TY - JOUR T1 - Transesophageal Versus Surface Electromyography of the Diaphragm in Ventilated Subjects JF - Respiratory Care SP - 1309 LP - 1314 DO - 10.4187/respcare.07094 VL - 65 IS - 9 AU - Joost LC Lokin AU - Soray Dulger AU - Gerie J Glas AU - Janneke Horn Y1 - 2020/09/01 UR - http://rc.rcjournal.com/content/65/9/1309.abstract N2 - BACKGROUND: Detection of diaphragmatic muscle activity during invasive ventilation may provide valuable information about patient-ventilator interactions. Transesophageal electromyography of the diaphragm () is used in neurally adjusted ventilatory assist. This technique is invasive and can only be applied with one specific ventilator. Surface electromyography of the diaphragm () is noninvasive and can potentially be applied with all types of ventilators. The primary objective of our study was to compare the ability of diaphragm activity detection between and .METHODS: In this single-center pilot study, and recordings were obtained simultaneously for 15 min in adult subjects in the ICU who were invasively ventilated. The number of breathing efforts detected by and were determined. The percentage of detected breathing efforts by compared with was calculated. Temporal and signal strength relations on optimum recordings of 10 breaths per subject were also compared. The Spearman correlation coefficient was used to determine the correlation between and . Agreement was calculated by using Bland-Altman statistics.RESULTS: Fifteen subjects were included. The detected 3,675 breathing efforts, of which 3,162 (86.0%) were also detected by . A statistically significant temporal correlation (r = 0.95, P < .001) was found between and in stable recordings. The mean difference in the time intervals between both techniques was 10.1 ms, with limits of agreement from –410 to 430 ms.CONCLUSIONS: Analysis of our results showed that was not reliable for breathing effort detection in subjects who were invasively ventilated compared with . In stable recordings, however, and had excellent temporal correlation and good agreement. With optimization of signal stability, may become a useful monitoring tool. ER -