Accuracy of single-breath counting test to determine slow vital capacity in hospitalized patients
Acurácia do teste de contagem em uma única respiração para determinar a capacidade vital lenta em pacientes hospitalizados
Anna Luiza Escóssio; Rodrigo Cappato de Araújo; Nicole Oliver; Emília Chagas Costa; José Ângelo Rizzo; Emanuel Sávio Cavalcanti Sarinho; Yossef Aelony; Marco Aurélio de Valois Correia Junior
Abstract
Purpose: to identify the accuracy of the single-breath counting test to determine slow vital capacity in hospitalized patients and to evaluate the repeatability of the same examiner.
Methods: a diagnostic study and the choice of techniques were randomly assigned. The area under the curve (receiver operating characteristic) was calculated from the slow vital capacity (20ml/kg) to evaluate the best psychometric characteristics of single-breath counting Test for this cutoff point. Repeatability observed by the same examiner was assessed using the Intraclass Correlation Coefficient.
Results: 516 patients hospitalized for various diseases were analyzed. In the curve analysis (receiver operating characteristic/slow vital capacity=20ml/Kg), the value of 21 in single-breath counting test with a sensitivity of 94.44% and specificity of 76.62% (area under the curve =0.93, p<0.005) was found. The intraclass correlation coefficient value for the single-breath counting test was 0.976 with p>0.005.
Conclusion: the single-breath counting test was a valid and repetitive technique, and may be an important screening option for assessment of lung function in the absence of specific equipment. This technique opens perspectives to replace slow vital capacity measurement in hospitals, which lack spirometric equipment, or in patients who may have a contagious disease, which has a risk of contamination and spread of disease from one patient to another.
Keywords
Resumo
Objetivo: identificar a acurácia do teste de contagem em uma única respiração para determinar a capacidade vital lenta em pacientes hospitalizados e avaliar sua repetibilidade entre o mesmo examinador.
Métodos: estudo de diagnóstico em que a escolha das técnicas foi aleatoriamente atribuída. A área sob a curva (característica de operação do receptor) foi calculada a partir da capacidade vital lenta (20ml/kg) para avaliar as melhores características psicométricas do teste de contagem em uma única respiração para este ponto de corte. A repetibilidade observada pelo mesmo examinador foi avaliada usando o coeficiente de correlação intraclasse.
Resultados: foram analisados (característica de operação do receptor/capacidade vital lenta=20ml/Kg), foi encontrado o valor de 21 em teste de contagem em uma única respiração com uma sensibilidade de 94,44% e especificidade de 76,62% (área abaixo da curva=0,93, p<0,005). O valor do coeficiente de correlação intraclasse para o teste de contagem foi 0,976 com p>0,005.
Conclusão: o teste de contagem em uma única respiração foi uma técnica válida, repetitiva e pode ser uma importante opção de rastreamento para avaliação da função pulmonar na ausência de equipamentos específicos. Essa técnica abre perspectivas no que se refere à substituição da medição da capacidade vital lenta em hospitais que não possuem equipamento espirométrico ou em pacientes que apresentam uma doença contagiosa com risco de contaminação e propagação de doença de um paciente para outro.
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Referencias
1. Pereira CA de C, Duarte AAO, Gimenez A, Soares MR. Comparison between reference values for FVC, FEV1, and FEV1/FVC ratio in white adults in Brazil and those suggested by the Global Lung Function Initiative 2012. J bras pneumol. 2014;40(4):397-402.
2. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319-38.
3. Heckman EJ, O'Connor GT. Pulmonary Function Tests for diagnosing lung disease. JAMA. 2015;313(22):2278.
4. Gosselink R, Bott J, Johnson M, Dean E, Nava S, Norrenberg M et al. Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients. Intensive Care Med. 2008;34(7):1188-99.
5. França EET, Ferrari F, Fernandes P, Cavalcanti R, Duarte A, Martinez BP et al. Physical therapy in critically ill adult patients: recommendations from the Brazilian Association of Intensive Care Medicine Department of Physical Therapy. Rev Bras Ter Intensive. 2012;24(1):6-22.
6. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948-68.
7. MacIntyre NR. The future of pulmonary function testing. Respir Care. 2012;57(1):154-61.
8. Ruppel GL, Enright PL. Pulmonary Function Testing. Respir Care. 2012;57(1):165-75.
9. Nygren-Bonnier M, Normi LT, Klefbeck B, Biquet G. Experiences of decreased lung function in people with cervical spinal cord injury. Disability And Rehabilitation. 2010;33(6):530-6.
10. Cardoso NFB, Araújo RC, Palmeira AC, Dias RF, França EET, Andrade FMD et al. Correlação entre o tempo máximo de fonação e a capacidade vital lenta em indivíduos hospitalizados. ASSOBRAFIR Ciência. 2013;4(3):9-17.
11. Lima DCB de, Palmeira AC, Costa EC, Mesquita FOC, Andrade FMD, Correia Junior MAV. Correlation between slow vital capacity and the maximum phonation time in healthy adults. Rev. CEFAC. 2014;16(2):592-7.
12. Palmeira AC, Escossio AL, Sarinho SW. Use of the technique of counting numbers as a predictor of slow vital capacity in hospitalized individuals. Rev. CEFAC. 2015;17(2):559-65.
13. Marfell-Jones M, Olds T, Stewart AD, Ridder JH. International standards for anthropometric assessment ISAK. Potchefstroom, South Africa; 2006.
14. Zou KH, O'Malley AJ, Mauri L. Receiver-operating characteristic analysis for evaluating diagnostic tests and predictive models. Circulation. 2007;115(5):654-7.
15. Stratford PW. Getting more from the literature: estimating the standard error of measurement from reliability studies. Physiother Can. 2004;56(1):27-30.
16. Latronico N, Rasulo F. Presentation and management of ICU myopathy and neuropathy. Curr Opin Crit Care. 2010;16(2):123-7.
17. Pinheiro AC, Novais MCM, Gomes Neto M, Rodrigues MVH, Rodrigues Junior ES, Aras-Junior R et al. Estimation of lung vital capacity before and after coronary artery bypass grafting surgery: a comparison of incentive spirometer and ventilometry. J Cardiothorac Surg. 2011;6(1):70.
18. Carvalho CRF, Paisani DM, Lunardi AC. Incentive spirometry in major surgeries: a systematic review. Rev Bras Fisioter. 2011;15(5):343-50.
19. Santos Pascotini F, Ribeiro VV, Christmann MK, Tomasi LL, Dellazzana AA, Haefner LS et al. Respiratory muscle strength, sound pressure level, and vocal acoustic parameters and waist circumference of children with different nutritional status. J Voice. 2016;30(1):30-5.
20. Rossi D, Munhoz D, Nogueira C. Relação do pico de fluxo expiratório com o tempo de fonação em pacientes asmáticos. Rev. CEFAC. 2006;8(4):509-17.
21. Izawa KP, Watanabe S, Tochimoto S, Hiraki K, Morio Y, Kasahara Y et al. Relation between maximum phonation time and exercise capacity in chronic heart failure patients. Eur J Phys Rehabil Med. 2012;48(4):593-9.
22. Toyoda C, Ogawa M, Oya Y, Kawai M. Maximum phonation time as a tool of screening respiratory muscle weakness in myopathic patients. No To Shinkei. 2004;56(10):873-6.
23. Speyer R, Bogaardt HCA, Passos VL, Roodenburg NP, Zumach A, Heijnen MA et al. Maximum phonation time: variability and reliability. J Voice. 2010;24(3):281-4.
Submitted date:
18/09/2018
Accepted date:
27/02/2019
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