BACKGROUND: Respiratory morbidity and the need for mechanical ventilation are very high among preterm infants. Chest physical therapy is therefore an essential component of neonatal care. OBJECTIVE: To compare the effects of conventional chest physical therapy (CCP) and increased expiratory flow (IEF) on the oxygen saturation (SpO2), heart rate, and respiratory rate (RR) of preterm infants following extubation. METHOD: This was a randomized clinical trial, in the neonatal intensive care unit of Botucatu Medical School-UNESP, comparing two physical therapy techniques applied to preterm infants during the first 48 hours following extubation. Statistical analyses were performed using the Student t, Mann-Whitney, Chi-squared and Fisher exact tests, with a significance level of 5%. RESULTS: The two study groups, CCP (n = 20) and IEF (n = 20), presented similar gestational ages (mean 28 weeks) and birth weights (mean 1,100 g). In both groups, respiratory distress syndrome was the main diagnosis. The median age for starting physical therapy was seven days in the IEF group and 11 days in the CCP group. Both techniques produced significantly increased SpO2 after 10 and 30 minutes of chest physical therapy, with no change in RR. There was a significant increase in heart rate after CCP, but no change occurred after IEF. CONCLUSION: Our data suggest that the IEF technique is less stressful than CCP and can be used for preterm infants following extubation. In these infants, IEF was seen to be safe and beneficial over the short term.

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