Thoracoabdominal interaction and its relationship with biological risk factors in premature newborns
DOI:
https://doi.org/10.1590/1809-2950/19011927022020Keywords:
Infant, Premature, Respiratory Mechanics, Thoracic Wall, PhotogrammetryAbstract
The objective of this study was to assess the participation of thoracoabdominal muscles in breathing and its relationship with clinical risk factors in preterm newborns (PTNBs). This is a multicenter, cross-sectional study conducted in two neonatal intermediate care units with PTNBs between 26 and 35 weeks of age, hemodynamically stable, who used oxygen or ventilatory support during hospital stay. The lateral movements of the thorax were filmed for 2 minutes and the videos were quantitatively evaluated by a researcher blinded to sample data using the MATLAB Software for assessing thoracoabdominal participation patterns. Data for the maximum, minimum and mean values of the participation of the thorax and abdomen were expressed graphically in cm2. The Pearson correlation coefficient was used to assess the correlation between neonatal variables and mobility. We evaluated 2,080 frames of 26 newborns with an average gestational age of 31 weeks ±2.34. The greater the age and weight, the greater the participation of the thorax in breathing (r=0.55, p=0.001); and the longer the hospital stay, the lower the thoracic participation (r=-0.40, p=0.04). The participation of the abdomen increases according to the increase in the number of days of oxygen use (r=0.33, p=0.001) and decreases with higher age and weight (r=-0.41, p=0.001). The thoracoabdominal participation pattern is directly related to gestational age and weight. Prolonged use of oxygen and the length of hospital stay adversely affect the respiratory pattern, since increasing abdominal participation in respiratory biomechanics may increase energy expenditure.
Downloads
References
Gaultier C. Respiratory muscle function in infants. Eur Respir
J. 1995;8:150-3. doi: 10.1183/09031936.95.08010150
Rugolo LMSS. Growth and developmental outcomes of
the extremely preterm infant. J Pediatr. 2005;81(1):S101-10.
doi: 10.1590/S0021-75572005000200013
Guerra JIA, Nagem DAP, Moran CA, Gomes VLS, Carvalho
JMC, Pereira SA. Avaliação da mobilidade toracoabdominal
por fotogrametria em recém-nascidos após a técnica de
aumento do fluxo expiratório. Fisioter Mov. 2017;30(4):789-95.
doi: 10.1590/1980-5918.030.004.ao14
Dimitriou G, Fouzas S, Vervenioti A, Tzifas S, Mantagos
S. Prediction of extubation outcome in preterm infants
by composite extubation indices. Pediatr Crit Care Med.
;12(6):e242-9. doi: 10.1097/PCC.0b013e3181fe3431
Ricieri DV, Rosário Filho NA. Efetividade de um modelo
fotogramétrico para a análise da mecânica respiratória
toracoabdominal na avaliação de manobras de isovolume
em crianças. J Bras Pneumol. 2009;35(2):144-50. doi: 10.1590/
S1806-37132009000200007
Oliveira HB, Pereira SA, Vale BEC, Nagem DAP. Sistema de
reconhecimento de imagens para avaliação do movimento
toracoabdominal em recém-nascidos. Rev Bras Inov Tecnol
Saúde. 2016;6(1):1-10. doi: 10.18816/r-bits.v6i1.9998
Sivan Y, Deakers TW, Newth CJL. Thoracoabdominal asynchrony
in acute upper airway obstruction in small children. Am Rev
Respir Dis. 1990;142(3):540-4. doi: 10.1164/ajrccm/142.3.540
Fernandes BP, Quaresma PA, Franco JDA. Atuação da
fisioterapia no esforço respiratório em crianças hospitalizadas
com infecção respiratória aguda: um estudo comparativo.
Fisioter Bras. 2017;18(2):140-7.
Gomes VLS, Farias PHS, Nagem DAP, Gomes DC, Silva GFA,
Moran CA, et al. Impact of type of delivery on thoracoabdominal
mobility of newborns. J Hum Growth Dev. 2018;28(2):148-53.
doi: 10.7322/jhgd.127865
Gomes DC, Fonseca Filho GG, Araújo AGF, Gomes VLS, Medeiros
Júnior NB, Cavalcanti BE, et al. Avaliação biofotogramétrica
da mobilidade toracoabdominal de recém-nascido após
fisioterapia respiratória. Fisioter Bras. 2018;19(1):28-34.
doi: 10.33233/fb.v19i1.2179
Mohan V, Perri M, Paungmali A, Sitilertpisan P, Joseph LH, Jathin R,
et al. Intra-rater and inter-rater reliability of total faulty breathing
scale using visual observation and videogrammetry methods.
J Bodyw Mov Ther. 2017;21(3):694-8. doi: 10.1016/j.jbmt.2016.10.007
Ripka WL, Ulbricht L, Gewehr PM, Application of a
photogrammetric kinematic model for prediction of lung
volumes in adolescents: a pilot study. Biomed Eng Online.
:13(1):21. doi: 10.1186/1475-925X-13-21
Fekr AR, Janidarmian M, Radecka K, Zilic Z. Movement analysis
of the chest compartments and a real-time quality feedback
during breathing therapy. Netw Model Anal Health Inform
Bioinform. 2015:4-21. doi: 10.1007/s13721-015-0093-2
Ricieri DV. Princípios processuais da biofotogrametria e sua
adaptação para medidas em estudos sobre movimentos
respiratórios toracoabdominais [tese] [Internet]. Curitiba:
Universidade Federal do Paraná; 2008 [cited 2020
Jun 16]. Available from: https://www.researchgate.net/
publication/259620336
Rocha G. Stress oxidativo na lesão pulmonar neonatal. Rev Port
Pneumol. 2008;14(1):113-26. doi: 10.1016/S0873-2159(15)30221-X
Pereira SA. O uso do oxigênio em prematuros: o que os olhos
não veem o pulmão sente. Movimenta [Internet]. 2012 [cited
Jun 16];5(3):207-8. Available from: https://www.revista.
ueg.br/index.php/movimenta/article/view/7069/4839
McEvoy CT, Jain L, Schmidt B, Abman S, Bancalari E, Aschner JL.
Bronchopulmonary dysplasia: NHLBI workshop on the primary
prevention of chronic lung diseases. Annal Am Thorac Soc.
;11 Suppl 3:S146-53. doi: 10.1513/AnnalsATS.201312-424LD
Weinberger B, Laskin DL, Heck DE, Laskin JD. Oxygen toxicity
in premature infants. Toxicol Appl Pharmacol. 2002;181(1):60-7.
doi: 10.1006/taap.2002.9387
Seddon P. Options for assessing and measuring chest wall motion.
Paediatr Respir Rev. 2015;16(1):3-10. doi: 10.1016/j.prrv.2014.10.006
Hammer J, Newth CJL. Assessment of thoraco-abdominal
asynchrony. Paediatr Respir Rev. 2009;10(2):75-80.
Arakaki VDSNM, Gimenez IL, Correa RM, Santos RSD, Sant’anna
CC, Ferreira HC. Mapeamento demográfico e caracterização do
perfil de assistência fisioterapêutica oferecida nas unidades de
terapia intensiva neonatais do Rio de Janeiro (RJ). Fisioter Pesq.
;24(2):143-8. doi: 10.1590/1809-2950/16470124022017
Silva ROE, Campos TF, Borja RO, Macêdo TMF, Oliveira JS,
Mendonça KMP. Valores de referência e fatores relacionados à
mobilidade torácica em crianças brasileiras. Rev Paul Pediatr.
;30(4):570-5.
Downloads
Published
Issue
Section
License
Copyright (c) 2020 Simone Nascimento Santos Ribeiro, Lorena Batista Lourenço, Giuliana de Souza Sena, Sabrinne Suelen Santos Sampaio, Silvana Alves Pereira
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
