RT Journal Article
SR Electronic
T1 Measurement of Diaphragmatic Electrical Activity by Surface Electromyography in Intubated Subjects and Its Relationship With Inspiratory Effort
JF Respiratory Care
FD American Association for Respiratory Care
SP 1341
OP 1349
DO 10.4187/respcare.06176
VO 63
IS 11
A1 Bellani, Giacomo
A1 Bronco, Alfio
A1 Arrigoni Marocco, Stefano
A1 Pozzi, Matteo
A1 Sala, Vittoria
A1 Eronia, Nilde
A1 Villa, Giulia
A1 Foti, Giuseppe
A1 Tagliabue, Giovanni
A1 Eger, Marcus
A1 Pesenti, Antonio
YR 2018
UL http://rc.rcjournal.com/content/63/11/1341.abstract
AB BACKGROUND: Quantification of patient effort during spontaneous breathing is important to tailor ventilatory assistance. Because a correlation between inspiratory muscle pressure (Pmus) and electrical activity of the diaphragm (EAdi) has been described, we aimed to assess the reliability of surface electromyography (EMG) of the respiratory muscles for monitoring diaphragm electrical activity and subject effort during assisted ventilation.METHODS: At a general ICU of a single university-affiliated hospital, we enrolled subjects who were intubated and on pressure support ventilation (PSV) and were on mechanical ventilation for > 48 h. The subjects were studied at 3 levels of pressure support. Airway flow and pressure; esophageal pressure; EAdi; and surface EMG of the diaphragm (surface EAdi), intercostal, and sternocleidomastoid muscles were recorded. Respiratory cycles were sampled for off-line analysis. The Pmus/EAdi index (PEI) was calculated by relying on EAdi and surface EAdi (surface PEI) from an airway pressure drop during end-expiratory occlusions performed every minute.RESULTS: surface EAdi well correlated with EAdi and Pmus, in particular, after averaging breaths into deciles (R = 0.92 and R = 0.84). When surface PEI was used with surface EAdi, it provided a reliable estimation of Pmus (R = 0.94 in comparison with measured Pmus).CONCLUSIONS: During assisted mechanical ventilation, EAdi can be reliably monitored by both EAdi and surface EMG. The measurement of Pmus based on the calibration of EAdi was also feasible by the use of surface EMG.