ABSTRACT
BACKGROUND: High-flow nasal cannula (HFNC) enables delivery of humidified gas at high flow while controlling the FIO2 . Although its use is growing in patients with acute respiratory failure, little is known about the impact of HFNC on lung volume. Therefore, we aimed to assess lung volume changes in healthy subjects at different flows and positions. METHODS: This was a prospective physiological study performed in 16 healthy subjects. The changes in lung volumes were assessed by measuring end-expiratory lung impedance by using electrical impedance tomography. All the subjects successively breathed during 5 min in these following conditions: while in a supine position without HFNC (T0) and 3 measurements in a semi-seated position at 45° without HFNC (T1), and with HFNC at a flow of 30 L/min (T2), and 50 L/min (T3). RESULTS: Compared with the supine position, the values of end-expiratory lung impedance significantly increased with the subjects in a semi-seated position. End-expiratory lung impedance significantly increased after HFNC initiation in subjects in a semi-seated position and further increased by increasing flow at 50 L/min. When taking the end-expiratory lung impedance measurement in subjects in a semi-seated position (T1) as reference, the differences among the medians of global end-expiratory lung impedance were statistically significant (P < .001), which amounted to 1.05 units in T1; 1.12 units in T2; and 1.44 units in T3 (P < .05 for all comparisons, Wilcoxon test). The breathing frequency did not differ between the supine and semi-seated position (T0 and T1) but significantly decreased after initiation of HFNC and further decreased at high flow. T0 and T1 were not different (P = .13); whereas there was a statistically significant difference among T1, T2, and T3 (P < .05, post hoc test with Bonferroni correction). CONCLUSIONS: In healthy subjects, the semi-seated position and the use of HFNC increased end-expiratory lung impedance globally. These changes were accompanied by a significant decrease in the breathing frequency.
Subject(s)
Oxygen Inhalation Therapy/methods , Posture/physiology , Adult , Cannula , Electric Impedance , Female , Healthy Volunteers , Humans , Lung Volume Measurements , Male , Prospective Studies , Respiratory Rate , Supine Position/physiology , Tidal VolumeABSTRACT
Introducción y objetivos: El Dizziness Handicap Inventory es una herramienta útil para cuantificarla autopercepción de la discapacidad en pacientes con vértigo, mareo o inestabilidad y su impacto en actividades de la vida diaria. El Dizziness Handicap Inventory identifica problemas de orden funcional, físico y emocional relacionados con trastornos del equilibrio. Nuestro objetivo es realizar la adaptación cultural y validación del Dizziness Handicap Inventory al castellano argentino a partir de la versión española. Métodos: Se incluyeron personas sanas y pacientes con vértigo, mareo o inestabilidad, de 18 a 85 años, argentinos nativos capaces de comprender castellano. Sobre la versión española se realizaron modificaciones lingüísticas y culturales para obtenerla versión argentina. Esta versión se administró a un grupo de 108 pacientes, 2 veces, en un lapso de 24 a 72 h. Se evaluó consistencia interna, confiabilidad test-retest y validez de constructo a través de: Escala Visual Análoga, Romberg, Romberg en tándem y marcha en tándem. Resultados: Se encontró una alta consistencia interna (Alfa=0,87), y muy alta confiabilidad testretest del Dizziness Handicap Inventory total (coeficiente de correlación intraclase: 0,98) y sus subescalas. Se encontraron correlaciones significativas entre Romberg y el Romberg en tándemcon el Dizziness Handicap Inventory total y la subescala funcional. La subescala emocional mostró una correlación significativa cuando se comparó con Romberg y Romberg en tándem ojos abiertos (p < 0,05).Conclusiones: La versión argentina del Dizziness Handicap Inventory mostró ser una herramienta confiable y válida para cuantificar la autopercepción de la discapacidad debida a vértigo, mareo o inestabilidad(AU)
Introduction and objectives: The Dizziness Handicap Inventory is a useful tool for quantifying self-perceived handicap in patients with vertigo, dizziness or unsteadiness and its impact on daily living activities. The Dizziness Handicap Inventory identifies functional, physical and emotional disorders related to balance disturbance. Our objective was to cross-culturally adapt the Peninsular Spanish version of the Dizziness Handicap Inventory for use in Argentina and validate the adapted Argentinian version. Methods: We included both healthy subjects and patients with vertigo, dizziness or unsteadiness, aged 18 to 85 years, native Spanish-speaking Argentinians. We introduced linguistic and cultural modifications to the Peninsular Spanish version to obtain the Argentinian one. This version was given twice to 108 patients, 24 to 72 h apart. Internal consistency, test-retest reliability and construct validity were assessed using a visual analogue scale, the Romberg test, the tandem Romberg test and the tandem gait test. Results: We found high internal consistency (Alfa=0.87) and very high test-retest reliability for the total Dizziness Handicap Inventory score (intraclass correlation coefficient: 0.98) and its subscales. The total Dizziness Handicap Inventory and the functional subscale were found to correlate significantly with the Romberg and tandem Romberg tests. The emotional subscales howed a significant correlation with the Romberg test and the eyes-open tandem Romberg test(P<.05)Conclusions: The Argentinian version of the Dizziness Handicap Inventory proved to be a reliable and valid tool to quantify self-perceived handicap resulting from vertigo, dizziness or unsteadiness(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Disability Evaluation , Vertigo/complications , Vertigo/diagnosis , Self Concept , Dizziness/complications , Dizziness/diagnosis , Cultural Factors , Statistics on Sequelae and Disability , International Classification of Functioning, Disability and Health , Cultural Characteristics , Cross-Cultural Comparison , Surveys and Questionnaires , 28599ABSTRACT
INTRODUCTION AND OBJECTIVES: The Dizziness Handicap Inventory is a useful tool for quantifying self-perceived handicap in patients with vertigo, dizziness or unsteadiness and its impact on daily living activities. The Dizziness Handicap Inventory identifies functional, physical and emotional disorders related to balance disturbance. Our objective was to cross-culturally adapt the Peninsular Spanish version of the Dizziness Handicap Inventory for use in Argentina and validate the adapted Argentinian version. METHODS: We included both healthy subjects and patients with vertigo, dizziness or unsteadiness, aged 18 to 85 years, native Spanish-speaking Argentinians. We introduced linguistic and cultural modifications to the Peninsular Spanish version to obtain the Argentinian one. This version was given twice to 108 patients, 24 to 72 h apart. Internal consistency, test-retest reliability and construct validity were assessed using a visual analogue scale, the Romberg test, the tandem Romberg test and the tandem gait test. RESULTS: We found high internal consistency (α=0.87) and very high test-retest reliability for the total Dizziness Handicap Inventory score (intraclass correlation coefficient: 0.98) and its subscales. The total Dizziness Handicap Inventory and the functional subscale were found to correlate significantly with the Romberg and tandem Romberg tests. The emotional subscale showed a significant correlation with the Romberg test and the eyes-open tandem Romberg test (P<.05) CONCLUSIONS: The Argentinian version of the Dizziness Handicap Inventory proved to be a reliable and valid tool to quantify self-perceived handicap resulting from vertigo, dizziness or unsteadiness.
