ArticleCritical care (London, England)2018
Estimation of the diaphragm neuromuscular efficiency index in mechanically ventilated critically ill patients.
Article in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04204967 (Impact of Totally Transdermal Sedation in the Weaning From Remifentanil Infusion Among Critically Ill Patients Undergoing Mechanical Ventilation), which is not on this map. Cited by 29 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of Totally Transdermal Sedation in the Weaning From Remifentanil Infusion Among Critically Ill Patients Undergoing Mechanical Ventilation: a Pilot Randomized-controlled Study (The TOES Trial)
Who cites it
29 citing papers in PubMed.
- Effects of levosimendan on respiratory muscle function in patients weaning from mechanical ventilation.Intensive care medicine · 2019Trial
- Neuromuscular and neuromechanical assessments of respiratory performance in the mdx mouse model of Duchenne muscular dystrophy across the natural history of disease.Experimental physiology · 2026Article
- Ventilator-induced lung injury: from mechanisms to integrated clinical management.Frontiers in medicine · 2026Review
- Monitoring of invasive assisted mechanical ventilation: a good clinical practice document by the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI).Journal of anesthesia, analgesia and critical care · 2025Review
- Dynamics of Preparatory Apneas and Their Influence on Maximal Dry Static Apnea in Breath-Hold Divers.Journal of functional morphology and kinesiology · 2025Article
- Application of neurally adjusted ventilatory assist (NAVA): a narrative review.Journal of thoracic disease · 2025Review
- Assessing inspiratory drive and effort in critically ill patients at the bedside.Critical care (London, England) · 2025Review
- Respiratory effort monitoring: a novel, bedside, non-invasive, real-time method.Critical care (London, England) · 2025Observational
- Advanced waveform analysis of diaphragm surface EMG allows for continuous non-invasive assessment of respiratory effort in critically ill patients at different PEEP levels.Critical care (London, England) · 2024Article
- The diaphragmatic electrical activity during spontaneous breathing trial in patients with mechanical ventilation: physiological description and potential clinical utility.BMC pulmonary medicine · 2024Article
- Dyssynchronous diaphragm contractions impair diaphragm function in mechanically ventilated patients.Critical care (London, England) · 2024Observational
- The predictive value of neurally adjusted ventilatory assist indexes for the prognosis of patients with severe cerebral hemorrhage.European journal of medical research · 2024Article
- Analysis and applications of respiratory surface EMG: report of a round table meeting.Critical care (London, England) · 2024Review
- The Neuromechanics of Inspiratory Muscles in Mechanical Ventilation Liberation Success and Failure.Cureus · 2024Article
- Highlights from the Respiratory Failure and Mechanical Ventilation 2022 Conference.ERJ open research · 2023Article
- Pressure-flow breath representation eases asynchrony identification in mechanically ventilated patients.Journal of clinical monitoring and computing · 2022Article
- Neurally Adjusted Ventilatory Assist in Acute Respiratory Failure-A Narrative Review.Journal of clinical medicine · 2022Review
- Surface EMG-based quantification of inspiratory effort: a quantitative comparison with PCritical care (London, England) · 2021Observational
- Quantification of airway conductance from noninvasive ventilatory drive in patients with sleep apnea.Journal of applied physiology (Bethesda, Md. : 1985) · 2021Article
- Evolution of inspiratory muscle function in children during mechanical ventilation.Critical care (London, England) · 2021Observational
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiaphragm dysfunction develops frequently in ventilated intensive care unit (ICU) patients. Both disuse atrophy (ventilator over-assist) and high respiratory muscle effort (ventilator under-assist) seem to be involved. A strong rationale exists to monitor diaphragm effort and titrate support to maintain respiratory muscle activity within physiological limits. Diaphragm electromyography is used to quantify breathing effort and has been correlated with transdiaphragmatic pressure and esophageal pressure. The neuromuscular efficiency index (NME) can be used to estimate inspiratory effort, however its repeatability has not been investigated yet. Our goal is to evaluate NME repeatability during an end-expiratory occlusion (NMEoccl) and its use to estimate the pressure generated by the inspiratory muscles (Pmus).
methodsThis is a prospective cohort study, performed in a medical-surgical ICU. A total of 31 adult patients were included, all ventilated in neurally adjusted ventilator assist (NAVA) mode with an electrical activity of the diaphragm (EAdi) catheter in situ. At four time points within 72 h five repeated end-expiratory occlusion maneuvers were performed. NMEoccl was calculated by delta airway pressure (ΔPaw)/ΔEAdi and was used to estimate Pmus. The repeatability coefficient (RC) was calculated to investigate the NMEoccl variability.
resultsA total number of 459 maneuvers were obtained. At time T = 0 mean NMEoccl was 1.22 ± 0.86 cmH
conclusionsRepeated measurements of NMEoccl exhibit high variability, limiting the ability of a single NMEoccl maneuver to estimate neuromuscular efficiency and therefore the pressure generated by the inspiratory muscles based on EAdi.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.