Avaliação da concordância entre as medidas da pressão inspiratória máxima em manovacuômetros analógico e digitais no Serviço de Terapia Intensiva do Hospital Naval Marcílio Dias.

Abstract

Introduction. The evaluation of maximal inspiratory pressure (MIP) is performed as a volitional measure of respiratory muscle strength, in adult and pediatric patients, using analog or digital manovacuometry. The measurement of respiratory muscle strength is an important parameter to guide the conduct of physiotherapists, in addition to monitoring clinical progress of patients and the results of different physiotherapeutic interventions in hospital and ambulatory. Manovacuometry, a simple, practical, accurate, low cost and non-invasive method of measuring respiratory muscle strength in intensive care units (ICUs) is performed using analog or digital manovacuometers. Objective. To evaluate the agreement of MIP values obtained with the digital manovacuometers MagnaTIE (Magnamed®, São Paulo, SP, Brasil), analog Murenas (Murenas®, Juiz de Fora, MG, Brasil) and digital MVD300 (Globalmed, Porto Alegre, RS, Brasil), in vitro and in vivo. Methods. This was a crosssectional, prospective study, with in vitro and in vivo measurements. In vivo measurements were performed in patients admitted to the intensive care unit (ICU), on orotracheal tube or tracheostomy cannula, in a convenience sample. To evaluate the correlation between measurements of MIP obtained by analog and digital manovacuometers, Pearson correlation coefficient (r) was used. To verify the agreement of MIP values the intraclass correlation coefficient (ICC) and the Bland-Altman diagram were used. Data dispersion was analyzed by the F-test. Results. Fifty-three patients were included in the study. The mean MIP obtained with the analog manovacuometer was 55,0±24,4 cmH2O, with the digital MVD300 was 55,2±24,7 cmH2O and with the digital MagnaTIE was 55,3±24,7 cmH2O. Obtained an ICC of 0,9971 (95% CI 0,9950 to 0,9984) for the measurements performed with the MVD300 analog and digital manovacuometer, 0,9975 (95%CI 0,9957 to 0,9986) for the measurements performed with the MagnaTIE analog and digital manovacuometer, 0,9992 (95%CI 0,9987 to 0,9996) for the measurements performed with the MVD300 digital and MagnaTIE digital manovacuometer. Conclusion. Our results showed that there is high correlation and agreement between MIP measurements in the three tested devices: analog, MVD300 digital and MagnaTIE digital. Our findings indicate that like the analog Murenas and digital MVD300 manovacuometry, already used in clinical practice, the MagnaTIE digital manovacuometry measures PImax concordantly.