International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
Bootstrap Slider

Indexed and Abstracted in: SCOPUS, Crossref, CAS Abstracts, Publons, CiteFactor, Open J-Gate, ROAD, Indian Citation Index (ICI), Indian Journals Index (IJINDEX), Internet Archive, IP Indexing, Google Scholar, Scientific Indexing Services, Index Copernicus, Science Central, Revistas Medicas Portuguesas, EBSCO, BOAI, SOROS, NEWJOUR, ResearchGATE, Ulrich's Periodicals Directory, DocStoc, PdfCast, getCITED, SkyDrive, Citebase, e-Print, WorldCat (World's largest network of library content and services), Electronic Journals Library by University Library of Regensburg, SciPeople.

Search Articles

Track manuscript

Readers around the world

Full Html

IJCRR - Vol 02 Issue 01, January, 2010

Pages: 28-31

Date of Publication: 30-Nov--0001

Print Article   Download XML  Download PDF


Author: Vaishali, Jithendra Kumar, V. Prem, Sushmitha.N, Shailendra Lende

Category: Healthcare

Abstract:Chest physiotherapy is often used to correct Atelectasis in the neonatal intensive care unit. This case report
describes about the importance and effectiveness of chest physiotherapy in a 24 days old neonate who presented with pulmonary haemorrhage and right upper lobe collapse. Chest physiotherapy was
administered every four hours for three days. Chest X ray revealed full expansion after three days of
physiotherapy intervention.

Full Text:


Chest physiotherapy (CPT) has been used in many neonatal nurseries around the world to improve airway clearance and treat lung collapse; however, the evidence to support its use has been conflicting. There is not enough evidence to determine whether active chest physiotherapy is beneficial or harmful in neonates on mechanical ventilation. Babies who require mechanical ventilation are at risk of lung collapse from increased secretions. Chest physiotherapy (patting or vibrating the chest) is used to improve clearance of secretions from the airway to try to prevent lung collapse1 .

Acute lobar Atelectasis is a common problem in infants receiving mechanical ventilation2 . Atelectasis contributes to morbidity in the neonatal nursery, necessitating prolongation of oxygen administration3 . In the neonatal population, CPT is used to prevent and treat lung collapse and consolidation. CPT in the neonates consists of a variety of techniques that include positioning, active techniques such as percussion and vibration, and suction1 .

Case report - A 24 day old full term female baby admitted to the hospital on 5-07-2008, with the complaints of bleeding from the nose, scanty in quantity for about half an hour. There was no history of fall, cough, breathlessness or seizures. Baby with a normal natal history, normal vaginal delivery, birth weight 2.8 kgs, with APGAR score 8 at first minute.

Baby was diagnosed to have pulmonary haemorrhage and respiratory distress by the Paediatrician. Chest x-ray on the day of admission showed non homogenous opacity and infiltrates suggestive of pulmonary haemorrhage (picture 1). CT scan confirmed the diagnosis of diffuse alveolar pulmonary haemorrhage.

Baby was mechanically ventilated on the same day with the following settings: PSIMV, RR 40 per min, FiO2 50%, PEEP- 6, Peak inspiratory pressure (PIP)- 22, oxygen saturation-94%, and ABG showed uncompensated respiratory alkalosis. Haemoglobin-16.2 gm%, Total count-12060, platelets-2.51 lakhs, WBCs-high, Calcium-9.0, SGPT-51, Creatinine-0.3, CRP-negative, stool for occult blood- positive, Prothrombin time- test-13.6, control-13.5, INR-1.

The next day (i.e.) on 6-07-2008, the ventilatory settings were P-SIMV, FiO2 30%, PEEP- 6, Flow rate- 7, PIP- 20, oxygen saturation- 95%.Heart rate 156 /min. Spontaneous respiratory rate was 40/ min. On auscultation, absence of breath sounds in right upper zone. ABG report showed respiratory alkalosis. Child was treated with IV antibiotics and supportive measures were given. In view of repeat chest x-ray on the next day which showed right upper lobe collapse and pneumonitis, the baby was referred for physiotherapy.

Chest physiotherapy

The baby was given chest physiotherapy from 6-07-2008 at 11 am. On observation, child skin colour was pink, no cyanosis, diminished chest movements on the right upper zone anteriorly, shallow breathing with respiratory rate 40/min. on palpation right upper zone chest asymmetry, no tracheal deviation, and positive tactile fremitus. On auscultation, diminished breath sounds in the right upper zone with occasional crepitations heard during expiration. Parameters were noted before and after chest physiotherapy sessions. The baby was positioned in upright with the help of towel rolls for 25 minutes. Proprioceptive neuromuscular facilitation (PNF) was given by tactile stimulation for five minutes on bare chest (tactile stimulation is a technique of placing therapist?s forefingers on baby?s chest i.e. on right upper zone).Gentle vibrations were given on the right upper zone with the help of three fingers (three finger technique i.e. with index, middle and ring fingers kept on the baby?s bare chest and vibrations were given for one minute during alternate expiration as the rate was high). Five sets of vibrations with one minute durations were carried out. After PNF for five minutes and vibrations for five minutes in the upright position, baby was positioned in supine, endotracheal (ET) and oral suctioning was done. The suctioning was terminated following no secretion removal from ET suctioning. All the parameters were noted. Five minutes post suction, the baby was positioned in the same upright position and PNF was given for five minutes. Position was maintained for two hours. Physiotherapy was given every six hourly. Same procedure was carried out six hourly for three days. On third day, there was an improvement in chest expansion, no asymmetry, decreased respiratory rate, improved breath sounds on right upper zone with expansion of right upper zone on chest x ray (picture 2). The ventilator parameters on the same day were as follows, P-SIMV, FiO2 30%, RR 26, HR 138/min, SpO2 100%, PIP-20, flow rate 4Lit. The baby was extubated the next day and was put on 2 litres of oxygen through face mask

Picture 2: x ray showing re expansion of the lung on third day of physiotherapy intervention


The aim of chest physiotherapy in this baby with pulmonary haemorrhage was to re expand the atelectatic lung and to improve the lung expansion. Positioning was used as it helps in optimizing oxygen transport through its effects of improving ventilation/perfusion (V/Q) matching, increasing lung volumes, reducing the work of breathing, minimizing the work of the heart, and enhancing mucociliary clearance. Upright position dimension of the chest wall is greatest, and the compression of heart and lungs is minimized. The Vibration technique used by us increased clearance of airway secretions by the transmission of an energy wave through the chest wall. Endotracheal Suctioning was used with the aim of removing secretions from the central airways and stimulating cough reflex. The proprioceptive and tactile stimuli selected by us produced expansion of the thoracic cage, reduced asymmetry and decreased respiratory ratewas used in this patient to maximize lung volumes and capacities, the vertical gravitational gradient is maximal, the anteroposterior.

Future research

Future studies with large sample size and randomized trials are needed.


Careful administration of chest physiotherapy can re expand the atelectatic lung in a pulmonary haemorrhage neonate.


1. Chest physiotherapy for reducing respiratory morbidity in infants requiring ventilatory support (Review) Hough JL, Flenady V, Johnston L, Woodgate PG, The Cochrane Library 2008, Issue 3

2. Who needs chest physiotherapy? Moving from anecdote to evidence, Colin Wallis and Ammani Prasad, Arch. Dis. Child. 1999;80;393-397

3. Ehrlich R, Arnon RG. The intermittent endotracheal intubation technique for the treatment of recurrent atelectasis. Pediatrics 1972; 50:1447

4. Jan Stephen Tecklin: Respiratory Failure in the Neonate. In Scot Irwin, Jan Stephen Tecklin, Cardiopulmonary Physical Therapy a Guide to Practice, ed 4, 2004, Mosby.

5. Jennifer A Pryor, Barbara A Webber Physiotherapy techniques. In: Jennifer A Pryor, S Ammani Prasad. Physiotherapy for respiratory and cardiac problems, adults and pediatrics. 3 rd edition, Elsevier, pg 161-234.

6. Elizabeth Dean Body positioning. In: Cardiovascular and Pulmonary Physical Therapy, Evidence and Practice. 4 th edition, Elsevier, pg 307-321.

Research Incentive Schemes

Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to for more details.

Best Article Award

A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Leow Jun Xian and Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh et al. entitled "Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma COLAKOGLU entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by Arpita M. et al entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09
Late to bed everyday? You may die early, get depression
Egg a day tied to lower risk of heart disease
88 Percent Of Delhi Population Has Vitamin D Deficiency: ASSOCHAM Report

List of Awardees

Awardees of COVID-19 Research

Woman Researcher Award

A Study by Neha Garg et al. entitled "Optimization of the Response to nCOVID-19 Pandemic in Pregnant Women – An Urgent Appeal in Indian Scenario" published in Vol 12 issue 09

A Study by Sana Parveen and Shraddha Jain entitled "Pathophysiologic Enigma of COVID-19 Pandemic with Clinical Correlates" published in Vol 12 issue 13

A Study by Rashmi Jain et al. entitled "Current Consensus Review Article on Drugs and Biologics against nCOVID-19 – A Systematic Review" published in Vol 12 issue 09

Emerging Researcher Award

A Study by Madhan Jeyaraman et al. entitled "Vitamin-D: An Immune Shield Against nCOVID-19" published in Vol 12 issue 09

Study by Dheeraj Kumar Chopra et al. entitled "Lipid-Based Solid Dispersions of Azilsartan Medoxomil with Improved Oral Bioavailability: In Vitro and In Vivo Evaluation" published in Vol 12 issue 19

RSS feed

Indexed and Abstracted in

Antiplagiarism Policy: IJCRR strongly condemn and discourage practice of plagiarism. All received manuscripts have to pass through "Plagiarism Detection Software" test before forwarding for peer review. We consider "Plagiarism is a crime"

IJCRR Code of Conduct: We at IJCRR voluntarily adopt policies on Code of Conduct, and Code of Ethics given by OASPA and COPE. To know about IJCRRs Code of Conduct, Code of Ethics, Artical Retraction policy, Digital Preservation Policy, and Journals Licence policy click here

Disclaimer: International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal.

Company name

International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal


148, IMSR Building, Ayurvedic Layout,
        Near NIT Complex, Sakkardara,
        Nagpur-24, Maharashtra State, India

Copyright © 2021 IJCRR. Specialized online journals by ubijournal .Website by Ubitech solutions