Noninvasive determination of inspiratory pressure in patients with spinal cord injury: what is the best method?

Abstract

:256-260 cular diseases, the prognostic value of SNIP for the evaluation of diaphragm strength has been shown to be comparable to that of nonvolumetric and invasive tests. (8)(9)(10)(11) The determination of SNIP is a rapid, easily executed procedure, and the equipment required is portable. To examine the hypothesis that SNIP can detect reduced inspiratory muscle strength in SCI patients, we compared SNIP, MIP and other pulmonary function parameters in SCI patients presenting total loss of motor function, stratifying the sample according to the level of the injury.From June to October of 2005, 26 SCI patients were evaluated at the Hospital SarahBrasilia. The inclusion criteria were as follows:Pulmonary complications are responsible for elevated morbidity and mortality rates in tetraplegic patients.(1) Spinal cord injury (SCI) can cause weakness and respiratory muscle paralysis in varying degrees, depending on the level and completeness of injury.(2,3) The traditional investigations used in SCI patients are spirometry and determination of lung volumes. However, various factors can influence MIP and MEP results, (4)(5)(6)(7) and the value of MIP as an index of inspiratory power has been questioned. AbstractThe aim of the study was to evaluate the performance of sniff nasal inspiratory pressure (SNIP) and MIP in individuals with spinal cord injury. We evaluated 26 patients with spinal cord injury. Mean FVC in those with tetraplegia was 52 ± 19% of predicted, compared with 78 ± 23% of predicted in those with paraplegia (p < 0.05). In contrast, the percentage of predicted SNIP was lower in those with tetraplegia than in those with paraplegia (p < 0.05). In all participants, SNIP correlated significantly with the level of the injury (r = 0.489; 95% CI: 0.125-0.737). The impact that the greater discriminatory power of SNIP has on the diagnosis of impaired pulmonary function in spinal cordinjured patients should be investigated further. Keywords