It has been suggested that SNIP is unlikely to replace MIP, however several groups have concluded that use of both tests in a complementary manner could be beneficial. Several groups have compared SNIP and MIP one has shown SNIP to be higher while others have shown no difference. SNIP measurements have been correlated with quality of life and mortality risk in conditions including amyotrophic lateral sclerosis and are an indication for therapy initiation. The sniff is dependent on inspiratory muscle contraction, predominately the diaphragm, therefore the pressures recorded indicate RMS. ![]() SNIP is a non-invasive measure of RMS, measured via a probe inserted into one nostril during a short, sharp sniff. ![]() In contrast to MIP, sniff nasal inspiratory pressure (SNIP) measurement does not require formation of such a seal, and requires relatively little effort. This can result in overdiagnosis and inappropriate treatment, impairing the quality of life of patients. MIP performance also requires a tight seal to be formed between the mouthpiece and the lips facial muscle weakness is common in NMDs, and may impair adequate seal formation, again conferring risk of RMS underestimation. This is disadvantageous to NMD patients, as they are prone to fatigue, meaning RMS underestimation is common when measuring MIP in these patients. Maximal inspiratory pressure (MIP) is currently the most commonly used RMS measure, however it demands significant effort, as it requires a maximum inspiration from residual volume. Such techniques are beneficial, as pressure-based values typically decline before volume-based measures such as vital capacity, allowing more timely diagnosis and treatment initiation, which can improve prognosis and quality of life. We believe these results are important in aiding the accurate collection of SNIP reference value data in the healthy population.Įstimation of respiratory muscle strength (RMS) by measuring pressures within the thoracic cavity aids diagnosis and monitoring of several conditions, such as neuromuscular disorders (NMDs ). We suggest that twenty repeats is sufficient to overcome any learning effect and that fatigue is unlikely after this number of repeats. Allowing subjects to choose which nostril to use is appropriate, as this did not significantly affect SNIP, but may increase ease of performance. We conclude that SNIP O is a more reliable RMS indicator than SNIP NO, as there is reduced risk of RMS underestimation. There was an initial learning effect for the first SNIP test SNIP did not decline during 80 repeats ( P = 0.64). ![]() SNIP O was significantly higher than SNIP NO ( P < 0.00001) but SNIP L and SNIP R did not significantly differ ( P = 0.60). There was no significant difference in SNIP depending on the interval between repeats ( P = 0.98) subjects preferred the 30 s. SNIP was measured from functional residual capacity via a probe in one nostril, while MIP was measured from residual volume. Methodĥ2 healthy subjects (23 males) were recruited for this study, of which a subset of 10 subjects (5 males) completed tests comparing the time interval between repeats. Additionally, we determined the optimal number of repeats for accurate SNIP measurement. ![]() We compared SNIP values from three conditions, namely with 30, 60 or 90 s time intervals between repeats, the right (SNIP R) and left (SNIP L) nostril, and the contralateral nostril occluded (SNIP O) or non-occluded (SNIP NO). However, no recent guidelines regarding the optimal method of SNIP measurement exist, and varied approaches have been described. Consequently, it has been suggested that use of SNIP could confirm the accuracy of MIP measurements. In contrast, sniff nasal inspiratory pressure (SNIP) requires a short, sharp sniff this is a natural manoeuvre, decreasing required effort. Falsely low values are therefore common, especially in fatigue-prone subjects, such as neuromuscular disorder patients. Maximal inspiratory pressure (MIP) is currently the most commonly used measure for respiratory muscle strength (RMS) estimation, however, requires significant effort.
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