Avaliação dos parâmetros fisiológicos em recém nascidos pré-termo em ventilação mecânica após procedimentos de fisioterapia neonatal

The physiotherapy in the Neonatal Intensive Care Unit can be considerated a new kind of therapy. It's believed that the neonatal physiotherapeutic care is able to provide a stable heart and respiratory rate, blood pressure, and oxygen saturation, as well as maintain the corporal temperature, providing the functional maintenance of brain circulation in newborns and also of air ways with minimal turbulent flow and without lung secretion, allowing the increase on permeability and the decrease of air ways intrinsically risk factors that contribute to increase the lung resistance and decrease in physiological events of gases exchange. Other authors show injurious effects of physiotherapy regarding the neonatal population. This controversy about the neonatal respiratory physiotherapy induced to study the effects of such procedure in physiologic parameters. The objective was this paper considers the effects of neonatal physiotherapy practice on the heart and respiratory rate, arterial pressure, oxygen saturation and temperature in preterm newborn babies submitted to mechanical ventilation. A prospective study about the neonatal population of the Hospital Municipal Universitario de Sao Bernardo do Campo, was carried out from January to December of 2005. A descriptive analysis of data was performed for the results. The Anova test, a model of variance analysis to repetitive measure, was done to compare if average values before and after the physiotherapy are statistically significant. A Newman-Keuls test was performed right away to heart and respiratory rate and oxygen saturation, and the T-test to arterial pressure and temperature. The significance level considered was 5%. The sample consisted of 27 preterm newborns, treated with invasive mechanical ventilation and interventionist procedures of physiotherapy. A reduction of heart and respiratory rate along the clinical sessions of neonatal physiotherapy was observed, with maintenance of the arterial pressure, increase of the SpO2 and reduction of the temperature. However, there have been no clinical repercussions in this population after interventionist procedure of physiotherapy. Many factors can influence on stability of physiological parameters, as well as monitoring each one of them, such as the neonatal physiology characteristics, enviroment factors and the type of intervention. In other words, the physiotherapy that is adjusted to each newborn situation, will determine the possible results regarding physiologic parameters in preterm newborns. In conclusion, the neonatal physiotherapy was shown to be a suitable therapeutical procedure for the treatment of preterm newborns.