ArticleAnnals of intensive care2020
Recruitment pattern of the diaphragm and extradiaphragmatic inspiratory muscles in response to different levels of pressure support.
Article in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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.
Analysis of Respiratory Drive Activation, Ventilation, and Pulmonary Aeration Resulting From Body Lateralization in Critically Ill Patients Under Mechanical Ventilation
the Effect of Doxapram on Diaphragmatic Excursion(DE) During Weaning From Mechanical Ventilation :a Randomized Double Blinded Study.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Surface electromyography signal processing and evaluation on respiratory muscles of critically ill patients: A systematic review.PloS one · 2023Pooled it
- Surface electromyography to quantify neuro-respiratory drive and neuro-mechanical coupling in mechanically ventilated children.Respiratory research · 2023Trial
- Acute intermittent hypoxia and respiratory muscle recruitment in people with amyotrophic lateral sclerosis: A preliminary study.Experimental neurology · 2022Trial
- Continuous and noninvasive respiratory effort monitoring: a narrative review of emerging techniques.Journal of intensive care · 2026Review
- ReSurfEMG: A Python Package for Comprehensive Analysis of Respiratory Surface EMG.Sensors (Basel, Switzerland) · 2025Article
- Differences in muscle atrophy between the lower limbs and the accessory respiratory muscles in critically ill patients.Journal of medical ultrasonics (2001) · 2025Article
- Advanced serial analysis of the diaphragm surface EMG: insights into the effect of pressure support on the neuro-ventilatory response during the ICU stay.Critical care (London, England) · 2025Article
- Monitoring patients with acute respiratory failure during non-invasive respiratory support to minimize harm and identify treatment failure.Critical care (London, England) · 2025Review
- A Simple, Low-Cost Implant for Reliable Diaphragm EMG Recordings in Awake, Behaving Rats.eNeuro · 2025Article
- 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
- MUltiparametric Score for Ventilation Discontinuation in Intensive Care Patients: A Protocol for an Observational Study.Methods and protocols · 2024Article
- Analysis and applications of respiratory surface EMG: report of a round table meeting.Critical care (London, England) · 2024Review
- Obstructive Sleep Apnea and Role of the Diaphragm.Cureus · 2022Review
- Accessory and Expiratory Muscles Activation During Spontaneous Breathing Trial: A Physiological Study by Surface Electromyography.Frontiers in medicine · 2022Article
- Proportional assist ventilation relieves clinically significant dyspnea in critically ill ventilated patients.Annals of intensive care · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInappropriate ventilator assist plays an important role in the development of diaphragm dysfunction. Ventilator under-assist may lead to muscle injury, while over-assist may result in muscle atrophy. This provides a good rationale to monitor respiratory drive in ventilated patients. Respiratory drive can be monitored by a nasogastric catheter, either with esophageal balloon to determine muscular pressure (gold standard) or with electrodes to measure electrical activity of the diaphragm. A disadvantage is that both techniques are invasive. Therefore, it is interesting to investigate the role of surrogate markers for respiratory dive, such as extradiaphragmatic inspiratory muscle activity. The aim of the current study was to investigate the effect of different inspiratory support levels on the recruitment pattern of extradiaphragmatic inspiratory muscles with respect to the diaphragm and to evaluate agreement between activity of extradiaphragmatic inspiratory muscles and the diaphragm.
methodsActivity from the alae nasi, genioglossus, scalene, sternocleidomastoid and parasternal intercostals was recorded using surface electrodes. Electrical activity of the diaphragm was measured using a multi-electrode nasogastric catheter. Pressure support (PS) levels were reduced from 15 to 3 cmH
resultsWe included 17 ventilated patients. Diaphragm and extradiaphragmatic inspiratory muscle activity increased in response to lower PS levels (36 ± 6% increase for the diaphragm, 30 ± 6% parasternal intercostals, 41 ± 6% scalene, 40 ± 8% sternocleidomastoid, 43 ± 6% alae nasi and 30 ± 6% genioglossus). Changes in diaphragm activity correlated best with changes in alae nasi activity (r
conclusionsExtradiaphragmatic inspiratory muscle activity increases in response to lower inspiratory support levels. However, there is a poor correlation and agreement with the change in diaphragm activity, limiting the use of surface electromyography (EMG) recordings of extradiaphragmatic inspiratory muscles as a surrogate for electrical activity of the diaphragm.
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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.