Primerjava izmerjenih vrednosti ekspiratornih pretokov z različnimi napravami : diplomsko delo

Strelec, Ana (author), Leonardis, Lea (mentor), Klinar, Polona (comentor)

Uvod: Kašelj je pomemben za čiščenje dihalnih poti. Zmožnost kašlja ocenjujemo z merjenjem ekspiratornih pretokov. Največji pretok zraka med izdihom (PEF) merimo s spirometrom, možno ga je meriti tudi s PEF-merilnikom ali izkašljevalnikom. Namen: V raziskavi smo vrednosti PEF, izmerjene z izkašljevalnikom in PEF-merilnikom, želeli primerjati s tistimi, izmerjenimi s spirometrom. Preveriti smo želeli vpliv starosti in spola na rezultat meritve PEF. Izmerili smo še največji pretok pri kašlju (PCF), kjer nas je zanimalo, ali se vrednosti PCF razlikujejo, ko preiskovanci pri testiranju uporabijo nosno ščipalko ali ne. Metode dela: Testirali smo PEF pri 31 zdravih preiskovancih, z uporabo spirometra, PEF-merilnika in izkašljevalnika. Vrednosti PCF smo izmerili na spirometru. Testiranje vrednosti PEF in PCF smo opravili trikrat ter za končni rezultat vzeli največjo vrednost. Najprej smo preverili, ali so vrednosti PEF med seboj primerljive s Friedmanovim testom. Nato smo z Wilcoxonovim testom primerjali vrednosti PEF, pridobljene z vsemi tremi merilniki. Vpliv starosti in spola na meritve smo preverili s testom ANOVA. Z Wilcoxonovim testom smo preverili, ali prihaja do razlik v vrednosti PCF med testiranjem z odprtim nosom in uporabo nosne ščipalke. Rezultati: Izkazalo se je, da so vrednosti PEF, izmerjene s PEF-merilnikom (p = 0,075) in spirometrom, primerljive, medtem ko so vrednosti na izkašljevalniku statistično pomembno nižje (p <= 0,001). Starost (p = 0,048) in spol (p = 0,011) vplivata na meritve PEF. Večje vrednosti PEF so dosegali mlajši in moški. Statistično pomembne razlike se pojavijo pri meritvah PCF z zaprtimi in odprtimi nosnicami (p =< 0,001). Meritve z uporabo nosne ščipalke so višje v primerjavi z meritvami brez nje. Razprava in sklep: Zaključimo lahko, da se za merjenje PEF poleg spirometra lahko uporablja še PEF-merilec, medtem ko je izkašljevalnik neprimeren, saj ne podaja natančnih rezultatov. PEF-merilec priporočamo predvsem za spremljanje stanja v domačem okolju. Pri normativnih vrednostih PEF moramo upoštevati starost in spol. Prav tako je pomembno, da meritve PCF vedno izvajamo na enak način – z uporabo nosne ščipalke ali brez. Le na ta način lahko primerjamo vrednosti čez čas. Glede na večje vrednosti PCF, ki smo jih izmerili z uporabo ščipalke, v prihodnje svetujemo meritve na ta način.

• Language: Slovenian
• Keywords: kašelj, ekspiratorni pretoki, izkašljevalnik, PEF-merilnik, spirometer
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-107768
• COBISS.SI-ID: 5624171
• Publication date in RUL: 24.05.2019

Secondary language

• Language: English
• Title: Comparison of measured expiratory flow values using various measuring devices : diploma work

Abstract

Introduction: Cough is an important mechanism for clearing airways. The ability to cough is evaluated by monitoring patients' expiratory flows. The peak expiratory flow (PEF) is measured using a spirometer; however, it can also be measured using a peak flow meter or a mechanical insufflator-exsufflator. Purpose: The research study compares the peak expiratory flow (PEF) values measured with the mechanical insufflator-exsufflator and the peak flow meter with those measured using a spirometer. It also examines the impact of age and gender on PEF results. Additionally, the peak cough flow (PCF) was measured, to see if the PCF values differ between subjects using a nose clip and those not using a nose clip. Methods: PEF was tested in 31 healthy subjects using a spirometer, a peak flow meter and a mechanical insufflator-exsufflator. PCF values were measured using a spirometer. The PEF and PCF values were tested three times and the best value was used as the final result. First, the Friedman test was performed to check if the PEF values were comparable with each other. Then the Wilcox test was performed to compare the PEF values of all three devices. The impact of age and gender on the measurement results was checked with the ANOVA test. The Wilcox test was used to check if there were any differences between the PCF values measured when testing with open nostrils and when using a nose clip. Results: The results showed that the PEF values measured with the peak flow meter (p=0.075) are comparable with those obtained with the spirometer, whereas the values obtained with the mechanical insufflator-exsufflator are statistically significantly lower (p=<0.001). Age (p=0.048) and gender (p=0.011) influence the PEF values. Higher PEF values were obtained by younger and male subjects. Statistically significant differences emerged in PCF measurements with closed and open nostrils (p=<0.001). The measurements using a nose clip are higher compared to the measurements without the clip. Discussion and conclusion: It can be concluded that a spirometer and peak flow meter can be used to obtain PEF values, whereas the mechanical insufflator-exsufflator is unsuitable, since it does not provide accurate results. The peak flow meter is recommended primarily for monitoring one's health status in a home environment. In the case of normative PEF values, age and gender must be considered. It is also important that the PCF measurements are always conducted in the same manner: either with or without the use of a nose clip. Only in this way can the values be compared over time. Considering the higher PCF values measured with the use of a nose clip, it is recommended that future measurements be conducted this way.

• Keywords: cough, expiratory flow, mechanical insufflator-exsufflator, peak flow meter, spirometer