{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T04:03:21Z","timestamp":1785643401827,"version":"3.56.0"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Tactile stimulation manoeuvres stimulate spontaneous breathing in preterm newborns. The aim of this study is to evaluate the effect of early respiratory physiotherapy on the need for mechanical ventilation during the first week of life in preterm infants with respiratory failure. Methods: This is a monocentric, randomised controlled trial. Preterm infants (gestational age \u2264 30 weeks) not intubated in the delivery room and requiring non-invasive respiratory support at birth were eligible for the study. The intervention group received early respiratory physiotherapy, while the control group received only a daily physiotherapy program (i.e., modifying the infant\u2019s posture in accordance with the patient\u2019s needs). Results: between October 2019 and March 2021, 133 preterm infants were studied, 68 infants in the study group and 65 in routine care. The study group showed a reduction in the need for mechanical ventilation (not statistically significant) and a statistically significant reduction in hemodynamically significant patent ductus arteriosus with respect to the control group (19\/68 (28%) vs. 35\/65 (54%), respectively, p = 0.03). Conclusions: early respiratory physiotherapy in preterm infants requiring non-invasive respiratory support at birth is safe and has proven to be protective against haemodynamically significant PDA.<\/jats:p>","DOI":"10.3390\/children10111761","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T12:50:42Z","timestamp":1698670242000},"page":"1761","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early Respiratory Physiotherapy versus an Individualized Postural Care Program for Reducing Mechanical Ventilation in Preterm Infants: A Randomised Controlled Trial"],"prefix":"10.3390","volume":"10","author":[{"given":"Milena","family":"Tana","sequence":"first","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9552-3484","authenticated-orcid":false,"given":"Anthea","family":"Bottoni","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9009-3997","authenticated-orcid":false,"given":"Francesco","family":"Cota","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Papacci","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Di Polito","sequence":"additional","affiliation":[{"name":"Servizio Medicina Fisica e Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Del Vecchio","sequence":"additional","affiliation":[{"name":"Servizio Medicina Fisica e Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Laura","family":"Vento","sequence":"additional","affiliation":[{"name":"Servizio Medicina Fisica e Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-8382","authenticated-orcid":false,"given":"Benedetta","family":"Campagnola","sequence":"additional","affiliation":[{"name":"Servizio Medicina Fisica e Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sefora","family":"Celona","sequence":"additional","affiliation":[{"name":"Servizio Medicina Fisica e Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Cricenti","sequence":"additional","affiliation":[{"name":"Servizio Medicina Fisica e Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Bastoni","sequence":"additional","affiliation":[{"name":"Servizio Medicina Fisica e Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Tirone","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Aurilia","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Lio","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Paladini","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5304-1485","authenticated-orcid":false,"given":"Stefano","family":"Nobile","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Perri","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-6751","authenticated-orcid":false,"given":"Annamaria","family":"Sbordone","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Esposito","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2991-2068","authenticated-orcid":false,"given":"Simona","family":"Fattore","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola Emilia","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Servizio Medicina Fisica e Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpaolo","family":"Ronconi","sequence":"additional","affiliation":[{"name":"Servizio Medicina Fisica e Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3121-9569","authenticated-orcid":false,"given":"Giovanni","family":"Vento","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Department of Woman and Child Health and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1041898","DOI":"10.3389\/fped.2022.1041898","article-title":"Tactile stimulation in very preterm infants and their needs of non-invasive respiratory support","volume":"10","author":"Kaufmann","year":"2022","journal-title":"Front. Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1159\/000528914","article-title":"European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update","volume":"120","author":"Sweet","year":"2023","journal-title":"Neonatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.resuscitation.2018.03.030","article-title":"Repetitive versus standard tactile stimulation of preterm infants at birth\u2014A randomized controlled trial","volume":"127","author":"Dekker","year":"2018","journal-title":"Resuscitation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1002\/dev.21526","article-title":"The manual orienting response habituation to repeated tactile stimuli in preterm neonates: Discrimination of stimulus locations and interstimulus intervals","volume":"59","author":"Dumont","year":"2017","journal-title":"Dev. Psychobiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1136\/archdischild-2020-318915","article-title":"Reflexes that impact spontaneous breathing of preterm infants at birth: A narrative review","volume":"105","author":"Kuypers","year":"2020","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1186\/s13063-021-05446-8","article-title":"Effects of early respiratory physiotherapy on spontaneous respiratory activity of preterm infants: Study protocol for a randomized controlled trial","volume":"22","author":"Tana","year":"2021","journal-title":"Trials"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e1322","DOI":"10.1542\/peds.2012-0511","article-title":"Developmental care for premature infants: A state of mind","volume":"129","author":"Goldstein","year":"2012","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1001\/jama.1994.03520110033025","article-title":"Individualized developmental care for the very low-birth-weight preterm infant. Medical and neurofunctional effects","volume":"272","author":"Als","year":"1994","journal-title":"JAMA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/S0022-3476(05)82166-3","article-title":"Postural effects on pulmonary function and heart rate of preterm infants with lung disease","volume":"118","author":"Mendoza","year":"1991","journal-title":"J. Pediatr."},{"key":"ref_10","first-page":"36","article-title":"Chest physiotherapy in preterm infants with lung diseases","volume":"26","author":"Giannantonio","year":"2010","journal-title":"Ital. J. Pediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1038\/sj.jp.7211861","article-title":"Clinical reliability and validity of the N-PASS: Neonatal pain, agitation and sedation scale with prolonged pain","volume":"28","author":"Hummel","year":"2008","journal-title":"J. Perinatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S2213-2600(20)30179-X","article-title":"Lung Recruitment before Surfactant Administration in Extremely Preterm Neonates with Respiratory Distress Syndrome (IN-REC-SUR-E): A Randomised, Unblinded, Controlled Trial","volume":"9","author":"Vento","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/ppul.24265","article-title":"Oxygen saturation\/FIO2 ratio at 36 weeks\u2019 PMA in 1005 preterm infants: Effect of gestational age and early respiratory disease patterns","volume":"54","author":"Nobile","year":"2019","journal-title":"Pediatr. Pulmonol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1164\/ajrccm.163.7.2011060","article-title":"Bronchopulmonary dysplasia","volume":"163","author":"Jobe","year":"2001","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1038\/s41390-018-0077-x","article-title":"Application of NPE in the assessment of a patent ductus arteriosus","volume":"84","author":"Gupta","year":"2018","journal-title":"Pediatr. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/S0022-3476(78)80282-0","article-title":"Incidence and evolution of the sub-ependymal intraventricular hemorrhage; a study of infants weighing less than 1500 grams","volume":"92","author":"Papile","year":"1978","journal-title":"J. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0166-4328(05)80189-5","article-title":"The spectrum of leukomalacia using cranial ultrasounds","volume":"49","author":"Eken","year":"1992","journal-title":"Behav. Brain Res."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"International Committee for the Classification of Retinopathy of Prematurity (2005). The International Classification of Retinopathy of Prematurity revisited. Arch. Ophthalmol., 123, 991\u2013999.","DOI":"10.1001\/archopht.123.7.991"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1159\/000449240","article-title":"The Effect of Head Positioning and Head Tilting on the Incidence of Intraventricular Hemorrhage in Very Preterm Infants: A Systematic Review","volume":"111","author":"Brouwer","year":"2017","journal-title":"Neonatology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.rpped.2015.08.013","article-title":"Avalia\u00e7\u00e3o do fluxo sangu\u00edneo cerebral de rec\u00e9m-nascidos prematuros durante a fisioterapia respirat\u00f3ria com a t\u00e9cnica do aumento do fluxo expirat\u00f3rio [Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique]","volume":"34","author":"Bassani","year":"2016","journal-title":"Rev. Paul. Pediatr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1111\/apa.14239","article-title":"Tactile stimulation during neonatal transition and its effect on vital parameters in neonates during neonatal transition","volume":"107","author":"Urlesberger","year":"2018","journal-title":"Acta Paediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1159\/000499361","article-title":"European Consensus Guidelines on the Management of Respiratory Distress Syndrome\u20142019 Update","volume":"115","author":"Sweet","year":"2019","journal-title":"Neonatology"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/11\/1761\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:14:04Z","timestamp":1760130844000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/11\/1761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,30]]},"references-count":22,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["children10111761"],"URL":"https:\/\/doi.org\/10.3390\/children10111761","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,30]]}}}