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[哮喘患儿中“气体交换受损”和“自主通气”诊断特征的充分性]

[The adequacy of the defining characteristics of the diagnostics "impaired gas exange" and spontaneous ventilation" in asmathic children].

作者信息

Carvalho Ocilia Maria Costa, da Silva Viviane Martins, Távora Rafaela Carolini de Oliveira, Chaves Daniel Bruno Resende, Beltrão Beatriz Amorim, Lopes Marcos Venícios de Oliveira

机构信息

Departamento de Enfermería, Universidad Federal de Ceará, Fortaleza, CE, Brasil.

Departamento de Enfermería, Universidad Federal de Ceará, Fortaleza, CE, Brasil.

出版信息

Enferm Clin. 2015 Nov-Dec;25(6):296-304. doi: 10.1016/j.enfcli.2015.07.007. Epub 2015 Oct 14.

DOI:10.1016/j.enfcli.2015.07.007
PMID:26459372
Abstract

OBJECTIVE

To determine the diagnostic accuracy measures of defining characteristics of respiratory nursing diagnoses "impaired gas exchange" and "impaired spontaneous ventilation" in asmathics children in emergency department.

METHODS

Observational, descriptive transversal study developed between April and September 2013 in a hospital in northeastern Brazil with a sample of 205 children. Diagnoses were established by nurses trained experts in this field. Measures of sensitivity, specificity, positive and negative value prediction right positive and negative likelihood ratio and diagnostic odds for the defining characteristics identified were calculated.

RESULTS

28.8% of the evaluated children had "impaired gas exchange". Dyspnea, abnormal breathing, tachycardia and hypoxemia had higher frequencies. Hypoxemia presented as clinical feature high sensitivity and specificity. 5.9% of the evaluated children had "impaired spontaneous ventilation" and their most frequent defining characteristics were dyspnea, increased heart rate and decreased SaO2. The increasing use of accessory muscles to breathe presented the best measures of validity for this diagnosis.

CONCLUSION

The hypoxemia and increased use of accessory muscles presented the best measures of the validity respectively to "deterioration in gas exchange" and "impairment of spontaneous ventilation". These characteristics is necessary to provide for adequate definition and use of diagnostics in clinical practice.

摘要

目的

确定急诊科哮喘儿童中呼吸护理诊断“气体交换受损”和“自主呼吸受损”定义特征的诊断准确性指标。

方法

2013年4月至9月在巴西东北部一家医院开展的观察性、描述性横断面研究,样本为205名儿童。诊断由该领域训练有素的专家护士确定。计算所确定定义特征的敏感性、特异性、阳性和阴性预测值、阳性和阴性似然比以及诊断比值。

结果

28.8%的评估儿童存在“气体交换受损”。呼吸困难、呼吸异常、心动过速和低氧血症出现频率较高。低氧血症作为临床特征具有较高的敏感性和特异性。5.9%的评估儿童存在“自主呼吸受损”,其最常见的定义特征为呼吸困难、心率加快和动脉血氧饱和度降低。呼吸时辅助肌使用增加对该诊断具有最佳的有效性指标。

结论

低氧血症和辅助肌使用增加分别是“气体交换恶化”和“自主呼吸受损”有效性的最佳指标。这些特征对于在临床实践中充分定义和使用诊断是必要的。

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