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Vol. 22. Issue 3.
Pages 124-129 (July - August 1986)
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Vol. 22. Issue 3.
Pages 124-129 (July - August 1986)
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Variabilidad intrasujeto de las curvas espiratorias flujo-volumen: valoracion de las formas de expresion y criterios de seleccion
Intraindividual variability in the expiratory flow-volume curves: evaluation of the way of expression and selection criteria
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L.A. Izquierdo del Amo, J.M. Arriero Marin, F. Rodriguez de Castro, J. Picher Nuñez, A. Sueiro Bendito, S. Romero Candeira
Servicio de Neumología. Hospital Ramón y Cajal. Madrid
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Se estudia la variabilidad de los flujos y los volúmenes espiratorios, interhora e interdia, en un grupo de veinte voluntarios sanos, encontrándose que los parámetros que presentan menor variabilidad son la capacidad vital forzada (FVC) y el volumen espiratorio forzado en el primer segundo (FEV1). Los flujos teleespiratorios son más variables, mientras que el pico espiratorio de flujo (PEF) y los flujos mesoespiratorios, presentan variabilidad intermedia. Para todos los parámetros, excepto para el PEF, la variabilidad interdia fue significativamente mayor que la interhora, lo que obliga a considerar el tiempo entre pruebas para valorar un cambio espirométrico.

Nuestros valores de incremento significativo concuerdan con publicaciones recientes, pero son inferiores a los considerados tradicionalmente por algunos laboratorios.

El efecto ejercido en la variabilidad por los distintos métodos de selección, es pequeña, si bien existen diferencias que aconsejan elegir el máximo valor para el PEF y obtener los restantes flujos del trazado con mayor suma de FVC y FEV1. Para estos últimos parámetros ambos criterios pueden ser igualmente válidos.

Se estudia la conveniencia de emplear la desviación estándar o el coeficiente de variación (CV) para el estudio de la variabilidad. Encontramos datos sugerentes de que la expresión de la variabilidad en CV puede no ser adecuado, al menos con ciertos parámetros.

Twenty healthy volunteers were included in a study to analyse the variations in respiratory flow and volume within the same hour and day. The parameters presenting the least variation were forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). Tele-expiratory flow was more variable and the peak expiratory flow (PEF) and mid-expiratory flow presented intermediate variability. AH parameters except PEF showed significantlv higher variability in interday than in interhour results, requiring to consider the intervals in the evaluation of the changes in spyrometric tests. Our findings of a significant increase were in agreement with recent reports by other authors but are inferiors to those reported traditionally by some laboratories.

The effect of different methods on variability is but small although there are some differences which make it advisible to chose a maximum value for PEF and take the other flow values from the highest sum for TVC and FEV1. For the two latter ones both criteria are equally valid. Both the standard deviation and the variation coefficient were examined to decide which of the two would be most suitable for variability study. Data were found which suggested that the VC expression of variability may not be adequate for certain parameters.

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Copyright © 1986. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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