Influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratório
Ano de defesa: | 2017 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de Santa Maria
Centro de Ciências da Saúde |
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Reabilitação Funcional
|
Departamento: |
Ciências da Saúde
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://repositorio.ufsm.br/handle/1/19027 |
Resumo: | The preterm newborn presents a compromise in gas exchange due to pulmonary immaturity and the disadvantages in respiratory mechanics, presenting a higher risk of developing neonatal respiratory distress syndrome (RDS). The therapeutic position of newborns is a type of non-invasive intervention used in the treatment of respiratory diseases, benefiting the neurosensory and psychomotor development. In order to investigate the benefits of the different positions of the preterm newborn, the purpose of this study was to investigate the influence of the therapeutic positioning on the cardiorespiratory indicators and motor activity (MA) of the preterm newborn in use respiratory support invasive or not, during the acute phase of respiratory distress. It is a cross-sectional, observational, prospective study with a cross-over and randomized design, performed with preterm newborns with clinical syndrome of respiratory distress, birth weight below 2.000 g, between the 3rd and 7th day of life , in use respiratory support invasive (IMV) or noninvasive (NIV), between July 2016 and June 2017. The newborns were maintained at each body position (supine, prone, right and left lateral) for 45 minutes and cardiorespiratory indicators (heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2) and MA were recorded in intervals of 7 minutes, obtaining a total of five records in each position. Analysis of variance for repeated measures (ANOVA) and Friedman test, with post hoc tests were used to compare the cardiorespiratory indicators in the different positions. Pearson correlation was performed to verify statistical dependence between MA and HR, in the different positions. Statistical significance was considered when p<0.05. We studied thirty-three preterm newborns, 12 in the IMV group, with a gestational age (GA) of 27.0 (± 1.5) weeks and a weight of 837 (± 284) grams, and 21 in the NIV group, with a GA of 30.5 (± 1.9) weeks and weight of 1297 (± 416) grams. In the NIV group, there was a significant increase in SpO2 when compared to the prone positions vs. supine -1.1 (95%CI -2.0 to -0.2), p=0.017, prone vs. right lateral 1.1 (95%CI 0.2 to 1.9), p=0.015 and prone vs. left lateral 1.3 (95%CI 0.5 to 2.2), p=0.003. In the IMV group, SpO2 presented a significant increase only when compared to the prone position vs. supine -1.5 (95%CI -2.5 to -0.5), p=0.010. The HR of the preterm newborns of the NIV group presented a significant decrease when compared to positions left lateral vs. right lateral (p=0.032) and RR remained within normal range during the different positions, but did not present significant differences in both groups. The prone position also presented a lower MA when compared to the other positions (p<0.001). Conclusion: the results showed that the prone position was beneficial for preterm infants in respiratory support invasive and noninvasive, during the acute phase of respiratory distress, standing out from the others, since it increased peripheral oxygenation, providing comfort, evidenced by the reduction of MA. |
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2019-11-22T18:55:40Z2019-11-22T18:55:40Z2017-08-17http://repositorio.ufsm.br/handle/1/19027The preterm newborn presents a compromise in gas exchange due to pulmonary immaturity and the disadvantages in respiratory mechanics, presenting a higher risk of developing neonatal respiratory distress syndrome (RDS). The therapeutic position of newborns is a type of non-invasive intervention used in the treatment of respiratory diseases, benefiting the neurosensory and psychomotor development. In order to investigate the benefits of the different positions of the preterm newborn, the purpose of this study was to investigate the influence of the therapeutic positioning on the cardiorespiratory indicators and motor activity (MA) of the preterm newborn in use respiratory support invasive or not, during the acute phase of respiratory distress. It is a cross-sectional, observational, prospective study with a cross-over and randomized design, performed with preterm newborns with clinical syndrome of respiratory distress, birth weight below 2.000 g, between the 3rd and 7th day of life , in use respiratory support invasive (IMV) or noninvasive (NIV), between July 2016 and June 2017. The newborns were maintained at each body position (supine, prone, right and left lateral) for 45 minutes and cardiorespiratory indicators (heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2) and MA were recorded in intervals of 7 minutes, obtaining a total of five records in each position. Analysis of variance for repeated measures (ANOVA) and Friedman test, with post hoc tests were used to compare the cardiorespiratory indicators in the different positions. Pearson correlation was performed to verify statistical dependence between MA and HR, in the different positions. Statistical significance was considered when p<0.05. We studied thirty-three preterm newborns, 12 in the IMV group, with a gestational age (GA) of 27.0 (± 1.5) weeks and a weight of 837 (± 284) grams, and 21 in the NIV group, with a GA of 30.5 (± 1.9) weeks and weight of 1297 (± 416) grams. In the NIV group, there was a significant increase in SpO2 when compared to the prone positions vs. supine -1.1 (95%CI -2.0 to -0.2), p=0.017, prone vs. right lateral 1.1 (95%CI 0.2 to 1.9), p=0.015 and prone vs. left lateral 1.3 (95%CI 0.5 to 2.2), p=0.003. In the IMV group, SpO2 presented a significant increase only when compared to the prone position vs. supine -1.5 (95%CI -2.5 to -0.5), p=0.010. The HR of the preterm newborns of the NIV group presented a significant decrease when compared to positions left lateral vs. right lateral (p=0.032) and RR remained within normal range during the different positions, but did not present significant differences in both groups. The prone position also presented a lower MA when compared to the other positions (p<0.001). Conclusion: the results showed that the prone position was beneficial for preterm infants in respiratory support invasive and noninvasive, during the acute phase of respiratory distress, standing out from the others, since it increased peripheral oxygenation, providing comfort, evidenced by the reduction of MA.O recém-nascido pré-termo apresenta comprometimento na troca gasosa devido a imaturidade pulmonar e as desvantagens na mecânica respiratória, apresentando maior risco de desenvolver a síndrome do desconforto respiratório (SDR) neonatal. O posicionamento terapêutico de recém-nascidos é um tipo de intervenção não-invasiva utilizado no tratamento de doenças respiratórias, beneficiando o desenvolvimento neurossensorial e psicomotor. Com o intuito de investigar os benefícios dos diferentes posicionamentos do recém-nascido pré-termo, o objetivo desse estudo foi investigar a influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora (AM) de recém-nascidos pré-termo em uso de suporte respiratório, invasivo ou não, durante a fase aguda do desconforto respiratório. Trata-se de um estudo transversal, observacional, prospectivo, com um delineamento cruzado e randomizado, realizado com recém-nascidos pré-termo com quadro clínico de desconforto respiratório, peso de nascimento inferior a 2.000g, entre o 3º e 7º dias de vida, em uso de suporte respiratório, invasivo (VMI) ou não invasivo (VNI), entre julho de 2016 a junho de 2017. Os recém-nascidos foram mantidos em cada posição corporal (supina, prona, laterais direita e esquerda) durante 45 minutos e os indicadores cardiorrespiratórios (frequências cardíaca (FC), respiratória (FR), saturação periférica de oxigênio (SpO2)) e AM foram registrados em intervalos de 7 minutos, obtendo-se um total de cinco registros em cada posição. Análise de variância para medidas repetidas (ANOVA) e Teste de Friedman, com testes post hoc foram utilizados para comparar os indicadores cardiorrespiratórios, nas diferentes posições. Correlação de Pearson foi realizada para verificar dependência estatística entre a AM e a FC, nas diferentes posições. Foi considerada significância estatística quando p<0,05. Foram estudados 33 recém-nascidos pré-termo, 12 no grupo VMI, com idade gestacional (IG) de 27,0 (±1,5) semanas e peso de 837 (±284) gramas, e 21 no grupo VNI, com IG de 30,5 (±1,9) semanas e peso de 1297 (±416) gramas. No grupo VNI, houve um aumento significativo da SpO2 quando comparado as posições prona vs. supina -1,1 (IC95% -2,0 a - 0,2), p=0,017, prona vs. lateral direita 1,1 (IC95% 0,2 a 1,9), p=0,015 e prona vs. lateral esquerda 1,3 (IC95% 0,5 a 2,2), p=0,003. No grupo VMI, a SpO2 apresentou um aumento significativo apenas quando comparado a posição prona vs. supina -1,5 (IC95% -2,5 a -0,5), p=0,010. A FC dos recém-nascidos pré-termo do grupo VNI apresentou uma diminuição significativa quando comparadas as posições lateral esquerda vs. lateral direita (p=0,032) e a FR manteve-se dentro da normalidade durante os diferentes posicionamentos, mas não apresentou diferenças significativas em ambos os grupos. A posição prona também apresentou uma menor AM quando comparado as demais posições (p<0,001). Conclusão: os resultados demonstraram que a posição prona foi benéfica para os recém-nascidos prétermo em suporte respiratório invasivo e não invasivo, durante a fase aguda do desconforto respiratório, destacando-se das demais, uma vez que aumentou a oxigenação periférica, proporcionando conforto, evidenciado pela redução da AM.porUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Reabilitação FuncionalUFSMBrasilCiências da SaúdeAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessPrematuridadeSíndrome do desconforto respiratório do recém-nascidoSuporte respiratórioPosicionamento terapêuticoPrematurityRespiratory distress syndrome of the newbornRespiratory supportTherapeutic positioningCNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONALInfluência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratórioInfluence of therapeutic positioning on cardiorrespiratory indicators and motor activity of pre-term newborn in respiratory supportinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisWeinmann, Angela Regina Macielhttp://lattes.cnpq.br/9151119377173425Resener, Tânia Denisehttp://lattes.cnpq.br/3067769343968380Martins, Juliana Saibthttp://lattes.cnpq.br/7166416433190302http://lattes.cnpq.br/9891376541894079Quoos, Marcia4008000000086001c5aefd6-6508-4d33-80c5-ebfe9227f0ffa4369292-f12d-428d-8390-80247315f66a868f326f-6300-48e7-9851-5b79bbe98aa88b33b63a-c0a2-4d91-a1d4-e0902bbd0f72reponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGRF_2017_QUOOS_MARCIA.pdfDIS_PPGRF_2017_QUOOS_MARCIA.pdfDissertação de Mestradoapplication/pdf1597489http://repositorio.ufsm.br/bitstream/1/19027/1/DIS_PPGRF_2017_QUOOS_MARCIA.pdf3c0ca052f6b3e77777bd225a1f2c8084MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/19027/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-816http://repositorio.ufsm.br/bitstream/1/19027/3/license.txtf8fcb28efb1c8cf0dc096bec902bf4c4MD53TEXTDIS_PPGRF_2017_QUOOS_MARCIA.pdf.txtDIS_PPGRF_2017_QUOOS_MARCIA.pdf.txtExtracted texttext/plain147861http://repositorio.ufsm.br/bitstream/1/19027/4/DIS_PPGRF_2017_QUOOS_MARCIA.pdf.txtb474c2fc08c92009a4d94d4d398bc138MD54THUMBNAILDIS_PPGRF_2017_QUOOS_MARCIA.pdf.jpgDIS_PPGRF_2017_QUOOS_MARCIA.pdf.jpgIM Thumbnailimage/jpeg4777http://repositorio.ufsm.br/bitstream/1/19027/5/DIS_PPGRF_2017_QUOOS_MARCIA.pdf.jpg02295214a8bab13edc52ef5332dd77f6MD551/190272019-11-23 03:02:12.36oai:repositorio.ufsm.br:1/19027Q3JlYXRpdmUgQ29tbW9ucw==Repositório Institucionalhttp://repositorio.ufsm.br/PUBhttp://repositorio.ufsm.br/oai/requestopendoar:39132019-11-23T06:02:12Manancial - Repositório Digital da UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratório |
dc.title.alternative.eng.fl_str_mv |
Influence of therapeutic positioning on cardiorrespiratory indicators and motor activity of pre-term newborn in respiratory support |
title |
Influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratório |
spellingShingle |
Influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratório Quoos, Marcia Prematuridade Síndrome do desconforto respiratório do recém-nascido Suporte respiratório Posicionamento terapêutico Prematurity Respiratory distress syndrome of the newborn Respiratory support Therapeutic positioning CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
title_short |
Influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratório |
title_full |
Influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratório |
title_fullStr |
Influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratório |
title_full_unstemmed |
Influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratório |
title_sort |
Influência do posicionamento terapêutico sobre os indicadores cardiorrespiratórios e atividade motora de recém-nascidos pré-termo em suporte respiratório |
author |
Quoos, Marcia |
author_facet |
Quoos, Marcia |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Weinmann, Angela Regina Maciel |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/9151119377173425 |
dc.contributor.referee1.fl_str_mv |
Resener, Tânia Denise |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/3067769343968380 |
dc.contributor.referee2.fl_str_mv |
Martins, Juliana Saibt |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/7166416433190302 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/9891376541894079 |
dc.contributor.author.fl_str_mv |
Quoos, Marcia |
contributor_str_mv |
Weinmann, Angela Regina Maciel Resener, Tânia Denise Martins, Juliana Saibt |
dc.subject.por.fl_str_mv |
Prematuridade Síndrome do desconforto respiratório do recém-nascido Suporte respiratório Posicionamento terapêutico |
topic |
Prematuridade Síndrome do desconforto respiratório do recém-nascido Suporte respiratório Posicionamento terapêutico Prematurity Respiratory distress syndrome of the newborn Respiratory support Therapeutic positioning CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
dc.subject.eng.fl_str_mv |
Prematurity Respiratory distress syndrome of the newborn Respiratory support Therapeutic positioning |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL |
description |
The preterm newborn presents a compromise in gas exchange due to pulmonary immaturity and the disadvantages in respiratory mechanics, presenting a higher risk of developing neonatal respiratory distress syndrome (RDS). The therapeutic position of newborns is a type of non-invasive intervention used in the treatment of respiratory diseases, benefiting the neurosensory and psychomotor development. In order to investigate the benefits of the different positions of the preterm newborn, the purpose of this study was to investigate the influence of the therapeutic positioning on the cardiorespiratory indicators and motor activity (MA) of the preterm newborn in use respiratory support invasive or not, during the acute phase of respiratory distress. It is a cross-sectional, observational, prospective study with a cross-over and randomized design, performed with preterm newborns with clinical syndrome of respiratory distress, birth weight below 2.000 g, between the 3rd and 7th day of life , in use respiratory support invasive (IMV) or noninvasive (NIV), between July 2016 and June 2017. The newborns were maintained at each body position (supine, prone, right and left lateral) for 45 minutes and cardiorespiratory indicators (heart rate (HR), respiratory rate (RR), peripheral oxygen saturation (SpO2) and MA were recorded in intervals of 7 minutes, obtaining a total of five records in each position. Analysis of variance for repeated measures (ANOVA) and Friedman test, with post hoc tests were used to compare the cardiorespiratory indicators in the different positions. Pearson correlation was performed to verify statistical dependence between MA and HR, in the different positions. Statistical significance was considered when p<0.05. We studied thirty-three preterm newborns, 12 in the IMV group, with a gestational age (GA) of 27.0 (± 1.5) weeks and a weight of 837 (± 284) grams, and 21 in the NIV group, with a GA of 30.5 (± 1.9) weeks and weight of 1297 (± 416) grams. In the NIV group, there was a significant increase in SpO2 when compared to the prone positions vs. supine -1.1 (95%CI -2.0 to -0.2), p=0.017, prone vs. right lateral 1.1 (95%CI 0.2 to 1.9), p=0.015 and prone vs. left lateral 1.3 (95%CI 0.5 to 2.2), p=0.003. In the IMV group, SpO2 presented a significant increase only when compared to the prone position vs. supine -1.5 (95%CI -2.5 to -0.5), p=0.010. The HR of the preterm newborns of the NIV group presented a significant decrease when compared to positions left lateral vs. right lateral (p=0.032) and RR remained within normal range during the different positions, but did not present significant differences in both groups. The prone position also presented a lower MA when compared to the other positions (p<0.001). Conclusion: the results showed that the prone position was beneficial for preterm infants in respiratory support invasive and noninvasive, during the acute phase of respiratory distress, standing out from the others, since it increased peripheral oxygenation, providing comfort, evidenced by the reduction of MA. |
publishDate |
2017 |
dc.date.issued.fl_str_mv |
2017-08-17 |
dc.date.accessioned.fl_str_mv |
2019-11-22T18:55:40Z |
dc.date.available.fl_str_mv |
2019-11-22T18:55:40Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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http://repositorio.ufsm.br/handle/1/19027 |
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http://repositorio.ufsm.br/handle/1/19027 |
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por |
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por |
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400800000008 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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Programa de Pós-Graduação em Reabilitação Funcional |
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UFSM |
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Brasil |
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Ciências da Saúde |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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