Bronchopleural Fistula-The Role Of Physiotherapy Rehabilitation: A Case Report

Purpose: Bronchopleural fistula is a commonest complication developed in post-traumatic cases and the management of which is still a challenge due to lack of scientific evidence. The purpose of this case report is to investigate the effects of physiotherapy treatment in management of patients with bronchopleural fistula. Case Description: A 20-year-old man met with a road traffic accident following which he was diagnosed with hemopneumothorax and ICD was placed. Continuous removal of ICD over 3 to 4 times by patient himself in unconscious state lead to the development of bronchopleural fistula. Results: The patient was seen for 15 sessions over 3 weeks period ( 5 days per week). At discharge, his Functional status score in ICU (FSS-ICU) was 35. He was able to complete exercise tolerance test in 6-minute time interval with 540 meters of distance involving 10 laps with single rest pause during 4th minute. Discussion: Though bronchopleural fistula is considered as a relative complication of physical therapy; this case report suggests that with appropriate care physical therapy along with other medical management team can help to cure it and improve patient’s functional status as well as his quality of living.

Study progress of near-infrared spectroscopy in neonatal necrotizing enterocolitis / 中华实用儿科临床杂志

Near-infrared spectroscopy(NIRS) is a technique for continuous,noninvasive,bedside monitoring of inadequate tissue perfusion and oxygenation.Intestinal ischemia is an important pathophysiologic in mucosal injury and the development of necrotizing enterocolitis (NEC).So somebody thinks that NIRS might be a useful tool to diagnose the earliest stages of NEC and to predict its progression.This review will describe the feasibility,safety,sensor location and associated research result of NIRS in NEC.

Oximetria de pulso: alternativa instrumental na avaliação clínica junto ao leito para a disfagia / Pulse oximetry: instrumental alternative in the clinical evaluation by the bed for the dysphagia

Introdução: A avaliação clínica junto ao leito é o procedimento clínico utilizado pela fonoaudiologia como um screening teste para se estabelecer se o indivíduo apresenta ou não um quadro clínico de disfagia. Sua realização conta com o uso da oximetria de pulso que é a medida não-invasiva da saturação periférica de O2. Quando relacionada à disfagia, a saturação pode declinar no momento da deglutição, sugerindo um comprometimento do sistema respiratório. Tal declínio é observado em indivíduos que aspiram com alimentos de consistência sólida e líquida, antes durante e após a alimentação, quando comparados aos indivíduos que não aspiram. Objetivo: Verificar a possibilidade da utilização da oximetria de pulso como alternativa instrumental na avaliação clínica para a disfagia. Método: Revisão de literatura, baseando-se em artigos indexados nas bases Lilacs e Medline tendo como referência os descritores: saturação de oxigênio, oximetria de pulso e transtorno de deglutição. Resultados: A associação da avaliação clínica à oximetria de pulso evidencia-se com alta sensibilidade na detecção da penetração e aspiração laringotraqueal e com baixo índice falso-positivo, considerando-se dessaturação, os índices que variam com valores maiores que 2%. Alguns dados encontrados são divergentes quanto à possibilidade detecção de aspiração. Considerações Finais: Os estudos analisados conferem a oximetria de pulso o caráter de praticidade e possibilidade de uso nas ações junto ao leito, sendo utilizada aliada a avaliação clínica para disfagia, embora se encontre certa discordância entre os mesmos quanto à utilização dos seus resultados como indicadores de aspiração laringotraqueal, sugerindo necessidade de pesquisas posteriores.

Introduction: The clinical evaluation by the bed is the clinical procedure utilized by the speech therapy as a screening test for established if the individual presents or not a clinical picture of dysphagia. Its achievement count with the use of the pulse oximetry that is the not-invasive measure of the peripheral saturation of O2. When it related to the dysphagia, the saturation can decline in the moment of the swallowing, suggesting a compromise of the respiratory system. Such decline is observed in individuals that aspire with sustenances of liquid and solid consistency, before during and after food, when compared to the individuals that do not aspire. Objective: To verify the possibility of the utilization of the pulse oximetry as an instrumental alternative in the clinical evaluation for the dysphagia. Method: Revision of literature, based in articles indexed in the bases Lilacs and Medline having as a reference the descriptors: saturation of oxygen, pulse oximetry and swallowing disorders. Results: The association of the clinical evaluation to the pulse oximetry shows up with high sensibility in the detection of the penetration and aspiration laringotraqueal and with bass false-positive index, considering it desaturation, the indices that pierced with bigger values than 2%. Some data found are divergent as the aspiration detection possibility. Final Comments: The studies analyzed confer to oximetria of wrist the character of practically and possibility of use in the actions by the bed, being utilized ally to the clinical evaluation for dysphagia, although certain disagreement between the same is found as regards the utilization of its results as indicator of aspiration laringotraqueal, suggesting need of subsequent researches.