Toledo Diogo Oliveira, Silva Débora Carneiro de Lima E, Santos Dyaiane Marques Dos, Freitas Branca Jardini de, Dib Rogério, Cordioli Ricardo Luiz, Figueiredo Evandro José de Almeida, Piovacari Silvia Maria Fraga, Silva João Manoel
Unidade de Terapia Intensiva, Hospital Israelita Albert Einstein - São Paulo (SP), Brasil.
Rev Bras Ter Intensiva. 2017 Oct-Dec;29(4):476-480. doi: 10.5935/0103-507X.20170071.
To evaluate the intra- and inter-reliability and the ease of measuring the quadriceps muscle thickness using bedside ultrasound.
This is a prospective, observational study. The assessment of quadriceps muscle thickness was performed at two reference points and was quantified using portable B-mode ultrasound in two healthy volunteers. For standardization of measurements and validation of image collections, the team was trained through theoretical and practical classes, with a 6-hour workload.
A total of 112 images were examined by the coach and compared with the trainees. Pearson's correlation analysis found an excellent relationship between the coach and all trainees (R2 > 0.90). The best association was between the coach and the dietitians (R2: 0.99; p < 0.001), and the worst association was between the coach and the medical trainees (R2: 0.92; p < 0.001). In the Bland-Altman comparison, the highest error rate found between coach and trainees was 5.12% (95% confidence interval [CI] 3.64-12.37), and the lowest was 1.01% (95%CI 0.72 - 2.58); the highest bias of the values described was -0.12 ± 0.19, and the lowest was -0.01 ± 0.04.
The data analyzed showed a good correlation between the measurements made by the coach and trainees, indicating that ultrasound of the quadriceps muscle is a viable and easily applicable tool.
评估使用床边超声测量股四头肌厚度的内部和外部可靠性以及测量的简易程度。
这是一项前瞻性观察性研究。在两名健康志愿者的两个参考点对股四头肌厚度进行评估，并使用便携式B型超声进行量化。为了使测量标准化并验证图像采集，团队通过理论和实践课程进行了培训，工作量为6小时。
教练共检查了112张图像并与学员进行比较。Pearson相关性分析发现教练与所有学员之间存在极佳的相关性（R2>0.90）。最佳关联是在教练与营养师之间（R2：0.99；p<0.001），最差关联是在教练与医学学员之间（R2：0.92；p<0.001）。在Bland-Altman比较中，教练与学员之间发现的最高错误率为5.12%（95%置信区间[CI]3.64 - 12.37），最低为1.01%（95%CI 0.72 - 2.58）；所描述值的最高偏差为-0.12±0.19，最低为-0.01±0.04。
分析的数据表明教练与学员所做测量之间具有良好的相关性，表明股四头肌超声是一种可行且易于应用的工具。
