from baseline cardiac frequency at 20 min, 30 min, 50 min, 80 min | Stability of the parameters | Baseline and at 20 min, 30 min, 50 min, 80 min | 
| Change from baseline respiratory frequency at 20 min, 30 min, 50 min, 80 min | Stability of the parameters | Baseline and at 20 min, 30 min, 50 min, 80 min | 
| Change from baseline systolic blood pressure at 20 min, 30 min, 50 min, 80 min | Stability of the parameters | Baseline and at 20 min, 30 min, 50 min, 80 min | 
| Change from baseline diastolic blood pressure at 20 min, 30 min, 50 min, 80 min | Stability of the parameters | Baseline and at 20 min, 30 min, 50 min, 80 min | 
| Change from baseline oxygen saturation at 20 min, 30 min, 50 min, 80 min | Stability of the parameters | Baseline and at 20 min, 30 min, 50 min, 80 min | 
| Change from baseline expiratory CO2 at 20 min, 30 min, 50 min, 80 min | Stability of the parameters | Baseline and at 20 min, 30 min, 50 min, 80 min | 
| Compare the atelectasis scores | Compare the atelectasis scores between thoracic ultrasound and chest x-ray | Baseline between thoracic ultrasound and chest x-ray | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of unexpected events | Pain, desaturation, accidentally extubation | At 20 min |