الفهرس 
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Abstract
The current study aimed to evaluate the effect of chest percussion post-nebulizer on respiratory status among infants with pneumonia. Quasi-experimental research design (study and control group) was used in the current study. A purposeful sample of 90 infants who had pneumonia participated in the study. The sample was divided into two equal groups: 45 for (the study group) those infants with pneumonia who received chest percussion post nebulization therapy and 45 for (the control group) those infants with pneumonia who received nebulization therapy only without percussion. The current study was conducted at pediatrics department at MUHOP.The following tools were found which includes a structured interview questionnaire sheet about the infants in demographic and medical data, and a respiratory status assessment scale about the infant’s clinical and physiological parameters.
The findings of the current study are summarized that:
• The mean ages of infants were 7.4 ± 2.4 and 7.5 ± 2.2 months in the study and control groups respectively.
• The highest percentage of infants (84.4 % &88.9% respectively) came from rural areas, and their mean weight was 7.1±1.5 kg and 6.5±1.6 kg in the study and control groups respectively.
• More than half (57.8 % & 55.6%) of infants were males in study and control groups respectively. There were 73.3% of infants in the study group and 64.4 % of infants in the control group received all their immunizations completely according to the Egyptian obligatory immunizations schedule at the time.
• The mean of the infant’s oxygen therapy duration was 4.8± 1.8 and 8.4±2.3 in the study and control groups respectively with high significance. In addition, 66.7% and 57.8% of infants in the study and control group received oxygen therapy by nasal cannula, respectively. while 95.6% and 97.7% of them received atrovent and pulmcort inhalation therapy as management for pneumonia, respectively.
• The infant’s hospital stay due to pneumonia in the study group decreased after the implementation of chest percussion for infants whereas the highest percentage of infants (82.2%) in the study group they are a current stay in the hospital less than 7 days with mean days was 6.1±1.5 day while 88.9% of infants in control group their stay in hospital was more than 7 days with mean days was 10.5±2.5.
• There were 86.6 % of infants in the study group and 60% in the control group were hospitalized for pneumonia for the first time.
• The infants with pneumonia had fever with their mean 37.9± 0.81 and 38.2± 0.75 in the study and control group respectively. In addition, 77.8% and 86.7% of infants in the study group and in the control group had a productive cough, respectively. And also, all infants in both group experienced tachypnea, 55.6% and 46.6% of infants in the study and control group had wheezing breathing sound.
• There 100% of infants in the study and 97.8% in the control group had retraction with no statistically significant differences between the study and control groups. And also 100% of infants in both groups had nasal flaring.
• There were 97.8% of infants in the study group and 91.1% of infants in the control group experienced cyanosis, and 82.2% and 77.8% of infants in the study and control group appeared irritable, restless, and lethargic in behavior, respectively. Also, 51.1% and 35.5 of the infant in the study and control group complained of anorexia, vomiting, and diarrhea, respectively. While 26.7 % of the infant in both the study and control complained of anorexia only.
• There was a high significance level at .0001, when the total mean of clinical parameters among infants was (5.8± 2.2, 3.4± 1.8, 1.6±1.5 and7.9± 2.9, 6.9 ± 2.6, 6 ±2.4) in study and control group on second, third and fourth days, respectively.
• There was a high significance level as 0001, when the mean of bio-physiological parameters among infants was (3.4±.75, 2.1±1, 1±1.13, 0.44±0.72 and 4±.73, 2.9±0.89, 2.2±1.16, 1.7±1. 2) in study and control group at first, second, third and fourth days, respectively. while was no significant difference between infants in the study and the control group on admission days.
• There was statistically significant differences in the level of distress on the second, third, and fourth days, where 73.3% and 42.2% had mild distress on the second day. And 15.5% of infants in the control group had severe distress compared to no one in the study group but, also the majority of infants had mild distress in study infants on the third day. There were 35.5% of infants in the study group moved to normal respiratory status compare to the control group were no one on the forth day.
• There was a statistically significant difference in the level of BMP altered on the first, second, third, and fourth days, 57.8% and 82.2% had to sever altered BMP on the first day, and 8.9% and 33.3% had to sever altered their BMP on the second da in the study as well as control group recpectively y. There were 46.7% of infants in the study group moved to normal BMP compare to the control group 4.5% only on the third day. There were 67.3% and 20% of infants in the study and control group moved to normal levels on a fourth day, respectively.
• There were statistically significant positive correlations between infants’ age and weight and heart rate, there was a statistically significant positive correlation between infants’ hospital stay and clnical parameters.
• There was a statistically significant positive correlation between heart rate and oxygen saturation and there was a statistically significant positive correlation between respiratory rate and clinical parameters after the application of chest percussion post-nebulizer on infants.
CONCLUSIONS
As pointed the current study results showed that, the clinical parameter distress decrease from second into forth day among infants in study group when their precent (73.3%,93.3%)in the second and third day had mild distress while in forth day their percent was(64.5%)had mild distress and(35.5%)whithin normal.also this study found that decrease alteration in bio-physiological paramters in study group from first into forth day when their percent in the first and second day was(42.2%,84.4%)had mid\modrate alteration while in the third and forth day their percent(46.7%,67.3%) within normal level.This reflects the effectiveness of chest percussion post-nebulizer on respiratory status among infants with pneumonia.