Cough Gastric Pressure and Maximum Expiratory Mouth Pressure in Humans

Maximal expiratory mouth pressure is a well established test that is used to assess expiratory muscle strength. However, low values are difficult to interpret, as they may result from technical difficulties in performing the test, particularly in patients with facial muscle weakness or bulbar dysfun...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2003-09, Vol.168 (6), p.714-717
Main Authors: Man, William D-C, Kyroussis, Dimitris, Fleming, Tracey A, Chetta, Alfredo, Harraf, Farzaneh, Mustfa, Naveed, Rafferty, Gerrard F, Polkey, Michael I, Moxham, John
Format: Article
Language:English
Subjects:
Biological and medical sciences
Case-Control Studies
Cough
Female
Humans
Investigative techniques of respiratory function
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Peak Expiratory Flow Rate
Pressure
Pulmonary Ventilation - physiology
Reference Values
Respiratory Mechanics - physiology
Respiratory Muscles - physiology
Risk Factors
Sensitivity and Specificity
Sex Factors
Stomach
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Summary:Maximal expiratory mouth pressure is a well established test that is used to assess expiratory muscle strength. However, low values are difficult to interpret, as they may result from technical difficulties in performing the test, particularly in patients with facial muscle weakness or bulbar dysfunction. We hypothesized that measuring the gastric pressure during a cough, a natural maneuver recruiting the expiratory muscles, might prove to be a useful additional test in the assessment of expiratory muscle function. Mouth expiratory and cough gastric pressures were measured in 99 healthy volunteers to obtain normal values and in 293 patients referred for respiratory muscle assessment to compare the two measurements. Between-occasion within-subject coefficient of variation, assessed in 24 healthy volunteers, was 10.3% for mouth pressure and 6.9% for cough. Mean +/- SD cough gastric pressure for normal males was 214.4 +/- 42.2 and 165.1 +/- 34.8 cm H2O for females. In 171 patients deemed weak by a low mouth expiratory pressure, 42% had a normal cough gastric pressure. In 105 patients deemed weak by a low cough gastric pressure, 5.7% had a normal expiratory mouth pressure. Low maximal expiratory mouth pressures do not always indicate expiratory muscle weakness. Cough gastric pressure provides a useful complementary test for the assessment of expiratory muscle strength.
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.200303-334BC