Chest
Clinical Investigations: Techniques: ArticlesPeak Inspiratory Mouth Pressure in Healthy Subjects and in Patients With COPD
Section snippets
Patients With COPD
We studied 34 patients with known COPD, according to the American Thoracic Society criteria, 13 at the start of a pulmonary rehabilitation program. All patients were in a clinical stable condition with optimal drug management. Entry criteria were (1) FEV1 <60% predicted and (2) FEV1/IVC (inspiratory vital capacity) <50% both after bronchodilation with two inhalations of 40 µg of ipratropium bromide. The study was approved by the medical ethics committee of the University Hospital of Groningen
Results
All variables showed no deviation from a normal distribution.
Discussion
This study shows that P. PImax had no learning effect, an acceptable intraindividual variation, and an acceptable agreement with sniff Pes in patients with COPD. Furthermore, the P. PImax in healthy subjects is significantly higher than P. PImax in patients with COPD of comparable age and gender.
As for the learning effect, patients with COPD needed only two attempts to achieve their maximal P. PImax, while seven attempts are needed for the sniff maneuver. This indicates that patients learn the
ACKNOWLEDGMENTS
We thank the Department of Human Movement Sciences, University of Groningen. Data on the healthy subjects were collected in the study “Physical Fitness, Medical Consumption and Lifestyle of Citizens Over the Age of 55 in the Province of Drenthe, The Netherlands.” This study was supported by a grant of the Health Insurance Company “Het Groene Land.” We thank the lung function laboratory staff of Beatrixoord for their technical assistance in the performance of this study.
References (22)
- et al.
Maximal sniff mouth pressure compared with maximal inspiratory pressure in acute respiratory failure
Chest
(1991) - et al.
Bedside criteria for discontinuation of mechanical ventilation
Chest
(1973) - et al.
Maximal inspiratory pressure: learning effect and test-retest reliability in patients with chronic obstructive pulmonary disease
Chest
(1993) - et al.
Respiratory muscle performance in normal elderly subjects and patients with COPD
Chest
(1989) - et al.
Maximal respiratory pressure: normal values and relationship to age and sex
Am Rev Respir Dis
(1969) - et al.
Predicted normal values for maximal respiratory pressures in Caucasian adults and children
Thorax
(1984) The ventilatory capacity in healthy subjects: an analysis of causal factors with special reference to the respiratory forces
Scand J Clin Invest
(1966)- et al.
Respiratory pressures and function in young adults
Am Rev Respir Dis
(1983) - et al.
Reference values of maximal respiratory mouth pressure: a population-based study
Am Rev Respir Dis
(1992) Function and assessment of respiratory muscles [abstract]
Eur Respir J
(1990)
Maximal inspiratory and expiratory pressures in adolescents: normal values
Chest
Cited by (49)
A review of upper airway physiology relevant to the delivery and deposition of inhalation aerosols
2022, Advanced Drug Delivery ReviewsCitation Excerpt :The correlation between PImax and COPD severity is apparent, and a number of studies have demonstrated a significant difference in PImax between patients with moderate and very severe COPD (e.g. Fig. 3). The age and gender effects of PImax on COPD patients are less understood, and there is some evidence showing that there is no gender-specific difference in the degree of muscle strength impairment in COPD [98,99]. COPD patients also typically suffer from impaired laryngopharyngeal sensitivity and pharyngeal muscle strength, which is critical for airflow modulation during inspiration [100], and the extent to which how this contributes to PImax independently requires further investigation.
Maximal inspiratory mouth pressure in Japanese elite female athletes
2017, Respiratory Physiology and NeurobiologyMaximal inspiratory mouth pressure in Japanese elite male athletes
2016, Respiratory Physiology and NeurobiologyCitation Excerpt :Volitional measurements were made because non-invasive techniques have been shown to be better tolerated by participants than the balloon catheter system. Though subject to greater variation than more invasive techniques, non-invasive measurements have been shown to be reliable and valid (Romer and McConnell, 2004; Wijkstra et al., 1995). This study demonstrates that the MIP characteristics of elite male athletes vary across sport types.
Importance of particle size and shape on the tensile strength distribution and de-agglomeration of cohesive powders
2013, Powder TechnologyCitation Excerpt :Powders (20 ± 1 mg) were dispersed horizontally from gelatine size 3 capsules (Capsugel, NSW, Australia) using a Rotahaler® (GSK, Middlesex, UK) through an inhalation cell of a laser diffraction instrument (Spraytec®, Malvern Instruments, Worcestershire, UK) for five seconds at 30, 45, 60, 90 and 120 l min− 1. The air flow rates were chosen as they are possible for patients with respiratory disorders (50–400 l min− 1) [29–31]. The measurements were conducted on five replicates by capturing 100 measurements per second over a five second period.
Effect of acetazolamide on respiratory muscle fatigue in humans
2013, Respiratory Physiology and NeurobiologyCitation Excerpt :As an index of the maximum force generating capacity of the inspiratory muscles, maximal inspiratory pressure (MIP) was measured at the mouth near residual volume (Coast and Weise, 1990) according to the procedures of Black and Hyatt (1969). This maneuver is widely used as a valid assessment of global inspiratory muscle strength and shows good agreement with invasive techniques (Wijkstra et al., 1995). During the MIP trials, subjects wore a nose clip, exhaled fully to near residual volume, and then inspired maximally once a tight seal was created around the mouth of a cylinder (20 cm in length with an internal diameter of 2 cm).
Supported by a grant of the Dutch Asthma Foundation (89.29) and the Foundation Astmabestrijding.