Measurement of Diaphragmatic Electrical Activity by Surface Electromyography in Intubated Subjects and Its Relationship With Inspiratory Effort.
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...
| Publicado en: | Respiratory Care Vol. 63; no. 11; pp. 1341 - 1350 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Nov2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=133121596&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 133121596 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Nov2018 vid: 63 iid: 11 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 133121596 133121596 133121596 10.4187/respcare.06176 133121596 ppf: 1341 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Measurement of Diaphragmatic Electrical Activity by Surface Electromyography in Intubated Subjects and Its Relationship With Inspiratory Effort. aug: au: Bellani, Giacomo Bronco, Alfio Arrigoni Marocco, Stefano Pozzi, Matteo Sala, Vittoria Eronia, Nilde Villa, Giulia Foti, Giuseppe Tagliabue, Giovanni Eger, Marcus Pesenti, Antonio affil: School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy sug: subj: Respiration, Artificial Diaphragm Physiology Inspiration, Respiratory Electromyography Reliability Human Italy Academic Medical Centers Intensive Care Units Pressure Support Ventilation Adult Middle Age Data Analysis Software Two-Way Analysis of Variance Linear Regression Descriptive Statistics Esophagus Pressure (Physiology) Adult: 19-44 years Middle Aged: 45-64 years 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. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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