Calidad de la espirometría en las consultas neumológicas de un área jerarquizada

López de Santa María, E.; Gutiérrez, L.; Legórburu, C.; Valero, M.; Zabala, M.

doi:10.1016/S0300-2896(02)75196-X

Archivos de Bronconeumología

ISSN: 0300-2896

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Vol. 38. Issue 5.

Pages 204-208 (May 2002)

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Pages 204-208 (May 2002)

DOI: 10.1016/S0300-2896(02)75196-X

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Calidad de la espirometría en las consultas neumológicas de un área jerarquizada

Spirometry: quality in the respiratory medicine clinics of a public health care area

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E. López de Santa Maríaa, L. Gutiérreza, C. Legórburua, M. Valeroa, M. Zabalaa

a Unidad de Patología Respiratoria. DUE. Hospital de Cruces. Baracaldo. Vizcaya

V. Sobradillo, J.B. Gáldiz

Corresponding author

jbgaldiz@hcru.osakidetza.net

Correspondencia: Laboratorio de Exploración Funcional. Unidad de Patología Respiratoria. Hospital de Cruces. 48903 Baracaldo. Vizcaya

Unidad de Patología Respiratoria. Hospital de Cruces. Baracaldo. Vizcaya

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Abstract

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Fundamento

La espirometría se puede considerar como una prueba habitual en el estudio del paciente neumológico, tanto en el ámbito hospitalario como extrahospitalario

Objetivo

Conocer la calidad de las espirometrías en un área jerarquizada valorando dos factores: la labor del técnico que la realiza y los espirómetros utilizados

Material y Método

Se han evaluado cuatro ambulatorios. Han participado 4 técnicos y se han valorado 4 espirómetros, comprobándose la respuesta a diferentes volúmenes (jeringas de calibración de 1 y 3 l) y a diferentes flujos (descompresor explosivo). Han participado 8 pacientes con diagnóstico de EPOC para la evaluación de la variabilidad intertécnicos

Resultados

La concordancia (CCF) entre los diferentes técnicos presenta unos valores muy elevados de FEV1 (0,98–0,99) y FVC (0,91‐0,98). Los valores medios obtenidos por los diferentes técnicos han sido: FEV1=2,15 ± 0,03 (rango, 2,20-2,14), FVC=3,25 ± 0,05 (rango, 3,30-3,21; NS). Los espirómetros, respecto a la calibración de volúmenes, presentaron una respuesta correcta con jeringa de calibración de 1 l, perdiendo la linealidad en 2 de los 4 espirómetros con la jeringa de calibración de 3 l. En cuanto a la calibración de flujos, un espirómetro se encontraba fuera de rango en todos los niveles de flujos, siendo 2 de 4 espirómetros los que estaban fuera de rango con flujos bajos

Conclusiones

a) no existen diferencias significativas en los resultados obtenidos por los diferentes técnicos, con un alto grado de concordancia entre ellos, lo que confirma la buena calidad en la realización de la espirometría, y b) los espirómetros han demostrado una deficiente linealidad a flujos bajos

Palabras clave:

Espirometría

Calidad

Extrahospitalario

Calibración

Background

Spirometry can be considered a routine way to evaluate patients with respiratory complaints, both inside and outside the hospital setting

Objective

To assess the quality of spirometry in a public health care area with respect to two factors: the technicians' performance and the calibration of spirometers

Material and Method

Four health care clinics were studied. Four technicians participated and the four spirometers were tested at different volumes (calibration syringes 1L and 3L) and different flows (explosive decompression). Eight patients with COPD participated in the study of inter-technician variability

Results

Agreement among the technicians was very high: 0.98-0.99 for FEV1 and 0.91-0.98 for FVC. The mean results obtained by the technicians were: FEV1=2.15 ± 0.03, range 2.20-2.14; FVC=3.25 ± 0.05, range 3.30-3.21 (ns). Volumetric readings from the spirometers were correct for the 1I calibration syringe, but 2 out of 4 spirometers lost linearity with the 3I calibration syringe. One spirometer gave readings out of range for all flow levels, and 2 out of 4 spirometers were out of range at low flows

Conclusions

1. Results obtained by different technicians were not significantly different and there was high agreement among them, confirming that performance of spirometry was good. 2. The spirometers showed poor linearity at low flows

Keywords:

Spirometry

Quality

Outpatient

Calibration

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