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Published online before print February 2, 2006
Eur Respir J 2006, doi:10.1183/09031936.06.00121305
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SHORT REPORT

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

F. Lofaso 1*, F. Nicot 2, M. Lejaille 3, L. Falaize 3, A. Louis 3, A. Clement 2, J-C. Raphael 3, D. Orlikowski 3, B. Fauroux 2

1 Services de Réanimation Médicale, de Physiologie-Explorations Fonctionnelles et Centre d’Innovations Technologiques, Hôpital Raymond Poincaré, AP-HP, 92380 Garches, France; and INSERM UMR 651, 9400 Créteil, France
2 Service de Pédiatrie Pneumologique et INSERM U 719, Université Pierre et Marie Curie-Paris6, Hôpital Armand Trousseau, AP-HP, 75012 Paris, France
3 Services de Réanimation Médicale, de Physiologie-Explorations Fonctionnelles et Centre d’Innovations Technologiques, Hôpital Raymond Poincaré, AP-HP, 92380 Garches, France

* To whom correspondence should be addressed. E-mail: f.lofaso{at}rpc.ap-hop-paris.fr.


  Abstract

Sniff nasal inspiratory pressure (SNIP) measurement is a volitional non-invasive assessment of inspiratory muscle strength. The maximum value of ten sniffs is generally used. The purpose of this study was to investigate whether the maximum SNIP improved after the tenth sniff.

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 20th sniff was marginal.

A learning effect persists after the 10th sniff. We suggest using 10 additional sniffs when the best result of the first 10 sniffs is slightly below normal or when SNIP is used to monitor a progressive decline in inspiratory muscle strength.

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




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