Document Detail

Use of Sniff nasal-inspiratory force to predict survival in amyotrophic lateral sclerosis.
MedLine Citation:
PMID:  15516537     Owner:  NLM     Status:  MEDLINE    
Respiratory muscle weakness is the usual cause of death in amyotrophic lateral sclerosis. The prognostic value of the forced vital capacity (FVC), mouth-inspiratory force, and sniff nasal-inspiratory force were established in a group of 98 patients with amyotrophic lateral sclerosis who were followed trimonthly for 3 years. Sniff nasal-inspiratory force correlated with the transdiaphragmatic pressure (r = 0.9, p < 0.01). Sniff nasal-inspiratory force was most likely to be recorded at the last visit (96% of cases), compared with either the FVC or mouth-inspiratory force (86% and 81%, respectively, p < 0.01). A sniff nasal-inspiratory force less than 40 cm H(2)O was significantly related with nocturnal hypoxemia. When sniff nasal-inspiratory force was less than 40 cm H(2)O, the hazard ratio for death was 9.1 (p = 0.001), and the median survival was 6 +/- 0.3 months. The sensitivity of FVC < 50% for predicting 6-month mortality was 58% with a specificity of 96%, whereas sniff nasal-inspiratory force less than 40 H(2)O had a sensitivity of 97% and a specificity of 79% for death within 6 months. Thus the sniff nasal-inspiratory force test is a good measure of respiratory muscle strength in amyotrophic lateral sclerosis, it can be performed by patients with advanced disease, and it gives prognostic information.
Ross K Morgan; Stephen McNally; Michael Alexander; Ronan Conroy; Orla Hardiman; Richard W Costello
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2004-10-29
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  171     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-25     Completed Date:  2005-03-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  269-74     Citation Subset:  AIM; IM    
Department of Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin 9, Ireland.
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MeSH Terms
Aged, 80 and over
Amyotrophic Lateral Sclerosis / physiopathology*
Anoxia / physiopathology
Follow-Up Studies
Inhalation / physiology*
Middle Aged
Mouth / physiopathology
Nose / physiopathology*
Proportional Hazards Models
Respiratory Paralysis / physiopathology
Sensitivity and Specificity
Sleep / physiology
Survival Rate
Vital Capacity / physiology
Work of Breathing / physiology
Comment In:
Am J Respir Crit Care Med. 2005 Oct 1;172(7):932-3; author reply 933   [PMID:  16183717 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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