Nawa Ricardo Kenji, Gastaldi Ada Clarice, da Silva Elisângela Aparecida Soares, Augusto Viviane Dos Santos, Rodrigues Alfredo José, Evora Paulo Roberto Barbosa
Department of Surgery and Anatomy, Ribeirão Preto Faculty of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil.
Rev Bras Cir Cardiovasc. 2012 Apr-Jun;27(2):240-50. doi: 10.5935/1678-9741.20120040.
Cardiac surgery (CC) determines systemic and pulmonary changes that require special care. Awareness of the importance of respiratory muscle dysfunction in the development of respiratory failure motivated several studies conducted in healthy subjects to assess muscle strength. These studies were carried out by evaluating the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) values. This study examined the concordance among the values predicted by the equations proposed by Black & Hyatt and Neder, and the measured values in cardiac surgery (CS) patients.
Data were collected from preoperative evaluation forms. The Lin coefficient and Bland-Altman plots were used for statistical concordance analysis. The multiple linear regression and analysis of variance (ANOVA) were used to produce new formulas.
There were weak correlations of 0.22 and 0.19 in the MIP analysis and of 0.10 and 0.32 in the MEP analysis, for the formulas of Black & Hyatt and Neder, respectively. The ANOVA for both MIP and MEP were significant (P <0.0001), and the following formulas were developed: MIP = 88.82 - (0.51 x age) + (19.86 x gender), and MEP = 91.36 - (0.30 x age) + (29.92 x gender).
The Black and Hyatt and Neder formulas predict highly discrepant values of MIP and MEP and should not be used to identify muscle weakness in CS patients.
心脏手术会引发全身及肺部的变化，需要特别护理。意识到呼吸肌功能障碍在呼吸衰竭发展中的重要性，促使在健康受试者中开展了多项研究以评估肌肉力量。这些研究通过评估最大吸气压力（MIP）和最大呼气压力（MEP）值来进行。本研究检验了Black和Hyatt以及Neder提出的公式所预测的值与心脏手术（CS）患者的测量值之间的一致性。
从术前评估表中收集数据。使用林氏系数和Bland - Altman图进行统计学一致性分析。采用多元线性回归和方差分析（ANOVA）来生成新公式。
对于Black和Hyatt以及Neder的公式，在MIP分析中相关性较弱，分别为0.22和0.19，在MEP分析中相关性分别为0.10和0.32。MIP和MEP的方差分析均具有显著性（P <0.0001），并得出以下公式：MIP = 88.82 - （0.51×年龄） + （19.86×性别），MEP = 91.36 - （0.30×年龄） + （29.92×性别）。
Black和Hyatt以及Neder的公式预测的MIP和MEP值差异很大，不应被用于识别CS患者的肌肉无力情况。
