从总肺活量推算被动呼气量可估测婴儿的呼气功能:一项回顾性研究

IF 9.5 1区 医学 Q1 CRITICAL CARE MEDICINE Chest Pub Date : 2024-10-25 DOI:10.1016/j.chest.2024.10.026
Avigdor Hevroni, Yael Simpson Lavy, Laurice Boursheh, Ephraim Bar-Yishay
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引用次数: 0

摘要

背景:评估婴儿呼气道功能具有挑战性,因为作为金标准的快速胸腹加压技术在技术上难度很大,而且失败率很高:研究问题:在婴儿被动呼气时获得的总肺活量测量值与通过提高容积技术获得的用力呼气测量值是否相关?这项观察性回顾分析包括 2011 年 1 月至 2019 年 12 月期间在哈大沙医疗中心使用升高容积快速胸腹压迫技术进行肺功能测试的妊娠≥36 周的婴儿。技术上可接受的强迫和被动血流-容积曲线测量结果均纳入分析:在 296 名符合条件的婴儿中,276 名(93%)婴儿的被动血流-容积曲线在技术上是可接受的,226 名(76%)婴儿的被迫血流-容积曲线是可接受的(p解释):被动流量-容积曲线提供了可靠、可重复的数据,与强迫流量-容积曲线高度相关。因此,被动流量-容积曲线可作为评估婴儿呼气道功能的替代工具。
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Passive Expiration from Total Lung Capacity Can Estimate Expiratory Function in Infants: A retrospective study.

Background: Evaluating expiratory airway function in infants is challenging, as the gold standard, the raised-volume rapid thoraco-abdominal compression technique is technically difficult and has a high failure rate.

Research question: Are measurements obtained during passive expiration from total lung capacity correlated with forced expiration measurements obtained by the raised-volume technique in infants?

Study design and methods: This observational retrospective analysis included infants born ≥ 36 weeks gestation who underwent pulmonary function testing using the raised-volume rapid thoraco-abdominal compression technique at Hadassah Medical Centre between January 2011 and December 2019. Technically acceptable forced and passive flow-volume curve measurements were included in the analysis.

Results: Out of 296 eligible infants, 276 (93%) had technically acceptable passive flow-volume curves while 226 (76%) had acceptable forced curves (p<0.001). The success rate of producing an acceptable curve was 70% for the passive curves and 39% for forced curves (p < 0.001). The Spearman correlation coefficients of vital capacity, expiratory volumes at 0.5 second, maximal expiratory flows, and expiratory flows at 50%, 75% and 85% of vital capacity were 0.92, 0.72, 0.83, 0.66, 0.67, 0.68, respectively (n= 226; p<0.001 for all). The correlation remained high regardless of the level of expiratory airway obstruction, gender or age. The mean inter-maneuver coefficients of variation were fairly low for both methods (5.2% vs 5.4%, p=NS).

Interpretation: The passive flow-volume curve offers reliable and reproducible data with high correlation to the forced flow-volume curve. Therefore, the passive flow-volume curve can serve as an alternative tool in evaluating expiratory airway function in infants.

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来源期刊
Chest
Chest 医学-呼吸系统
CiteScore
13.70
自引率
3.10%
发文量
3369
审稿时长
15 days
期刊介绍: At CHEST, our mission is to revolutionize patient care through the collaboration of multidisciplinary clinicians in the fields of pulmonary, critical care, and sleep medicine. We achieve this by publishing cutting-edge clinical research that addresses current challenges and brings forth future advancements. To enhance understanding in a rapidly evolving field, CHEST also features review articles, commentaries, and facilitates discussions on emerging controversies. We place great emphasis on scientific rigor, employing a rigorous peer review process, and ensuring all accepted content is published online within two weeks.
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