Effects of respiratory physiotherapeutic interventions on pulmonary mechanics, vital parameters and pain in newborns: A systematic review.

Objective: To evaluate the effects of conventional and non-conventional respiratory physiotherapy on pulmonary mechanics, vital parameters, and pain in newborns admitted to a neonatal intensive care unit. Methods and Analyses: Databases including PubMed, LILACS, SciELO, Science Direct, Cochrane Library, and Web of Science were searched. Randomized clinical trials comparing conventional and non-conventional respiratory physiotherapy in newborns (1 hour to 28 days) in neonatal intensive care units were included. Two reviewers independently screened titles and abstracts and assessed bias using the PEDro scale. Data were presented as mean, standard deviation, median, and quartiles. Meta-analysis was not feasible due to incomplete post-intervention data. Results: Out of 5,653 articles found, four were included. Two studies reported major increases in peripheral oxygen saturation after both respiratory physiotherapy techniques, a third showed decreased respiratory rate, and a fourth showed increased heart rate. Neither conventional nor non-conventional respiratory physiotherapy was suggested to cause pain in participants. No study evaluated lung mechanics parameters. The methodological quality of the included studies was predominantly moderate. Only one study exhibited low methodological quality. Conclusion: Both conventional and non-conventional respiratory physiotherapy techniques showed no adverse effects on vital signs or pain in NICU newborns. Further clinical trials are encouraged to assess lung function more comprehensively. Future studies should include short- and long-term evaluations of lung mechanics, respiratory distress, and pain.