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Chest Physiotherapy

Chest physiotherapy is a treatment for newborns to help them clear mucus from their lungs. It is often used in addition to medical therapy for babies with lung problems.

The lungs normally produce a certain amount of mucus (also called phlegm or sputum). The primary function of mucus is to trap irritants, dust particles, bacteria, or other debris that a person may breathe. Thus, it helps protect the delicate tissue inside the lung from irritation or infection. Cells in the lung lined with hair-like structures called cilia gently sweep the mucus out of the lung. The person then coughs it up.

Babies with certain respiratory problems or infections make too much mucus. This can clog the lungs and cause difficulty breathing. Doctors will run tests to look for the cause of the breathing problem and treat it with medications such as antibiotics or steroids. Chest physiotherapy is used in addition to the medical treatments.

Chest physiotherapy is usually started in the hospital in the NICU (neonatal intensive care unit). In some cases, the healthcare team may instruct the parent to perform certain types of chest physiotherapy once the baby is discharged home. If this occurs, they will give the parent detailed instructions on what to do and how often to do it.

The goals of chest physiotherapy include:

  • Helping a baby move mucus out of their lungs
  • Improving oxygen levels
  • Reducing a baby’s need for machines to help them breathe
  • Preventing mucus blockage of a breathing tube already in place. This then decreases having to change a breathing tube too often, which decreases the amount of time that a baby has low oxygen levels
  • Helping a baby who has recently had their breathing tube removed to breathe normally on their own

Reference Articles

How Chest Physiotherapy is Performed

In the hospital, chest physiotherapy includes the following:

  • Gentle active vibrations – a respiratory therapist uses the fingers of one hand to quickly rub a baby’s chest while supporting the child’s head with the other hand. There is very little pressure placed on the child’s chest during this treatment.
  • Suctioning – this is performed after the active vibrations in newborns that have a breathing tube. A machine helps suck the mucus secretions from the lungs through the breathing tube.
  • Saline installation – placing saline in the breathing tube to help wash out mucus while suctioning.
  • Placing the baby in a position that allows mucus to drain from their lungs more easily.

At home chest physiotherapy includes:

  • Chest percussion – using a special tool called a percussing cup, the parent taps specified areas on the child’s chest or back continuously for two to four minutes. This should not be painful.
  • Positioning the child to allow drainage of mucus

Diseases Which Chest Physiotherapy Can Help Treat

Chest physiotherapy may be used in many different types of lung conditions that include difficulty breathing and thick mucus, such as:

  • Cystic fibrosis – a genetic condition which causes build-up of mucus in the lungs
  • Lung infections
  • Partial or complete collapse of a lung
  • Infants who have breathed in meconium (first stool passed by the infant, sometimes passed in the womb prior to birth)
  • Bronchiolitis – a viral infection common in babies and toddlers

Complications of Chest Physiotherapy

A doctor will not recommend chest physiotherapy unless they believe that the benefits of the treatment outweigh potential risks. Here are some possible complications:

  • Brain bleeds – this complication occurs mostly in preterm infants. During normal development in the womb, the blood vessels of the brain strengthen in the last ten weeks of pregnancy. If a child is born too early, the blood vessels are fragile. Thus, movement such as occurs in chest physiotherapy runs the risk of causing the fragile vessels to burst and cause of bleed of the brain.
  • Encephaloclastic porencephaly – a very rare brain lesion which can occur with trauma in the womb or early days of life

Respiratory physiotherapy is a necessary speciality that provides a key role in management and treatment of children with respiratory diseases.

 
 
 

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