Contexto social e clínico de crianças e adolescentes com doenças pulmonares submetidos à técnica de aumento do fluxo expiratório

Abstract

INTRODUCTION: Knowledge of socio-demographic risk factors and gestational conditions are essential in the treatment of children and adolescents with pulmonary diseases. Respiratory physiotherapy aims at bronchial clearance, treatment and prevention of respiratory diseases through techniques such as increased slow expiratory flow (AFEL) and fast (AFER). OBJECTIVE: To observe the clinical and social context and parameters of oxygen saturation (SatO2), heart rate (HR) and respiratory rate (RF) in children and adolescents with pulmonary diseases when submitted to expiratory flow enhancement technique. METHODOLOGY: This is a descriptive, quasi-experimental study with a quantitative and longitudinal approach, performed at the Lauro Wanderley University Hospital (HULW). The sample consisted of 18 children and adolescents, aged between 0 and 17 years. A semi-structured questionnaire and slow and rapid expiratory flow (AFE) technique were applied, as well as SatO2, HR and RF before, immediately after and 5 minutes after AFE. The data were tabulated and analyzed through the Statistical Package for Social Sciences 21.0 (SPSS), through a descriptive analysis, being considered a significance level of 5%. RESULTS: The sample presented an age of 5.7 ± 5.1 years, living in adjacent cities, with access to daycare or school, hospitalized in the ward between 7 and 29 days, with a major diagnosis of pneumonia. Profile of those in charge: age of 30.2 ± 6.3 years, female, single, mother, main caretaker, black race, catholic, fundamental 1 incomplete, monthly income up to 2 minimum wages, autonomous and household, and use the Unit The age of the mother in the pregnancy was 25.1 ± 7.1 years, she underwent prenatal care, did not smoke, did not ingest alcohol, cesarean delivery, term without hospitalization of the child in the ICU, and breastfed for more than one month. Of the 18 patients, mixed respiratory pattern prevailed, symmetrical thoracic expansion, normal chest, synchronous respiratory rhythm, breathing in ambient air or oxygen therapy. Vesicular murmur was observed with adventitious noises, mucoid secretion, with viscosity, effective cough, unproductive and ineffective. Regarding the AFEL and AFER technique, the variables SatO2, FC and FR presented similar behavior in the three moments evaluated, considering specific alterations and which resembled the two techniques. Regarding respiratory rhythm, AFEL interference occurs in respiratory synchronism, as well as changes in thoracic cirtometry before AFEL and AFER. CONCLUSION: Characteristic alterations of both AFEL and AFER variables were observed, as well as positive changes in respiratory timing and thoracic expandability.