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Previous issue date: 2010-05-18 / The clinical importance of evaluating the respiratory muscles with a variety of tests
has been proposed by several studies, once that the combination of several tests
would allow a better diagnosis and therefore, a better clinical follow of disorders of
the respiratory muscles. This study aimed to evaluate the feasibility of adapting a
national electronic manovacuometer to measure the nasal inspiratory pressure (study
1) and analyze the level of load intensity of maximum voluntary ventilation, as well as
the variables that may influence this maneuver in healthy subjects (study 2). We
studied 20 healthy subjects by a random evaluation of two measures of SNIP in
different equipments: a national and an imported. In study 2 it was analyzed the
intensity of the load of MVV test, change in pressure developed during the maneuver,
the possible differences between genders, and the correlations between the flow
developed in the test and the result of MVV. In study 1 it was found the average for
both measures of nasal inspiratory pressures: 125 ? 42.4 cmH2O for the imported
equipment and 131.7 ? 28.7 cmH2O for the national one. Pearson analysis showed a
significant correlation between the average, with a coefficient r = 0.63. The average
values showed no significant differences evaluated by paired t test (p> 0.05). In the
Bland-Altman analysis it was found a BIAS = 7 cmH2O, SD 32.9 and a confidence
interval of - 57.5 cmH2O up to 71.5 cmH2O. In the second study it was found
significant differences between the genders in the air volume moved, being higher in
males 150.9 ? 13.1 l / min vs 118.5 ? 15.7 L / min for (p = 0.0002, 95% CI 44.85 to
20:05). Regarding the inspiratory and expiratory loading, they were significantly
higher in men than in women, peak inspiratory pressure (34.7 ? 5.3 cmH2O vs 19.5 ?
4.2 cmH2O, 95% CI - 18.0 to -12.3, p <0.0001), peak expiratory (33.8 vs. 23.1 ? 5.9
cmH2O ? 5.4 cmH2O, 95% CI -17.1 to - 4.6, p <0.0001), and the delta pressure (59.7
? 10 cmH2O vs 36.8 ? 8.3 cmH2O, 95% CI 14.5 to 31.2, p <0.0002). The Pearson
correlation showed that the flow generated by the maneuver is strongly correlated
with the delta-expiratory pressure / inspiratory (r2= 0.83,R = 0.91, 95%IC 0.72 a 0.97
e p< 0.0001).Through these results we suggest that the national electronic
manovacuometer is feasible and safe to perform the sniff test in healthy subjects. For
the MVV, there are differences between the genders in the intensity of pressure
developed during the maneuver. We found a load intensity considered low during the
MVV, and found a strong correlation between the flow generated in the test and the
delta pressure expiratory / inspiratory / A import?ncia clinica de avaliar os m?sculos respirat?rios com uma variedade de
testes vem sendo proposta por diversos trabalhos, pois a combina??o de v?rios
testes possibilitaria um melhor diagn?stico e consequentemente um melhor
seguimento cl?nico das disfun??es dos m?sculos respirat?rios. Este trabalho teve
como objetivo avaliar a viabilidade da adapta??o do manovacu?metro nacional
eletr?nico para a realiza??o da medida de press?o inspirat?ria nasal (estudo 1) e
analisar o n?vel de intensidade de carga da ventila??o volunt?ria m?xima, assim
como as vari?veis que possam influenciar a manobra em sujeitos saud?veis (estudo
2). Foram estudados 20 sujeitos saud?veis atrav?s da avalia??o aleat?ria de duas
medidas de SNIP em equipamentos diferentes: um nacional e outro importado. No
estudo 2 foi analisado a intensidade da carga do teste da ventila??o volunt?ria
m?xima(VVM), a varia??o de press?o desenvolvida durante manobra, as poss?veis
diferen?as entre g?neros, e as correla??es entre o fluxo desenvolvido no teste e o
resultado da VVM. No estudo 1 as m?dias encontradas durante as duas medidas
das press?es nasais foram de 125 ? 42,4 cmH2O para o aparelho importado e de
131,7 ? 28,7 cmH2O para o nacional. A an?lise de Pearson demonstrou uma
correla??o significativa entre as m?dias com um coeficiente r=0.63. Os valores
m?dios n?o apresentaram diferen?as significativas avaliadas pelo teste t pareado
(p>0,05).Na an?lise de Bland-Altman foi encontrado um BIAS igual a 7 cmH2O,
desvio padr?o 32,9 e um intervalo de confian?a de - 57,5cmH2O at? 71,5 cmH2O.
No estudo 2 foi encontrada diferen?a significativa entre os g?neros para o volume
de ar deslocado maior em homens 150.9 ? 13.1 l/mim vs 118.5 ? 15.7 L/mim para
(p= 0.0002, IC95% 20.05 ? 44.85). Em rela??o carga inspirat?ria e expirat?ria foram
significativamente maiores em homens que nas mulheres: pico inspirat?rio (34.7 ?
5.3 cmH2O vs 19.5 ? 4.2 cmH2O, IC95% - 18.0 a -12.3, p< 0.0001), pico expirat?rio
(33.8 ? 5.9 cmH2O vs 23.1 ? 5.4 cmH2O, IC95% -17.1 a - 4.6, p< 0.0001), assim
como o delta de press?o (59.7 ? 10 cmH2O vs 36.8 ? 8.3 cmH2O, IC95% 14.5 a 31.2
, p< 0.0002). A correla??o de Pearson mostrou que o fluxo gerado pela manobra
est? fortemente correlacionado com o delta de press?o expirat?ria/inspirat?ria (r2=
0.83,R = 0.91, (95%IC 0.72 a 0.97 e p< 0.0001). Atrav?s dos resultados
encontrados podemos sugerir que o manovacu?metro eletr?nico nacional ? vi?vel e
seguro para realiza??o do sniff teste em sujeitos saud?veis. Em rela??o a VVM,
existem diferen?as entre os g?neros na intensidade de press?o desenvolvida
durante a VVM, a uma intensidade de carga durante a VVM foi considerada baixa
assim como foi encontrada uma forte correla??o entre o fluxo gerado no teste e o
delta de press?o expirat?rio/inspirat?rio
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/16687 |
| Date | 18 May 2010 |
| Creators | Severino, Fernanda Gadelha |
| Contributors | CPF:02357307935, http://lattes.cnpq.br/2201375154363914, Parreira, Ver?nica Franco, CPF:62846060606, http://lattes.cnpq.br/3540796454981012, Andrade, Armele de F?tima Dornelas de, CPF:27578208420, http://lattes.cnpq.br/2911134983219799, Fregonezi, Guilherme Augusto de Freitas |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Fisioterapia, UFRN, BR, Movimento e Sa?de |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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