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Vol. 33. Issue 10.
Pages 488-493 (November 1997)
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Vol. 33. Issue 10.
Pages 488-493 (November 1997)
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Evaluación de seis medidores portátiles de flujo espiratorio máximo
Evaluation of six portable devices for measuring peak flow
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J. Belda, J. Giner, P. Casan, J. Sanchis*
Unidad de Función Pulmonar. Departamento de Neumología. Hospital de la Santa Creu i Sant Pau. Barcelona
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El objetivo del trabajo fue evaluar seis modelos de medidor de flujo máximo (MFM), comparándolos con una señal de flujo conocida, en condiciones de laboratorio (CL) y en condiciones clínicas (CC). Los seis MFM fueron: a) PF-control (LETI); b) personal best (HEALTHSCAN); c) vitalograph escala logarítmica y lineal (VITALOGRAPH); d) miniwright (AIRMED), y e), assess (HEALTHSCAN). CL: comprobación de las lecturas con una servojeringa controlada por ordenador (Pulmonary Waveform Generator System) en tres niveles de flujo correspondientes a 185, 302 y 595 1/m, antes y después de las mediciones clínicas. CC: comprobación con un neumotacómetro en 50 individuos con diferentes niveles de flujo aéreo (rango entre 86 y 888 1/min), en todos los modelos, de forma aleatoria y consecutiva, repitiendo al Anal la medición en el primero de los equipos seleccionados. Los resultados fueron: CL: la exactitud de los seis aparatos osciló entre el 0,9% del F y el 9,4% del E, y en ningún caso con una diferencia estadísticamente significativa al comparar con la servojeringa. La reproducibilidad (coeficiente de variación) osciló entre el 0,7% del F y el 3,3% del B. La estabilidad de los aparatos tras la comprobabión clínica mostró una diferencia con la servojeringa, que osciló entre –18,3 1/min, para el A y del +16,7 l/min para el B y sólo fue significativa para el B. CC: Los porcentajes de error respecto al neumotacómetro fueron inferiores a los de la normativa del NHLBI para los aparatos A y B, y superiores para el resto. Las diferencias no fueron estadísticamente significativas para el A y B y sí lo fueron para el resto. El análisis de la concordancia mostró una dependencia de estas diferencias del nivel de flujo y en todos los casos, excepto en el F, pudo establecerse una ecuación de regresión que expresa el error de las lecturas. En conclusión, todos los modelos estudiados muestran un sesgo directamente relacionado con el flujo medido. La precisión obtenida fue buena y, además, los aparatos se mantienen estables después de más de 200 lecturas, por lo tanto, resultan adecuados para las mediciones repetidas en un mismo enfermo.

Palabras clave:
Medidor de flujo máximo
Flujo máximo espiratorio

The aim of this study was to evaluate six peak flow meters, comparing them to a flow signal recorded under laboratory and clinical conditions (LC and CC, respectively). The six peak flow meters studied were the PF-Control (A), the Personal Best (Healthscan) (B), the logarithimc scale and linear Vitalographs (Vitalograph) (C and D), the Miniwright (Airmed) (E), and the Assess (Healthscan) (F), LC: Readings were compared to those obtained with a computer-controlled syringe attached to a servomechanism (Pulmonary Waveform Generator System) at flow levels of 185, 302 and 595 L/m before and after clinical measurements. CC: Readings from each model, taken randomly and consecutively, were compared with those obtained by pneumotachometer in 50 individuals with different air flow levels (range 86 to 888 L/min), ending by repeating the measurement procedure with the first device used. The LC results were as follows: precisión varied among the six models from 0.9% (F) to 9.4% (E), and in no case was there a statistically significant difference from the servosyringe reading; reproducibility (coefficient of variation) ranged from 0.7% (F) to 3.3% (B); stability after clinical testing showed results that differed from those of the servosyringe in a range of –18.3 L/min (A) to +16.7 L/min (B) and the difference was significant only for device B. The CC results were as follows: in comparison with the pneumotachometer readings, percent error was within NHLBI limits for devices A and B in excess of the limits for the other peak flow meters. Analysis of concordance showed that differences were related to level of flow for all devices except F and that measurement errors conformed to an equation of linear regression. We conclude that all the studied models give readings that are biased in direct proportion yo the flow measured. Precision was good and the devices remained stable over more than 200 readings, such that peak flow meters are appropriate for repeated measurements in a single patient.

Key words:
Peak flow meter
Peak expiratory flow
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Copyright © 1997. Sociedad Española de Neumología y Cirugía Torácica
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