Maximal sniff nasal inspiratory pressure cut-offs for defining inspiratory muscle weakness

Maximal sniff nasal inspiratory pressure (SNIP) is a complementary way to assess the strength of inspiratory muscles along with maximal inspiratory pressure (PImax). To date, a definition of inspiratory muscle weakness based on SNIP reference values does not exist. <bold>Aim:</bold> To establish the lower limit of normality for SNIP using T-scores to define inspiratory muscle weakness. <bold>Methos:</bold> A multicentre cross-sectional study was undertaken across 14 Spanish centres. Healthy non-smoking volunteers 18-80 years old were stratified by sex and decades. SNIP was measured according to ERS guidelines from 2019. Cut-offs for SNIP were established by T-scores, following a method used in sarcopenia to define weak grip strength (Dodds et al., 2014) and already applied to PImax cut-offs (Lista-Paz et al., 2023). Interval of ages with maximum average values of SNIP were calculated and ≥2.5SD below those were considered to represent inspiratory muscle weakness. <bold>Results:</bold> The sample included 600 subjects (48±17 years, 309 females). SNIP in females was 92±23cmH2O and in males 107±26cmH2O. Cut-offs based on T-scores≥2.5 SD below the average peak values (achieved at 24-38 years) were in females 47cmH2O and 43cmH2O in males (fig1). <fig><object-id>erj;64/suppl_68/OA945/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusions:</bold> These cut-offs will allow to better interpreted SNIP clinically. They will be useful worldwide to identify inspiratory muscle weakness, particularly in patients with facial weakness.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.oa945
Primary Topic
Airway Management and Intubation Techniques
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article
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article

Maximal sniff nasal inspiratory pressure cut-offs for defining inspiratory muscle weakness

Marina Francín Gallego, Yolanda Sanesteban Hermida, Pilar Bravo Cortés, Daniël Langer et al.
Airway Management and Intubation Techniques
article

Maximal sniff nasal inspiratory pressure cut-offs for defining inspiratory muscle weakness

Marina Francín Gallego, Yolanda Sanesteban Hermida, Pilar Bravo Cortés, Daniël Langer, Ana Lista-Paz, Beatriz Herrero‐Cortina, Jordi Vilaró, José Luis Valera, Jorge Álvarez Rivas, A.T. Ríos Cortés, Esther García Delgado, Margarita Barral-Fernández, S. Souto Camba, Rocío Martín‐Valero, Rodrigo Torres‐Castro, Esther Giménez Moolhuyzen, Luz González Doníz, Concepción Martín Cortijo, Cristina Serrano Veguillas, Ane Arbillaga‐Etxarri, Guilherme Fregonezi, Alejandro Quintela Del Río, María Amalia Jácome Pumar, Alberto Llorente de la Fuente, Carolina González Montañez, Elena Guimeno-Santos
article en

Abstract

Maximal sniff nasal inspiratory pressure (SNIP) is a complementary way to assess the strength of inspiratory muscles along with maximal inspiratory pressure (PImax). To date, a definition of inspiratory muscle weakness based on SNIP reference values does not exist. <bold>Aim:</bold> To establish the lower limit of normality for SNIP using T-scores to define inspiratory muscle weakness. <bold>Methos:</bold> A multicentre cross-sectional study was undertaken across 14 Spanish centres. Healthy non-smoking volunteers 18-80 years old were stratified by sex and decades. SNIP was measured according to ERS guidelines from 2019. Cut-offs for SNIP were established by T-scores, following a method used in sarcopenia to define weak grip strength (Dodds et al., 2014) and already applied to PImax cut-offs (Lista-Paz et al., 2023). Interval of ages with maximum average values of SNIP were calculated and ≥2.5SD below those were considered to represent inspiratory muscle weakness. <bold>Results:</bold> The sample included 600 subjects (48±17 years, 309 females). SNIP in females was 92±23cmH2O and in males 107±26cmH2O. Cut-offs based on T-scores≥2.5 SD below the average peak values (achieved at 24-38 years) were in females 47cmH2O and 43cmH2O in males (fig1). <fig><object-id>erj;64/suppl_68/OA945/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusions:</bold> These cut-offs will allow to better interpreted SNIP clinically. They will be useful worldwide to identify inspiratory muscle weakness, particularly in patients with facial weakness.

Universidade da Coruña (ES), Universidad de Deusto (ES), Hospital Universitario de Canarias (ES), Universidade Federal do Rio Grande do Norte (BR), Research Institute Hospital 12 de Octubre (ES), Hospital Universitário Onofre Lopes (BR), Hospital Universitario 12 De Octubre (ES), Universidad San Jorge (ES), Hospital Clínico de la Universidad de Chile (CL), Instituto de Investigación Sanitaria Aragón (ES), Hospital Nacional de Parapléjicos (ES), Santa Lucía University General Hospital (ES), Barcelona Institute for Global Health (ES), Hospital Universitario Son Espases (ES), Complejo Hospitalario Universitario de Toledo (ES), University of Córdoba (ES), Universitat Ramon Llull (ES), Universidad Autónoma de Madrid (ES), Cordoba University (US), Universidad de Málaga (ES), KU Leuven (BE)
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