Sniff nasal pressures are a useful way to measure inspiratory muscle loading in patients with chronic obstructive pulmonary disease (COPD).
Besides the advantage of being a non-invasive approach, it can detect slowing of the inspiratory muscles both in clinical settings and exercise studies, say specialists at hospitals in London, England and Goteborg, Sweden.
They point out that slowing of the inspiratory muscle maximum relaxation rate, a useful index of severe inspiratory muscle loading and potential fatigue in COPD, has customarily been measured from esophageal pressure during sniffs.
The specialists investigated whether it was possible to measure maximum relaxation rate and detect inspiratory muscle slowing using sniff nasal pressure. They also studied the relationship between sniff esophageal and sniff nasal maximum relaxation rate.
Eight patients with COPD (mean forced expiratory volume-1, 0.7 l; 26.0 percent predicted) were studied. Each patient performed submaximal sniff manoeuvres before and after walking to a state of severe dyspnoea on a treadmill. Esophageal and gastric pressures were measured with balloon tipped catheters and nasal pressure with individually modeled nasal casts.
The researchers determined maximum relaxation rate (percent pressure fall/10 ms.) for each sniff. Any change after exercise was reported as a percentage of baseline in order to compare sniff nasal and esophageal maximum relaxation rate.
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