I would be very interested to hear what actually happens in your NICU:
Do you use chest/respiratory physiotherapy in preterm infants? If so, for which specific indications, which techniques are used, and who performs them? Do you have a written protocol?

We have daily physiotherapy in all preterms to facilitate breathing, position to prevent contructures and neck disorders related to uncomfortable position, joints movement and inhancing suckling activity

Chest physiotherapy, as in thumping/vibration to mobilize lung secretions has scarce scientific support. As Nasser mentioned, positioning and flexing is most likely a better option.

No the nurses stopped, since the mid 90s. When there was association of brain injury and death. Now it’s individuality assessed and we very rarely, if at all give chest physio.

Jane E. Harding et al., 1988. Chest physiotherapy may be associated with brain damage in extremely premature. The Journal of Pediatrics. Volume 132, Issue 3, March 1998, Pages 440-444

Thank you all for your replies — very interesting to hear your different perspectives.

@Fiona Dineen, I share many of your concerns. My main concern is whether, particularly in extremely preterm infants, we may sometimes be intervening without clear evidence of benefit while potentially adding unnecessary handling and risk. This is really what prompted my “to benefit, or at least, not to harm” question.

When you say that chest physiotherapy is now very rarely used, could you share in which specific clinical situations your team would still consider it indicated?