Transcutaneous electromyographic respiratory muscle recordings to quantify patient-ventilator interaction in mechanically ventilated children

Alette A Koopman, Robert G T Blokpoel, Leo A van Eykern, Frans H C de Jongh, Johannes G M Burgerhof, Martin C J Kneyber

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BACKGROUND: To explore the feasibility of transcutaneous electromyographic respiratory muscle recordings to automatically quantify the synchronicity of patient-ventilator interaction in the pediatric intensive care unit.

METHODS: Prospective observational study in a tertiary paediatric intensive care unit in an university hospital. Spontaneous breathing mechanically ventilated children < 18 years of age were eligible for inclusion. Patients underwent a 5-min continuous recording of ventilator pressure waveforms and transcutaneous electromyographic signal of the diaphragm. To evaluate patient-ventilator interaction, the obtained neural inspiration and ventilator pressurization timings were used to calculate trigger and cycle-off errors of each breath. Calculated errors were displayed in the dEMG-phase scale.

RESULTS: Data of 23 patients were used for analysis. Based on the dEMG-phase scale, the median rates of synchronous, dyssynchronous and asynchronous breaths as classified by the automated analysis were 12.2% (1.9-33.8), 47.5% (36.3-63.1), and 28.9% (6.6-49.0).

CONCLUSIONS: The dEMG-phase scale quantifying patient-ventilator breath synchronicity was demonstrated to be feasible and a reliable scale for mechanically ventilated children, reflected by high intra-class correlation coefficients. As this non-invasive tool is not restricted to a type of ventilator, it could easily be clinical implemented in the ventilated pediatric population. However; correlation studies between the EMG signal measured by surface EMG and esophageal catheters have to be performed.

Originele taal-2English
Aantal pagina's9
TijdschriftAnnals of Intensive Care
Nummer van het tijdschrift1
StatusPublished - 24-jan-2018

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