Respiratory distress assessment instrument: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{ | {{Respiratory failure}} | ||
{{CMG}} | |||
{{SK}} RDAI | {{SK}} RDAI | ||
==Overview== | ==Overview== | ||
The {{PAGENAME}} (RDAI) is | The {{PAGENAME}} (RDAI) is an assessment scale to evaluate the severity of illness in infants. | ||
== | ==Historical Perspective== | ||
The RDAI was developed in 1987 to measure response to treatment of [[bronchiolitis]].<ref name="pmid3295741">{{cite journal| author=Lowell DI, Lister G, Von Koss H, McCarthy P| title=Wheezing in infants: the response to epinephrine. | journal=Pediatrics | year= 1987 | volume= 79 | issue= 6 | pages= 939-45 | pmid=3295741 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3295741 }} </ref> | The RDAI was developed in 1987 to measure response to treatment of [[bronchiolitis]].<ref name="pmid3295741">{{cite journal| author=Lowell DI, Lister G, Von Koss H, McCarthy P| title=Wheezing in infants: the response to epinephrine. | journal=Pediatrics | year= 1987 | volume= 79 | issue= 6 | pages= 939-45 | pmid=3295741 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3295741 }} </ref> | ||
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==Usage and Application of the Instrument== | ==Usage and Application of the Instrument== | ||
Recently, the construct validity of the RDAI has been challenged due to low correlation with subsequent admission to the hospital or length of stay (LOS).<ref name="pmid24313026">{{cite journal| author=Destino L, Weisgerber MC, Soung P, Bakalarski D, Yan K, Rehborg R et al.| title=Validity of respiratory scores in bronchiolitis. | journal=Hosp Pediatr | year= 2012 | volume= 2 | issue= 4 | pages= 202-9 | pmid=24313026 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24313026 }} </ref> | Recently, the construct validity of the RDAI has been challenged due to low correlation with subsequent admission to the hospital or length of stay (LOS).<ref name="pmid24313026">{{cite journal| author=Destino L, Weisgerber MC, Soung P, Bakalarski D, Yan K, Rehborg R et al.| title=Validity of respiratory scores in bronchiolitis. | journal=Hosp Pediatr | year= 2012 | volume= 2 | issue= 4 | pages= 202-9 | pmid=24313026 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24313026 }} </ref> In a study of 65 children, the intraclass correlation coefficient was 0.39 (95% CI: 0.17–0.58 [n = 65]) as measured by respiratory therapists.<ref name="pmid24313026"/> This suggests 'poor' agreement.<ref name="pmid18487593">{{cite journal| author=Wrobel JS, Armstrong DG| title=Reliability and validity of current physical examination techniques of the foot and ankle. | journal=J Am Podiatr Med Assoc | year= 2008 | volume= 98 | issue= 3 | pages= 197-206 | pmid=18487593 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18487593 }} </ref> The Children's Hospital of Wisconsin Respiratory Score (CHWRS) may better predict the need for admission.<ref name="pmid24313026"/> | ||
Additional alternative scales are: | Additional alternative scales are: | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: RDAI
Overview
The Respiratory distress assessment instrument (RDAI) is an assessment scale to evaluate the severity of illness in infants.
Historical Perspective
The RDAI was developed in 1987 to measure response to treatment of bronchiolitis.[1]
Data Source for Derivation and Validation
The RDAI was tested for reliability by two of the original investigators. They reported weighted kappa of 0.9.[1]
Usage and Application of the Instrument
Recently, the construct validity of the RDAI has been challenged due to low correlation with subsequent admission to the hospital or length of stay (LOS).[2] In a study of 65 children, the intraclass correlation coefficient was 0.39 (95% CI: 0.17–0.58 [n = 65]) as measured by respiratory therapists.[2] This suggests 'poor' agreement.[3] The Children's Hospital of Wisconsin Respiratory Score (CHWRS) may better predict the need for admission.[2]
Additional alternative scales are:
The Instrument
| Points | |||||
|---|---|---|---|---|---|
| 0 | 1 | 2 | 3 | 4 | |
| Wheezing | |||||
| Expiration | None | End | 1/2 | 3/4 | All |
| Inspiration | None | Part | All | ||
| Location | None | Segmental < 2 of 4 lung fields |
Diffuse > 3 of 4 lung fields |
||
| Retractions | |||||
| Supraclavicular | None | Mild | Moderate | Marked | |
| Intercostal | None | Mild | Moderate | Marked | |
| Subcostal | None | Mild | Moderate | Marked | |
References
- ↑ 1.0 1.1 Lowell DI, Lister G, Von Koss H, McCarthy P (1987). "Wheezing in infants: the response to epinephrine". Pediatrics. 79 (6): 939–45. PMID 3295741.
- ↑ 2.0 2.1 2.2 Destino L, Weisgerber MC, Soung P, Bakalarski D, Yan K, Rehborg R; et al. (2012). "Validity of respiratory scores in bronchiolitis". Hosp Pediatr. 2 (4): 202–9. PMID 24313026.
- ↑ Wrobel JS, Armstrong DG (2008). "Reliability and validity of current physical examination techniques of the foot and ankle". J Am Podiatr Med Assoc. 98 (3): 197–206. PMID 18487593.
- ↑ Campbell ML (2008). "Psychometric testing of a respiratory distress observation scale". J Palliat Med. 11 (1): 44–50. doi:10.1089/jpm.2007.0090. PMID 18370892.
- ↑ McCallum GB, Morris PS, Wilson CC, Versteegh LA, Ward LM, Chatfield MD; et al. (2013). "Severity scoring systems: are they internally valid, reliable and predictive of oxygen use in children with acute bronchiolitis?". Pediatr Pulmonol. 48 (8): 797–803. doi:10.1002/ppul.22627. PMID 22949369.