Educação em saúde: efeito de modalidades fisioterapêuticas na assistência à criança traqueostomizada

Abstract

Evaluate whether manual hyperinflation maneuver with chest compression (bag squeezing) has a better impact on stability on vital signs than vibrocompression thoracic in spontaneously breathing tracheostomized children. Methods: A longitudinal prospective, non-randomized clinical trial was conducted. The sample consisted of 33 children randomly distributed into two groups according to the technique used (G1; n=16) manual hyperinflation maneuver with chest compression and vibrocompression thoracic (G2; n=17). In the manual hyperinflation maneuver with chest compression, all children received a O2 supply at 5 L/minute, and in vibrocompression thoracic maneuver, they received the usual O2 supply they were already using – otherwise, they remained in room air. The following variables were analyzed: peripheral oxygen saturation (SpO2), heart rate (HR), respiratory rate (RR), systemic arterial pressure (SBP), and mean arterial pressure (MAP). All variables were checked before the procedure and 15 minutes after the procedure. Variables were analyzed using descriptive and inferential statistics. Data were replicated in an absolute and relative way. The analysis of the inferential part of the statistical crossings was carried out to verify the variation of the results between the analyzed groups, aiming to know the relationship between them. One variable was parameterized as dependent and the other as independent to analyze the prediction between them. The Kruskal-Wallis method was used to test a hypothesis. We analyzed the correlations between variables and the degree of explanation of the dependent variable towards independent variables. The result was considered significant when p<0.05, characterizing the significance between the studied groups. All tests include an alpha error of 5% and a reliability of 95%. Results: In the inferential statistics analysis, the inferential crossings showed that when comparing the Bag-squeezing Group x Vibrocompression with their respective variables, the p-value was as follows: peripheral oxygen saturation (%) 0.105 x 0.434; heart rate 0.300 and 0.588; respiratory rate 0.763 and 0.836; systolic blood pressure 0.300 and 0.756; diastolic blood pressure 0.985 and 0.179; mean blood pressure 0.678 and 0.459. The analysis showed that the observed p values do not have statistically significant differences between the two moments (M1 and M2), that is, the variables are not dependent. Conclusion: Manual hyperinflation with chest compression had better clinical repercussions, however there was no statistical significance between the groups, both techniques proved to be safe. Currently, publications demonstrate controversies regarding the benefits of respiratory physiotherapy in all areas. Studies aimed at spontaneously breathing tracheostomized children were not found in recent literature, so that this research can contribute to the construction of knowledge about the safest physical therapy treatment and its actual benefits for this audience.