Measuring electrical activity of the diaphragm on the ICU

Patients on the intensive care unit often need mechanical ventilation. Mechanical ventilation is harmful for the diaphragm. This leads to diaphragmatic dysfunction and weakness. One of the causes is patient-ventilator dyssynchrony (PVD). PVD is a frequent problem on the ICU, but detection demands expertise and time. PVD can lead to prolonged mechanical ventilation and ICU stay.
In patients with diaphragmatic weakness, weaning from mechanical ventilation has to be done carefully. This time-consuming process leads to a prolonged stay on the ICU, which is associated with an increased risk of infections, mortality and increased costs.

Optimized monitoring of diaphragm function might be able to detect patient-ventilator dyssynchrony and might accelerate the weaning process and diminish the length of mechanical ventilation and ICU stay.

The electrical activity of the diaphragm (EAdi) can be detected by three electromyography (EMG) methods: transcutaneous EMG, intramuscular EMG and transesophageal EMG. Transcutaneous electromyography, also called surface electromyography (sEMG), is the least invasive method. In this pilot study we aim to investigate the additional value of sEMG signals of respiratory muscles during ICU admission in adults.

-Surface electromyography (sEMG) of the diaphragm can detect patient-ventilator dyssynchrony

-sEMG of the diaphragm correlates with the Eadi signals of a transesophageal EMG catheter

-sEMG changes with increased physical activity on the ICU

-sEMG fatigue parameters correlate with clinical parameters of fatigue during weaning from mechanical ventilation

Recordings of 15 minutes to maximum 4 hours (depending on research question)

Surface electromyography of the diaphragm and intercostal muscles