EFFECT OF POSTOPERATIVE CHEST PHYSIOTHERAPY PROGRAM FOR CONGENITAL HEART DISEASE IN PEDIATRIC CARE UNIT

Abstract

The purpose of the current study was to investigate the effect of postoperative selected chest physiotherapy program for various types of congenital heart diseases in pediatric care unit. Subject: Thirty infants of both sexes (22 males and 8 females) in the immediate postoperative period following cardiac surgery in Cardio-Pulmonary intensive care unit (ICU) with age ranged from 3 months to 17 months were included in the study. They were classified into two groups of equal number (control group A and study group B) which were matched in age, sex, severity and complexity. Methods: Both groups were assessed in their first day postoperative for arterial blood gases (PH, PaC02, Pa02, and Sa02), peripheral oxygen saturation by pulse oximetry (SP02) and chest X-ray; these examinations were repeated by the end of 151 week (critical stage), 2nd week (weaning stage) and 3rd week (last stage), except the chest X-ray that was repeated by the end of 3rd week. Control group (A) received medical treatment in addition to traditional postoperative respiratory care in form of (humidification, vibration and suctioning). Study group (B) also received the same as in control group in addition to selected chest physical therapy program which included modified posture drainage, percussion, specialized breathing techniques, and assisted cough techniques. The treatment program was conducted for 6 days per I week for 3 successive weeks. Each session was applied for 30 minutes, three times daily thus offering total physiotherapy program of one hour and half daily for 3 weeks. Results: The post treatment findings of the current study at the end of last stage revealed that there were signs of moderate hypoxemia and respiratory acidosis in the control group when compared to the results of the study group that showed very mild hypoxemia and normal acid-base balance. By comparing pre to post treatment, the control group deteriorated from critical to last stage, while in the study group the deterioration degree was lower than the control group till the weaning stage then study group showed improvement in last stage. The study group had less pulmonary complications in form of pneumonia and atelectasis than in the control group. Conclusion: Selected chest physiotherapy program was very effective in preventing or at least minimizing the incidence of pulmonary complications. Consequently chest physiotherapy program was considered as an integral part ofthe postoperative management for infants with congenital heart diseases in pediatric care unit.