A Novel Scale to Assess Humidification during Noninvasive Ventilation: A Prospective Observational Study

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM
Longfang Pan, Yueling Hong, Xiaoqing Zhong, Jiao He, Zuli Zhang, Qianru Zhao, Linfu Bai, Mengyi Ma, Jun Duan
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Abstract

Objective. To develop a novel scale to assess humidification during noninvasive ventilation (NIV). Methods. This study was performed in an ICU of a teaching hospital. Three ICU practitioners with more than 10 years of clinical experience developed an oral humidification scale with a range of 1–4 points. Each studied the current literature on humidification and examined 50 images of mouths of NIV patients with different levels of humidification. Then, through discussion, a consensus scale was developed. Next, 10 practitioners and 33 NIV patients were recruited to validate the scale. Finally, the patients rated the dryness of their mouths using the 1–4 visual scale just after the practitioners’ assessment. Talking and discussion were forbidden during the assessment, and the scorers were blinded to each other. Results. We performed 36 assessments in 33 NIV patients. Three patients were assessed twice each more than 2 days apart. The interitem correlation coefficients between the 10 practitioners ranged from 0.748 to 0.917. Fleiss’s kappa statistic was 0.516, indicating moderate agreement among practitioners. Of the 33 patients, 5 (15%) were unable to make an assessment using the 1–4 visual scale. Among the remainder, 55.7% provided scores that matched those given by the practitioners; 13.7% of scores were 1 point higher than that rated by the practitioners, and 20.7% were 1 point lower. Only 10% were beyond a 1-point difference. The kappa coefficient was 0.483 between patients and practitioners. Conclusions. The oral humidification scale showed moderate agreement between practitioners. It was also highly accurate in reflecting the level of humidification assessed by patients.
评估无创通气过程中湿度的新型量表:前瞻性观察研究
目的开发一种新型量表,用于评估无创通气 (NIV) 过程中的加湿情况。方法。本研究在一家教学医院的重症监护室进行。三位拥有 10 年以上临床经验的 ICU 医生制定了口腔湿度评分表,评分范围为 1-4 分。他们各自研究了有关湿度的现有文献,并检查了 50 张不同湿度水平的 NIV 患者口腔图像。然后,通过讨论形成了一个共识量表。接着,招募了 10 名从业人员和 33 名 NIV 患者对量表进行验证。最后,在医生进行评估后,患者使用 1-4 级视觉量表对自己的口腔干燥程度进行评分。评估过程中禁止交谈和讨论,评分者之间互不设盲。结果。我们对 33 名 NIV 患者进行了 36 次评估。有三名患者接受了两次评估,每次相隔两天以上。10 名医生之间的项目间相关系数从 0.748 到 0.917 不等。Fleiss's kappa 统计量为 0.516,表明从业人员之间的一致性适中。在 33 名患者中,有 5 人(15%)无法使用 1-4 视觉量表进行评估。在其余患者中,55.7%的患者提供的评分与医生的评分一致;13.7%的患者的评分比医生的评分高1分,20.7%的患者的评分比医生的评分低1分。只有 10%的差异超过 1 分。患者和医生之间的卡帕系数为 0.483。结论。口腔湿度量表在医生之间显示出中等程度的一致性。该量表在反映患者评估的加湿水平方面也非常准确。
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来源期刊
Canadian respiratory journal
Canadian respiratory journal 医学-呼吸系统
CiteScore
4.20
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
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