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Feasibility of high-frequency percussions in people with severe acquired brain injury and tracheostomy: an observational study
- Source :
- Monaldi Archives for Chest Disease (2024)
- Publication Year :
- 2024
- Publisher :
- PAGEPress Publications, 2024.
-
Abstract
- People with severe acquired brain injury (pwSABI) frequently experience pulmonary complications. Among these, atelectasis can occur as a result of pneumonia, thus increasing the chance of developing acute respiratory failure. Respiratory physiotherapy contribution to the management of atelectasis in pwSABI is yet poorly understood. We conducted a retrospective analysis on 15 non-cooperative pwSABI with tracheostomy and spontaneously breathing, hospitalized and treated with high-frequency percussion physiotherapy between September 2018 and February 2021 at the Neurological Rehabilitation Unit of the IRCCS “S.Maria Nascente - Fondazione Don Gnocchi”, Milan. Our primary aim was to investigate the feasibility of such a physiotherapy intervention method. Then, we assessed changes in respiratory measures (arterial blood gas analysis and peripheral night-time oxygen saturation) and high-resolution computed tomography lung images, evaluated before and after the physiotherapy treatment. The radiological measures were a modified radiological atelectasis score (mRAS) assigned by two radiologists, and an opacity score automatically provided by the software CT Pneumonia Analysis® that identifies the regions of abnormal lung patterns. Treatment diaries showed that all treatments were completed, and no adverse events during treatment were registered. Among the 15 pwSABI analyzed, 8 were treated with IPV® and 7 with MetaNeb®. After a median of 14 (I-III quartile=12.5-14.5) days of treatment, we observed a statistical improvement in various arterial blood gas measures and peripheral night-time oxygen saturation measures. We also found radiological improvement or stability in more than 80% of pwSABI. In conclusion, our physiotherapy approach was feasible, and we observed respiratory parameters and radiological improvements. Using technology to assess abnormal tomographic patterns could be of interest to disentangle the short-term effects of respiratory physiotherapy on non-collaborating people.
- Subjects :
- Brain injuries
tracheostomy
pulmonary atelectasis
respiratory therapy
Medicine
Subjects
Details
- Language :
- English
- ISSN :
- 11220643 and 25325264
- Database :
- Directory of Open Access Journals
- Journal :
- Monaldi Archives for Chest Disease
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.1c3cf0d1ed094b03a7094e6d236bc44e
- Document Type :
- article
- Full Text :
- https://doi.org/10.4081/monaldi.2024.2734