The following is a summary of “Sniff and reverse-sniff nasal respiratory pressures after exacerbation of chronic obstructive pulmonary disease: A single-center prospective study,” published in the NOVEMBER 2023 issue of Pulmonology by Ichikawa, et al.

For a study, researchers sought to assess the validity of sniff nasal inspiratory pressures (SNIP) and reverse-sniff nasal expiratory pressures (RSNEP) as indicators of respiratory muscle strength and their predictive value for poor life expectancy post-exacerbation in patients with chronic obstructive pulmonary disease (COPD).

A prospective study was conducted involving COPD patients admitted for exacerbation who subsequently underwent rehabilitation. At hospital discharge, measurements of SNIP, RSNEP, maximum mouth inspiratory (MIP), and expiratory pressures (MEP) were taken. The Body Mass Index, degree of Airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index were calculated based on body mass index, forced expiratory volume in 1 s (FEV₁), the Modified Medical Research Council Dyspnea Scale, and 6-minute walk distance.

Data from 43 patients (mean age 76.8 years, FEV₁ 42.8% predicted) were analyzed. SNIP and RSNEP demonstrated moderate correlations with MIP and MEP, respectively. Bland-Altman plot means of SNIP (48.3 ± 17.5) and RSNEP (44.7 ± 23.8 cmH₂O) were slightly lower than those of MIP (54.8 ± 19.9) and MEP (76.4 ± 31.2 cmH₂O), respectively, with wide 95% limits of agreement for SNIP–MIP and RSNEP–MEP. Logistic regression revealed significant associations between SNIP, RSNEP, and BODE score ≥7 (indicative of poor life expectancy). The combined SNIP ≤49 and RSNEP ≤42 cmH₂O showed a predictive accuracy of 81.4%.

SNIP and RSNEP, when utilized post-exacerbation in COPD patients, served as valuable indicators complementing MIP and MEP assessments. Moreover, a combined SNIP and RSNEP test may enhance the prediction of poor life expectancy.

Source: resmedjournal.com/article/S0954-6111(23)00326-8/fulltext