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Published online before print February 2, 2006, 10.1183/09031936.06.00121305
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Eur Respir J 2006; 27:980-982
Copyright ©ERS Journals Ltd 2006

Sniff nasal inspiratory pressure: what is the optimal number of sniffs?

F. Lofaso1,2, F. Nicot3, M. Lejaille1, L. Falaize1, A. Louis1, A. Clement3, J-C. Raphael1, D. Orlikowski1 and B. Fauroux3

1 Services de Réanimation Médicale, de Physiologie-Explorations Fonctionnelles et Centre d'Innovations Technologiques, Hôpital Raymond Poincaré, AP-HP, Garches, 2 INSERM, Créteil, and 3 Service de Pédiatrie Pneumologique et INSERM, Université Pierre et Marie Curie, Hôpital Armand Trousseau, AP-HP, Paris, France.

CORRESPONDENCE: F. Lofaso, Service de Physiologie-Explorations Fonctionnelles, Hôpital Raymond Poincaré, 92380 Garches, France. Fax: 33 147107943. E-mail: f.lofaso{at}rpc.ap-hop-paris.fr

Keywords: Cystic fibrosis, learning effect, neuromuscular disease, respiratory muscle strength

Received: October 17, 2005
Accepted January 10, 2006

Sniff nasal inspiratory pressure (SNIP) measurement is a volitional noninvasive assessment of inspiratory muscle strength. A maximum of 10 sniffs is generally used. The purpose of the present study was to investigate whether the maximum SNIP improved after the tenth sniff.

In total, 20 healthy volunteers and 305 patients with various neuromuscular and lung diseases were encouraged to perform 40 and 20 sniffs, respectively.

The best SNIP among the first 10 sniffs was lower than the best SNIP among the next 10 sniffs in the healthy volunteers and patients. The SNIP improvement after the twentieth sniff was marginal.

In conclusion, a learning effect persists after the tenth sniff. The current authors suggest using 10 additional sniffs when the best result of the first 10 sniffs is slightly below normal, or when sniff nasal inspiratory pressure is used to monitor a progressive decline in inspiratory muscle strength.




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