Transesophageal Versus Surface Electromyography of the Diaphragm in Ventilated Subjects.

BACKGROUND: Detection of diaphragmatic muscle activity during invasive ventilation may provide valuable information about patient-ventilator interactions. Transesophageal electromyography of the diaphragm (tEAdi) is used in neurally adjusted ventilatory assist. This technique is invasive and can onl...

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Publicado en:Respiratory Care Vol. 65; no. 9; pp. 1309 - 1315
Autores principales: Lokin, Joost LC, Dulger, Soray, Glas, Gerie J., Horn, Janneke
Formato: research tables/charts tracings Journal Article
Publicado: Mary Ann Liebert, Inc. Sep2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2020
      vid: 65
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      pub: Mary Ann Liebert, Inc.
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        atl: Transesophageal Versus Surface Electromyography of the Diaphragm in Ventilated Subjects.
      aug:
        au:
          Lokin, Joost LC
          Dulger, Soray
          Glas, Gerie J.
          Horn, Janneke
        affil: Department of Cardiovascular Surgery, Amsterdam UMC, Amsterdam, the Netherlands
      sug:
        subj:
          Ventilator Patients
          Diaphragm Physiology
          Electromyography Methods
          Work of Breathing Evaluation
          Predictive Value of Tests Evaluation
          Human
          Male
          Female
          Middle Age
          Aged
          Pilot Studies
          Prospective Studies
          Nonexperimental Studies
          Spearman's Rank Correlation Coefficient
          Descriptive Statistics
          Data Analysis Software
          Monitoring, Physiologic
          Respiratory Rate Evaluation
          Respiration, Artificial
          Respiratory Mechanics
          APACHE (Acute Physiology and Chronic Health Evaluation)
          Scales
          Clinical Assessment Tools
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: BACKGROUND: Detection of diaphragmatic muscle activity during invasive ventilation may provide valuable information about patient-ventilator interactions. Transesophageal electromyography of the diaphragm (tEAdi) 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 (sEAdi) 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 sEAdi and tEAdi. METHODS: In this single-center pilot study, sEAdi and tEAdi recordings were obtained simultaneously for 15 min in adult subjects in the ICU who were invasively ventilated. The number of breathing efforts detected by sEAdi and tEAdi were determined. The percentage of detected breathing efforts by sEAdi compared with tEAdi 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 sEAdi and tEAdi. Agreement was calculated by using Bland-Altman statistics. RESULTS: Fifteen subjects were included. The tEAdi detected 3,675 breathing efforts, of which 3,162 (86.0%) were also detected by sEAdi. A statistically significant temporal correlation (r = 0.95, P < .001) was found between sEAdi and tEAdi 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 sEAdi was not reliable for breathing effort detection in subjects who were invasively ventilated compared with tEAdi. In stable recordings, however, sEAdi and tEAdi had excellent temporal correlation and good agreement. With optimization of signal stability, sEAdi may become a useful monitoring tool.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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