ABSTRACT
Objetivos: Comparar y establecer el grado de acuerdo entre los valores de Presión Inspiratoria máxima (PImáx) y Presión Espiratoria máxima (PEmáx) medidos con pipeta bucal y boquilla de buceo, en adultos. El objetivo secundario fue evaluar el grado de acuerdo entre los valores calculados con las ecuaciones de Evans y Whitelaw y los valores máximos obtenidos con cada interfaz. Materiales y método: Se llevó a cabo un estudio observacional, descriptivo, prospectivo y transversal. Se realizó un muestreo consecutivo no probabilístico de sujetos argentinos entre 18 y 69 años de edad. Se midieron PImáx y PEmáx utilizando un sistema de válvulas unidireccionales y un manovacuómetro aneroide, con boquilla de buceo y pipeta bucal. Resultados: Se incluyeron 240 sujetos que completaron la totalidad de las mediciones con ambas interfaces. Los valores de PEmáx con pipeta bucal fueron mayores que los obtenidos con boquilla de buceo (p < 0.01), con un Coeficiente de Correlación Intraclase (ICC sigla en inglés) entre ambas de 0.80 (IC 95% 0.74-0.84). Para PImáx no hubo diferencias entre ambas interfaces, con un ICC de 0.88 (IC 95% 0.85-0.91). Los ICC para las ecuaciones de Evans y Whitelaw y los máximos valores alcanzados por los sujetos fueron de -0.15 a 0.09 mostraron un grado de acuerdo pobre. Conclusión: Los valores de PEmáx con pipeta bucal fueron mayores que los obtenidos con la boquilla de buceo. No se detectaron diferencias entre ambas interfaces para PImáx. En la población estudiada las fórmulas de Evans y Whitelaw no fueron exitosas en la predicción de presiones máximas.
Objectives: To compare and establish the degree of agreement between the values of Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) measured with a plastic mouthpiece and a scuba type mouthpiece in adults. The secondary objective was to evaluate the degree of agreement between the values calculated with Evans and Whitelaw equation and the maximal values attained with each mouthpiece. Methods: We conducted an analytical observational transversal study. Sampling was non-probabilistic, of Argentinian subjects aged between 18 and 69 years old. We measured MIP and MEP with an unidirectional valves system and an aneroid manovacuometer, with a plastic mouthpiece and a scuba type mouthpiece. Results: 240 subjects were included and completed all the measurements with both mouthpieces. MEP values were higher when measured with a plastic mouthpiece than with the scuba type (p < 0.01), with an Intraclass Correlation Coefficient (ICC) between both of 0.80 (CI 95% 0.74-0.84). There were no differences in MIP between both mouthpieces, with an ICC of 0.88 (CI 95% 0.85-0.91). The ICC between Evans and Whitelaw predictive values and the maximal values attained by the subjects varied from -0.15 to 0.09, showing a poor degree of agreement. Conclusion: MEP values attained with a plastic mouthpiece are greater than those attained with a scuba type mouthpiece. There are no differences between both mouthpieces for MIP. Evans and Whitelaw equations are not successful in predicting maximal pressures in the population here studied.
Subject(s)
Respiratory Muscles , Maximal Respiratory PressuresABSTRACT
Objectives: To compare and establish the degree of agreement between the values of Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP) measured with a plastic mouthpiece and a scuba type mouthpiece in adults. The secondary objective was to evaluate the degree of agreement between the values calculated with the equations by Evans and Whitelaw and the maximal values attained with each interface. Materials and Method: We conducted an observational, descriptive, prospective transversal study. We carried out a consecutive, non-probabilistic sampling of Argentinian subjects aged between 18 and 69 years. We measured the MIP and MEP with a unidirectional valve system and an aneroid manovacuometer, with a plastic mouthpiece and a scuba type mouthpiece. Results: A total of 240 subjects were included and completed all the measurements with both interfaces. MEP values were higher when measured with a plastic mouthpiece compared to the scuba type (p < 0.01), with an Intraclass Correlation Coefficient (ICC) between them of 0.80 (95% CI [confidence interval]: 0.74-0.84). There were no differences in the MIP between both interfaces, with an ICC of 0.88 (95% CI: 0.85-0.91). The ICC between the equations by Evans and Whitelaw and the maximal values attained by the subjects varied from -0.15 to 0.09, showing a low degree of agreement. Conclusion: MEP values attained with a plastic mouthpiece are greater than those attained with the scuba type mouthpiece. There are no differences between both interfaces for the MIP. Evans and Whitelaw equations were not successful in predicting maximal pressures in the population under study.
Subject(s)
Respiratory Muscles , Maximal Respiratory PressuresABSTRACT
Introducción: la enfermedad de Steinert es una enfermedad neuromuscular crónica y progresiva de carácter autosómico dominante. Debido a que puede afectar a los músculos respiratorios, los pacientes se benefician de distintas técnicas de fisioterapia con el fin de evitar complicaciones. Caso clínico: paciente con enfermedad de Steinert que fue tratada en un hospital público de la provincia de Buenos Aires durante un cuadro de insuficiencia respiratoria aguda, de manera no invasiva. Comentarios: esta experiencia muestra que estos pacientes pueden ser tratados de manera no invasiva, fuera de la unidad de cuidados intensivos, y ser controlados ambulatoriamente luego de su egreso pudiendo reinsertarse en la comunidad. Asimismo, cabe destacar que esto fue posible en un hospital público, dentro de un contexto institucional y socioeconómico desfavorable(AU)
Introduction: Steinert's disease is a chronic and progressive autosomal dominant neuromuscular disease. Because this disease can affect respiratory muscles, these patients benefit from different physiotherapy techniques in order to avoid complications. Case presentation: patient with Steinert's disease who was treated in a Public Hospital of the Province of Buenos Aires during an acute respiratory failure with non-invasive way. Comments: This experience shows that these patients can be treated non-invasively, outside the intensive care unit, and be controlled outpatient after discharge, being able to be reinserted in the community. It should also be noted that this was possible in a public hospital, within an unfavorable institutional and socio-economic context(AU)