Comparison of two methods of measurement of maximal respiratory pressures in health and cystic fibrosis
- 1 Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK Department of Paediatrics, University of Patras Medical School, Rio, Greece
- 2 Department of Cystic Fibrosis, Aghia Sophia Children’s Hospital, Thivon & Papadiamantopoulou, Athens, Greece
- 3 Department of Cystic Fibrosis, Aghia Sophia Children’s Hospital, Thivon & Papadiamantopoulou, Athens, Greece
- 4 Department of Paediatrics, University of Patras Medical School, Rio, Greece
Abstract
Introduction: Respiratory muscle strength can be assessed by static mouth measurements of maximal inspiratory pressure (Pi max ) and maximal expiratory pressure (Pe max ). Impaired respiratory muscle strength is common in neuromuscular and obstructive pulmonary disease such as Cystic Fibrosis (CF). Maximal respiratory pressures can easily be measured with a portable manometer on the bedside and in the community. Our objective was to compare maximal respiratory pressures as measured by standard laboratory equipment and the portable mouth pressure meter Micro RPM. Methods: Pi max and Pe max were assessed in 296 healthy subjects and patients with CF with the Micro RPM and standard laboratory equipment. The Micro RPM measures and digitally displays maximal respiratory pressures after averageing over a one second period. Standard laboratory equipment consisted of a differential pressure transducer, whose amplified signals were analyzed by Lab-VIEW software. Each subject performed at least five reproducible maneuvers after familiarizing with the equipment. Results: The Micro RPM accurately measured maximal inspiratory and maximal expiratory pressures both in healthy individuals as well as in patients with CF. Mean difference (standard deviation) of the methods was 1.37 (17.73) cm H 2 O for Pi max maneuvers and 1.84 (9.09) cm H 2 O for Pe max maneuvers. Conclusions: The Micro RPM can relia-bly and accurately measure maximal respiratory mouth pressures and its use could be applied both in the clinical and the research setting.
- Fauroux, B. and Lofaso, F. (2005) Measurements of respiratory muscle function in children. In: Hammer, J. and Eber, E., Eds, Paediatric Pulmonary Function Testing, Karger, Basel, 138. doi:10.1159/000083531
- Similowski, T. and Derenne, J.P. (1994) Inspiratory muscle testing in stable COPD patients. European Respiratory Journal, 7, 1871-1876. doi:10.1183/09031936.94.07101871
- Mulreany, L.T., Weiner, D.J., McDonough, J.M. et al. (2003) Noninvasive measurement of the tension-time index in children with neuromuscular disease. Journal of Applied Physiology, 95, 931-937.
- Barry, S.C. and Gallagher, C.G. (2003) Corticosteroids and skeletal muscle function in cystic fibrosis. Journal of Applied Physiology, 95, 1379-1384.
- Polkey, M.I., Kyroussis, D., Hamnegard, C.H., et al. (1996) Diaphragm strength in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 154, 1310-1317. doi:10.1164/ajrccm.154.5.8912741
- Hart, N., Tounian, P., Clement, A., et al. (2004) Nutritional status is an important predictor of diaphragm strength in young patients with cystic fibrosis. The American Journal of Clinical Nutrition, 80, 1201-1206.
- Hamnegard, C.H., Wragg, S., Kyroussis, D., et al. (1994) Portable measurement of maximum mouth pressures. European Respiratory Journal, 7, 398-401. doi:10.1183/09031936.94.07020398
- Bruschi, C., Cerveri, I., Zoia, M.C., et al. (1992) Reference values of maximal respiratory mouth pressures: A population-based study. American Review of Respiratory Disease, 146, 790-793. doi:10.1164/ajrccm/146.3.790
- Black, L.F. and Hyatt, R.E. (1969) Maximal respiratory pressures: Normal values and relationship to age and sex. American Review of Respiratory Disease, 99, 696-702.
- Gaultier, C. and Zinman, R. (1983) Maximal static pressures in healthy children. Respiration Physiology, 51, 45-61. doi:10.1016/0034-5687(83)90101-9
- Hayot, M., Guillaumont, S., Ramonatxo, M., et al. (1997) Determinants of the tension-time index of inspiratory muscles in children with cystic fibrosis. Pediatric Pulmonology, 23, 336-343. doi:10.1002/(SICI)1099-0496(199705)23:5 3.0.CO; 2-I
- Hahn, A., Ankermann, T., Claass, A., et al. (2008) Noninvasive tension time index in relation to severity of disease in children with cystic fibrosis. Pediatric Pulmonology, 43, 973-981. doi:10.1002/ppul.20887