ABSTRACT
Resumen: Objetivo: Correlacionar la presencia de estridor laríngeo con el diámetro de la columna de aire de cuerdas vocales a través de ultrasonido de vía aérea en pacientes intubados en UCI. Material y métodos: Descriptivo. Se midió el diámetro de la columna de aire de cuerdas vocales con ultrasonido lineal en pacientes con weaning, se tomaron cinco grupos de acuerdo con el diámetro: < 5 mm, 5.1-5.5 mm, 5.5-6.0 mm, 6.1-6.4 y > 6.5 mm. Se observó la presencia o la ausencia de estridor laríngeo. Se realizó análisis estadístico tipo frecuencias y porcentajes, con variables de tipo cuantitativo se determinaron medidas de tendencia central, media, moda y desviación estándar. Resultados: Se incluyeron 30 pacientes, la media de edad fue de 39.5 años, una desviación estándar de 18.666, 78.6% de los pacientes permaneció intubado por un periodo de 2-5 días, 83.3% tuvo extubación exitosa, cinco fracasaron a la extubación, dos de ellos por estridor laríngeo, que correspondió a 6.7% con un diámetro de 5.1-5.5 mm., Pearson 0.48. Conclusiones: La medición del diámetro de la columna de aire de cuerdas vocales es una herramienta útil para el médico intensivista como predictor de estridor laríngeo postextubación.
Abstract: Objective: To correlate the presence of laryngeal stridor with the diameter of the vocal cord air column through airway ultrasound in patients intubated in the ICU. Material and methods: Descriptive. The diameter of the vocal cord air column was measured with linear ultrasound in weaning patients, five groups were taken according to the diameter: < 5 mm, 5.1-5.5 mm, 5.5-6.0 mm, 6.1-6.4 and > 6.5 mm. The presence or absence of laryngeal stridor was observed. Statistical analysis was carried out, such as frequencies and percentages, with variables of a quantitative type, measures of central tendency, mean, mode, and standard deviation were determined. Results: Thirty patients were included, the mean age was 39.5 years, a standard deviation of 18.666, 78.6% of the patients remained intubated for a period of 2-5 days, 83.3% presented successful extubation, five presented failure to extubation, two of them due to laryngeal stridor, which corresponded to 6.7% with a diameter of 5.1-5.5 mm., Pearson 0.48. Conclusions: The measurement of the diameter of the vocal cord air column is a useful tool for the intensivist physician as a predictor of laryngeal stridor after extubation.
Resumo: Objetivo: Correlacionar a presença de estridor laríngeo com o diâmetro da coluna aérea das cordas vocais por meio de ultrassonografia das vias aéreas em pacientes intubados na UTI. Material e métodos: Descritivo. O diâmetro da coluna de ar das cordas vocais foi medido com ultrassonografia linear em pacientes com desmame ventilatório. 5 grupos foram selecionados de acordo com o diâmetro: < 5 mm, 5.1-5.5 mm, 5.5-6.0 mm, 6.1-6.4 e > 6.5 mm. Observou-se a presença ou ausência de estridor laríngeo. Realizou-se análise estatística tipo frequências e porcentagens, com variáveis de tipo quantitativo, foram determinadas medidas de tendência central, média, moda e desvio padrão. Resultados: Foram incluídos 30 pacientes, a média de idade foi de 39.5 anos, um desvio padrão de 18.666, 78.6% dos pacientes permaneceram intubados por um período de 2-5 dias, 83.3% apresentaram sucesso na extubação, 5 apresentaram falha na extubação, 2 deles por estridor laríngeo, correspondendo a 6.7% com diâmetro de 5.1 a 5.5 mm. Pearson 0.48. Conclusão: A medida do diâmetro da coluna aérea das cordas vocais é uma ferramenta útil para o médico intensivista como preditor de estridor laríngeo após a extubação.
ABSTRACT
INTRODUCTION: Sonography has gained a broad field of applications in current anesthetic practice. During airway management, it could have an important role, because it allows real-time measurement of anatomical aspects and a functional evaluation with high safety profile. However, assessment of the reliability and precision of these measurements is critical if sonography is used as a clinical diagnostic tool. The aim of the study was to estimate inter-rater and intra-rater reliability of the airway diameter measured by sonography in heathy volunteers. METHODS: We conducted a cross-sectional study during 2015 on healthy adult volunteers. Using sonography, transverse internal diameter of subglottic space was measured twice by two blinded sonographers. RESULTS: Agreement was classified as very good for intra-rater measurements (ICC = 0.84) and good for the inter-rater measurements (ICC = 0.71). The 95% CI of agreement limits for the intra-rater measurements were inferior to those for the inter-rater measurements. CONCLUSIONS: Ultrasound measurement is a reliable and precise method to measure the internal subglottic diameter of the airway. Ultimately, this method may provide clinicians valuable information regarding airway diameter in adults and may help to guide treatment options.