Transcutaneous electromyography of the diaphragm: A cardio-respiratory monitor for preterm infants.

Abstract:

INTRODUCTION:Chest impedance (CI) is the current standard for cardio-respiratory monitoring in preterm infants but fails to provide direct and quantitative information on diaphragmatic activity. Transcutaneous electromyography (dEMG) is able to measure diaphragmatic activity, but its feasibility and repeatability to monitor respiratory rate (RR) and heart rate (HR) in preterm infants needs to be established. METHODS:RR and HR were measured simultaneously by dEMG and CI for 1-hour on day 1, 3, and 7 of life in 31 preterm infants (gestational age 29.6 ± 1.8 weeks; birth weight 1380 ± 350 g) on non-invasive respiratory support. Six fixed 1-minute time intervals were selected from each 1-hour recording and both RR and HR were calculated using all intervals or only those with stable dEMG and CI recordings. RESULTS:dEMG was well tolerated and signal quality was good. Both RR and HR measured by dEMG and CI were significantly correlated (RR: r = 0.85, HR: r = 0.98) and showed good agreement by the Bland-Altman plot (mean difference (limits of agreement): RR: -2.3 (-17.3 to 12.7) breaths/min and HR: -0.3 (-5.3 to 4.7) beats/min. When analyzing only stable recordings, the correlation (r = 0.92) and agreement (-1.8 (-12.3 to 8.7) breaths/min) for RR improved. Subgroup analyses for postnatal age, gestational age, and mode of support showed similar results suggesting good repeatability of dEMG. CONCLUSION:This study shows that monitoring RR and HR with transcutaneous dEMG is feasible and repeatable in preterm infants.

journal_name

Pediatr Pulmonol

journal_title

Pediatric pulmonology

authors

Kraaijenga JV,Hutten GJ,de Jongh FH,van Kaam AH

doi

10.1002/ppul.23116

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

889-95

issue

9

eissn

8755-6863

issn

1099-0496

journal_volume

50

pub_type

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