Study design (if review, criteria of inclusion for studies)
RCT
Participants
18 CF children, mean age 12 years (range 2.8-15 years) were recruited, with 9 in each group.
Interventions
Children were randomized either to receive physiotherapy or not following anesthesia and intubation.
Outcome measures
Respiratory mechanics (C(rs) and R(rs)), tidal volume, and peak inspiratory pressure (PIP) were measured immediately before and after physiotherapy. FEV(1) was measured before and after surgery and post-operative physiotherapy requirements were recorded.
Main results
Both groups showed a non-significant decline in FEV(1) the day after surgery compared with pre-operative values (-5.8%: physiotherapy and -7.1%: control). Both PIP and R(rs) increased significantly following physiotherapy (within- and between-groups, P < 0.05). In addition, there was a significant within-group reduction in C(rs) after physiotherapy which approached significance between-groups (P = 0.07). There were no significant within- or between-group differences in tidal volume following treatment in either group.
Authors' conclusions
The unanticipated decline in respiratory function immediately following physiotherapy was short-lived and not discernible in longer term outcomes measured by FEV(1) or physiotherapy requirements post-operatively. If respiratory physiotherapy under anesthesia is considered necessary and the benefits of removing secretions are deemed to outweigh the short-term risks, it may be necessary for the anaesthetist to consider modifying ventilatory support to counteract any short-term negative effects of the treatment.
Keywords: Adolescent; Anaesthesia; Child; Intraoperative Care; non pharmacological intervention - devices OR physiotherapy; non pharmacological intervention - surg; pharmacological_intervention;