[Clinical indicators of "ineffective breathing pattern" in children with congenital heart disease].

Unlabelled: Clinical indicators of ineffective breathing pattern in children with congenital heart disease.

Objectives: To analyze the accuracy of clinical predictors of nursing diagnosis "Ineffective breathing pattern in children with congenital heart disease".

Method: 1:1 case-control study with 30 children with congenital heart disease. Fifteen children with the nursing diagnosis "Ineffective breathing pattern" (cases) were compared with other 15 without this diagnosis (controls). A total of 15 clinical indicators were analyzed for their sensibility, specificity, predictive values, likelihood ratios and area under the ROC curve.

Results: Four indicators showed an area under the ROC curve > 70%: chest x-ray findings (0.750), adventitious breath sounds (0.737), coughing (0.710) and asymmetric chest expansion (0.702). The indicators of the chest x-ray findings and adventitious breath sounds had a better overall performance for the identification of ineffective breathing pattern.

Discussion: These findings suggest that both indicators can be useful for inference of ineffective breathing pattern. Moreover, the presence of the diagnosis was associated with a greater likelihood of the presence of cough, and its absence with an increased probability of the absence of asymmetric chest expansion and percussive sounds.

Conclusions: The comparison among populations with different diseases and carriers of the same nursing diagnosis shows that the predictive ability of clinical indicators can be influenced.