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1 Dept of Pneumology, University Hospital Freiburg, Freiburg, 2 North Sea Clinic Westerland, Westerland, and 3 Dept of Pneumology, Respiratory Intensive Care Unit and Sleep Laboratory, Evangelical Hospital Göttingen-Weende Incorporated Society, Bovenden-Lenglern, Germany
CORRESPONDENCE: W. Windisch, Dept of Pneumology, University Hospital Freiburg, Killianstraße 5, D-79106, Freiburg, Germany. Fax: 49 7612703704. E-mail: windisch@med1.ukl.uni-freiburg.de
Keywords: Muscle strength, normal values, reproducibility, respiratory failure, respiratory muscles, respiratory pressures
Received: December 8, 2003
Accepted December 22, 2003
There is no clear evidence as to how maximal inspiratory mouth pressure (PI,max) should be measured, although plateau pressures sustained for 1 s and measured at residual volume (RV) are usually recommended.
Peak and plateau PI,max were measured at RV and at functional residual capacity (FRC) in 533 healthy subjects (aged 10–90 yrs) in order to comparably test all PI,max measurements for their predictors, reproducibility and normal values.
Plateau pressures accounted for 82.0–86.3% of peak pressures. Peak and plateau pressures measured at FRC accounted for 84.3–90.5% of pressures at RV, and were highly correlated. Age was negatively predictive and weight and body mass index positively predictive of PI,max, but regression parameters were low. All PI,max measurements were comparable when calculating regression parameters, between-subject variability and reproducibility.
In conclusion, peak and plateau maximal inspiratory mouth pressure are comparably useful for the assessment of inspiratory muscle strength and can be reliably measured at functional residual capacity and at residual volume. Regression equations are of low impact in predicting normal values due to the weak influence of demographic and anthropometric factors and to the high unexplained between-subject-variability. Age-related 5th percentiles can indicate the lower limit of the normal range.
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