Journal Menu
By: Bandita Goswami, Bishakha Shyam, Kangkan Talukdar, and Ankur J. Bora.
1.MPT Scholar, Department of Physiotherapy, Jorhat Medical College, Jorhat, Assam, India.
2.Lecturer, Department of Physiotherapy, Jorhat Medical College, Jorhat, Assam, India.
3.Senior Physiotherapist cum Course Coordinator, Department of Physiotherapy, Jorhat Medical College, Jorhat, Assam, India.
Aim: To present a rare case of a neonate with meconium aspiration syndrome treated with neurophysiological facilitation therapy, demonstrating significant improvements in respiratory function and oxygenation. Purpose: To assess the efficacy of neurophysiological facilitation in improving respiratory distress and reducing the need for mechanical respiratory support in a neonate diagnosed with meconium aspiration syndrome, respiratory distress syndrome. Methodology: This case report follows the progress of a male neonate born at 39 weeks of gestation with a birth weight of 1.002 kg. Upon birth, the infant exhibited poor respiratory effort and was admitted to the Special Newborn Care Unit at Jorhat Medical College and Hospital, Assam. Initial respiratory support was provided via non-invasive ventilation on Day 1, followed by a transition to continuous positive airway pressure (CPAP) on Day 3. Neurophysiological facilitation therapy, consisting of perioral stimulation and intercostal stretch, was introduced concurrently with CPAP. Neurophysiological facilitation techniques were administered twice daily for 30 seconds each, with a 30-second rest between applications, for 14 days. Outcome measures, including the Modified Downes score, respiratory rate, and oxygen saturation, were recorded pre- and post-intervention. Results: This study found that neurophysiological facilitation therapeutic intervention significantly reduced Downes scores (p < 0.001) and respiratory rate (p < 0.001), while increasing oxygen saturation (p < 0.001) in patients with meconium aspiration syndrome. Strong pre- to post-intervention correlations further support its effectiveness. Conclusion: Neurophysiological facilitation therapy played a pivotal role in facilitating the reduction of respiratory distress and improving oxygen saturation in this neonate with meconium aspiration syndrome. The therapy contributed to early weaning from CPAP and demonstrated its potential as an effective adjunctive treatment for respiratory support in neonates with meconium aspiration syndrome. This case underscores the potential benefits of incorporating neurophysiological facilitation into the management of neonates with complex respiratory conditions.
Keywords: Neurophysiological facilitation (NPF), meconium aspiration syndrome (MAS), respiratory distress syndrome (RDS), continuous positive airway pressure (CPAP), oxygen saturation, respiratory rate
Citation:
Refrences:
- Pryor JA, Prasad AS. Physiotherapy for Respiratory and Cardiac Problems: Adults and Paediatrics. 4th ed. Edinburgh & New York: Churchill Livingstone; 2008. ISBN 978‑0‑08‑044985‑2.
- Brunherotti MAA, Martinez FE. Response of oxygen saturation in preterm infants receiving rib cage stabilization with an elastic band in two body positions: A randomized clinical trial. Braz J Phys Ther. 2013;17(2):105–111. doi: 10.1590/S1413-35552012005000082.
- Harries JT. Meconium in health and disease. Br Med Bull. 1978;34(1):75–78. doi: 10.1093/oxfordjournals.bmb.a071462.
- Greenough A, Milner AD. Pulmonary Diseases of New-born. In: Renne JM, et al., editors. Textbook of Neonatology. 4th ed. Churchill Livingstone; 2006. pp. 199, 502–508.
- Sedaghatian MR, Othman L, Rashid N, Ramachandran P, Bener AB. An 8-year study of meconium stained amniotic fluid in different ethnic groups. Kuwait Med J. 2004;36(4):266–269.
- Burris HH. Meconium Aspiration. In: Cloherty JP, et al., editors. Manual of Neonatal Care. 7th ed. Philadelphia: Lippincott Williams & Wilkins, A Wolters Kluwer business; 2012. pp. 429–434.
- Ehret DEY, Demtse Gebremedhin A, Hadgu Berhe A, Hailu Y, Metaferia G, Kessler K, et al. High inter-rater reliability between physicians and nurses utilising modified Downes’ scores in preterm respiratory distress. Acta Paediatr. 2023;112(11):2329–2337. doi: 10.1111/apa.16957.
- Raghupathy MK, Lewis LES, Shubha G. Does Neurophysiological facilitation (NPF) influence respiratory function in a preterm infant with respiratory distress? A case report. ESS Open Archive. 2022. doi: 10.22541/au.166201563.31362109/v1.
- Dargaville PA. Respiratory support in meconium aspiration syndrome: A practical guide. Int J Pediatr. 2012:965159. doi: 10.1155/2012/965159.
- Rubin BK, Tomkiewicz RP, Patrinos ME, Easa D. The surface and transport properties of meconium and reconstituted meconium solutions. Pediatr Res. 1996;40(6):834–838. doi: 10.1203/00006450-199612000-00010.
- Fox RE, Viscardi RM, Taciak VL, Niknafs H, Cinoman MI. Effect of position on pulmonary mechanics in healthy preterm newborn infants. J Perinatol. 1993;13(3):205–211.
- Prajapati DH. Effect of neurophysiological facilitation [NPF] of respiration on ventilation of mechanically ventilated patients: An experimental study. 2016;7(9):3.
- Chang A, Paratz J, Rollston J. Ventilatory effects of neurophysiological facilitation and passive movement in patients with neurological injury. Aust J Physiother. 2002;48(4):305–310. doi: 10.1016/s0004-9514(14)60170-7.