Does the use of a diving mask adapted for non-invasive ventilation in hypoxemic acute respiratory failure in individuals with and without COVID-19 increase the ratio of arterial oxygen partial pressure to fractional inspired oxygen? A randomized clinical trial.

Non-invasive ventilation (NIV) can be used in acute hypoxemic respiratory failure (AHRF); however, verifying the best interface for its use needs to be evaluated in the COVID-19 pandemic scenario. The objective of this study was to evaluate the behavior of the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2 ratio) in patients with AHRF with and without COVID-19 undergoing NIV with the conventional orofacial mask and the adapted diving mask. This is a randomized clinical trial in which patients were allocated into four groups: i) group 1: COVID-19 + adapted mask (n=12); ii) group 2: COVID-19 + conventional orofacial mask (n=12); iii) group 3: non-COVID-19 + adapted mask (n=2); iv) group 4: non-COVID-19 + conventional orofacial mask (n=12). The PaO2/FiO2 ratio was obtained 1, 24, and 48 hours after starting NIV, and the success of NIV was evaluated. This study followed the norms of the Consolidated Standards of Reporting Trials statement and was registered in the Brazilian Registry of Clinical Trials under registration RBR-7xmbgsz. Both the adapted diving mask and the conventional orofacial mask increased the PaO2/FiO2 ratio. The interfaces differed in terms of the PaO2/FiO2 ratio in the first hour [309.66 (11.48) and 275.71 (11.48), respectively] (p=0.042) and 48 hours [365.81 (16.85) and 308.79 (18.86), respectively] (p=0.021). NIV success was 91.7% in groups 1, 2, and 3, and 83.3% in group 4. No adverse effects related to interfaces or NIV were observed. NIV through the conventional orofacial mask interfaces and the adapted diving mask was effective in improving the PaO2/FiO2 ratio; however, the adapted mask presented a better PaO2/FiO2 ratio during use. There was no significant difference between interfaces regarding NIV failure.

Static and dynamic balance of children and adolescents with sensorineural hearing loss.

OBJECTIVE: To assess the static and dynamic balance performance of students with normal hearing and with sensorineural hearing loss. METHODS: A cross-sectional study assessing 96 students, 48 with normal hearing and 48 with sensorineural hearing loss of both sexes, aged 7 and 18 years. To evaluate static balance, Romberg, Romberg-Barré and Fournier tests were used; and for the dynamic balance, we applied the Unterberger test. RESULTS: Hearing loss students showed more changes in static and dynamic balance as compared to normal hearing, in all tests used (p<0.001). The same difference was found when subjects were grouped by sex. For females, Romberg, Romberg-Barré, Fournier and Unterberger test p values were, respectively, p=0.004, p<0.001, p<0.001 and p=0.023; for males, the p values were p=0.009, p<0.001, p<0.001 and p=0.002, respectively. The same difference was observed when students were classified by age. For 7 to 10 years old students, the p values for Romberg, Romberg-Barré and Fournier tests were, respectively, p=0.007, p<0.001 and p=0.001; for those aged 11 and 14 years, the p values for Romberg, Romberg-Barré, Fournier and Unterberger tests were p=0.002, p<0.001, p<0.001 and p=0.015, respectively; and for those aged 15 and 18 years, the p values for Romberg-Barré, Fournier and Unterberger tests were, respectively, p=0.037, p<0.001 and p=0.037. CONCLUSION: Hearing-loss students showed more changes in static and dynamic balance comparing to normal hearing of same sex and age groups.

Static and dynamic balance of children and adolescents with sensorineural hearing loss / Equilíbrio estático e dinâmico de crianças e adolescentes com perda auditiva sensório-neural

ABSTRACT Objective To assess the static and dynamic balance performance of students with normal hearing and with sensorineural hearing loss. Methods A cross-sectional study assessing 96 students, 48 with normal hearing and 48 with sensorineural hearing loss of both sexes, aged 7 and 18 years. To evaluate static balance, Romberg, Romberg-Barré and Fournier tests were used; and for the dynamic balance, we applied the Unterberger test. Results Hearing loss students showed more changes in static and dynamic balance as compared to normal hearing, in all tests used (p<0.001). The same difference was found when subjects were grouped by sex. For females, Romberg, Romberg-Barré, Fournier and Unterberger test p values were, respectively, p=0.004, p<0.001, p<0.001 and p=0.023; for males, the p values were p=0.009, p<0.001, p<0.001 and p=0.002, respectively. The same difference was observed when students were classified by age. For 7 to 10 years old students, the p values for Romberg, Romberg-Barré and Fournier tests were, respectively, p=0.007, p<0.001 and p=0.001; for those aged 11 and 14 years, the p values for Romberg, Romberg-Barré, Fournier and Unterberger tests were p=0.002, p<0.001, p<0.001 and p=0.015, respectively; and for those aged 15 and 18 years, the p values for Romberg-Barré, Fournier and Unterberger tests were, respectively, p=0.037, p<0.001 and p=0.037. Conclusion Hearing-loss students showed more changes in static and dynamic balance comparing to normal hearing of same sex and age groups.

RESUMO Objetivo Avaliar o desempenho do equilíbrio estático e dinâmico de escolares ouvintes e com perda auditiva sensório-neural. Métodos Estudo de corte transversal que avaliou 96 escolares, sendo 48 ouvintes e 48 com perda auditiva sensório-neural, de ambos os sexos, na faixa etária entre 7 e 18 anos. Para a avaliação do equilíbrio estático, foram utilizados os testes de Romberg, Romberg-Barré e Fournier, e, para avaliar o equilíbrio dinâmico, foi usado o teste de Unterberger. Resultados Os escolares com perda auditiva apresentaram maior ocorrência de alterações no equilíbrio estático e dinâmico, comparados aos ouvintes, em todos os testes empregados (p<0,001). O mesmo foi observado quando os escolares foram agrupados pelos sexos. Para o sexo feminino, os valores de p para os testes de Romberg, Romberg-Barré, Fournier e Unterberger foram, respectivamente, p=0,004, p<0,001, p<0,001 e p=0,023; para o sexo masculino, foram p=0,009, p<0,001, p<0,001 e p=0,002. A mesma diferença foi observada quando os escolares foram estratificados pelas faixas etárias. Para aqueles de 7 a 10 anos, os valores de p foram, respectivamente, para os testes de Romberg, Romberg-Barré e Fournier p=0,007, p<0,001 e p=0,001; entre 11 e 14 anos, para os testes de Romberg, Romberg-Barré, Fournier e Unterberger, foram, respectivamente p=0,002, p<0,001, p<0,001, p=0,015; entre 15 e 18 anos, para os testes Romberg-Barré, Fournier e Unterberger foram, respectivamente, p=0,037, p<0,001 e p=0,037. Conclusão Os escolares com perda auditiva apresentaram maior ocorrência de alterações no desempenho do equilíbrio estático e dinâmico que os ouvintes, do mesmo sexo e faixa etária.