Outcomes of parent education programme in regular respiratory physiotherapy in prolonged mechanical ventilated child via tracheostomy after home- discharge

Abstract

The purpose of this research is to investigate the results of parental education and the systematic application of respiratory physiotherapy in the case of a child with tracheostomy and prolonged mechanical ventilation at home. Physiotherapy intervention included parent training in the application of physiotherapy techniques and the application of systematic respiratory physiotherapy for a period of 5 months. The child was evaluated before and after the intervention by completing a questionnaire. The measurements made are pulse oximetry before and after each physiotherapy session, arterial blood gases and nocturnal oximetry at the end of each month. An improvement in oxygen saturation (SaO₂) was observed, with statistically significant differences between pre-post physiotherapy measurements (p<0.05). Throughout the intervention, blood PO₂, PCO₂, HCO₃– was improved, but there was no statistically significant difference between the measurements (p>0.05). Also, statistically significant differences (p<0.05) occurred in nighttime oximetry throughout the intervention, which augmented the interruption of oxygen delivery during sleep. Completing the assessment questionnaire showed improvement in the family’s psychological profile and quality of life. The contribution of respiratory physiotherapy to children with tracheostomy and prolonged mechanical ventilation is considered to be very important both in the Intensive Care Unit of Children and after hospital discharge. Further research is needed to clarify its effects on improving pulmonary function, preventing respiratory infections, reducing hospital admission, releasing children from the ventilator and / or tracheostomy, and improving their quality of life.

Keywords: Pediatric tracheostomy, mechanical ventilation, tracheostomy parental education, chest physiotherapy.