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光电肺容量测量在限制性疾病中的应用。

Optoelectronic vital capacity measurement for restrictive diseases.

机构信息

Services de Physiologie-Explorations Fonctionnelles, Plateforme d'Analyse du Mouvement, et Centre d'Innovations Technologiques, Unité Mixte de Recherche 805, Hôpital Raymond Poincaré, Assistance Publique Hôpitaux de Paris, Garches, France.

出版信息

Respir Care. 2013 Apr;58(4):633-8. doi: 10.4187/respcare.01916.

Abstract

OBJECTIVE

To determine whether optoelectronic plethysmography accurately evaluated vital capacity (VC) in patients with respiratory muscle dysfunction of variable severity, including those with paradoxical abdominal movements.

METHODS

In 20 subjects, VC was measured in the supine position using both spirometry and optoelectronic plethysmography (6 optoelectronic cameras and 52 reflective markers on the anterior chest wall).

RESULTS

Spirometry VC (VC-Spiro) correlated positively with optoelectronic VC (VC-Opto) (r(2) = 0.99, P < .001), and the regression line was very close to the identity line (VC-Opto [mL] = -1.202 + 1.007 × VC-Spiro [mL]). A Bland-Altman plot showed that the mean difference was -20 mL (95% CI -63 mL to 24 mL) and the limits of agreement were 163 mL (95% CI 106 mL to 231 mL) and -203 mL (95% CI -271 mL to -146 mL). The difference between the 2 values expressed as the percentage of the mean value was < 15% in all 20 subjects, < 10% in 17 (85%) subjects, and < 5% in 11 (55%) subjects. The difference, expressed as the percentage of the mean value, was unrelated to the contribution of abdominal motion to VC (r = 0.02 and P = .94), but was significantly related to body mass index (r = 0.53, P = .02).

CONCLUSIONS

Optoelectronic plethysmography is accurate and suitable for VC measurement in patients with various degrees of respiratory failure, including those with paradoxical abdominal movements. This noninvasive method may be an attractive alternative for accurately measuring VC in the event of air leakage (through the mouth or tracheostomy) or when patients are unable to breathe with the dead space added by the spirometer.

摘要

目的

确定光电体积描记法是否能准确评估呼吸肌功能障碍患者的肺活量(VC),包括那些存在反常腹部运动的患者。

方法

在 20 名受试者中,使用肺活量计和光电体积描记法(6 个光电摄像头和前胸壁上的 52 个反射标记)在仰卧位测量 VC。

结果

肺活量计 VC(VC-Spiro)与光电 VC(VC-Opto)呈正相关(r²=0.99,P<0.001),回归线非常接近恒等线(VC-Opto[mL]=-1.202+1.007×VC-Spiro[mL])。Bland-Altman 图显示,平均差值为-20 mL(95%CI-63 至 24 mL),一致性界限为 163 mL(95%CI 106 至 231 mL)和-203 mL(95%CI-271 至-146 mL)。2 种方法的差值与平均值的百分比均<20%,在所有 20 名受试者中,差值<10%的占 17 名(85%),差值<5%的占 11 名(55%)。差值与腹部运动对 VC 的贡献无关(r=0.02,P=0.94),但与体重指数显著相关(r=0.53,P=0.02)。

结论

光电体积描记法准确,适用于各种程度呼吸衰竭患者的 VC 测量,包括存在反常腹部运动的患者。这种非侵入性方法可能是一种有吸引力的替代方法,适用于在发生漏气(通过口腔或气管造口)或患者无法通过肺活量计增加的死腔呼吸时准确测量 VC。

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