Physical therapy in premature infants in the intensive care unit and risk of the porencephaly

Abstract

Introduction: In the early 1970s, technological improvements provided neonatal mechanical ventilation and there was an increase in survival of very low birth weight preterm infants (VLBW). From this, physiotherapy has been evidenced as a relevant part of the favorable outcome of this population. Encephaloclastic Porencephaly (EP) has been described by Cross et al. and since then her etiology has been studied, focusing on three main risk factors: breech presentation, early hypotension, and amount of respiratory therapy (RT).

Objective: To verify whether RT in premature infants VLBW is associated with EP.

Methods: The study consists of a bibliographic review, carried out through a search in the Medline / Pubmed database, Scielo lasting six months. Observational studies, cohort, and randomized controlled trials were selected, published between 1929 and 2017, in English, in which the keywords were present in the title or abstract.

Results: Eleven articles were identified and three were included because they associated EP and RT in VLBW infants. Of the three articles analyzed, two had cases of EP associated with RT and one did not report any cases.

Conclusion: RT alone does not appear to be a risk factor for EP. However, in infants who are associated with other risk factors, RT can be performed, but stabilizing the head of VLBW preterms should be imperative. To define the relationship between RT and adverse neurological outcomes, a randomized and controlled clinical trial would be ideal.