824 Physiotherapy Techniques for Pleural Effusions in a Pediatric Intensive Care Unit (PICU): Which Technique is the Most Efficient?

Abstract

Aims To compare different chest physiotherapy techniques in pediatric patient with infectious pleural effusion and thorax drain admitted in PICU. Methods We conducted a monocentric, randomized, assessorblind trial. The patients were randomized in three groups: those who have received intrapulmonary percussive ventilation (IPV), those who have received autogene drainage (AD) and were compared to the control group (CG) which no physiotherapy was administered. Only physiotherapists were aware of the allocation group of the patients. Results 24 patients were included (IPV: 7, AD:8, CG: 9). All patients had a infectious pleural effusion and thorax drainage. The occurrence of lung-necrosis, empyema, drained pleural fluid per body area, need of fibroscopy and Video assisted thoracoscopy (VATS), total length of stay in PICU and in hospital, days of oxygenothepy needed and the evolution of CRP were compared in the three groups. No differences on the occurrence of empyema, the need of VATS, length of hospital stay in hospital and in PICU stay, the number of oxygenothepy days and the CRP evolution. But there were less occurrence of lung-necrosis, more drained pleural fluid and less need of fibroscopy in the IPV group. Conclusions These preliminary results show that the different chest physiotherapy has not been effective in reducing hospital stay, length of oxygenotherapy in patients with pleural effusion and thorax drain when compared to the CG. In the IPV group less complications has occurred.