Observational studyCritical care (London, England)2021
Surface EMG-based quantification of inspiratory effort: a quantitative comparison with P
Observational study in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Surface electromyography signal processing and evaluation on respiratory muscles of critically ill patients: A systematic review.PloS one · 2023Pooled it
- Potential Diaphragm Muscle Weakness-related Dyspnea Persists 2 Years after COVID-19 and Could Be Improved by Inspiratory Muscle Training: Results of an Observational and an Interventional Clinical Trial.American journal of respiratory and critical care medicine · 2024Trial
- Continuous and noninvasive respiratory effort monitoring: a narrative review of emerging techniques.Journal of intensive care · 2026Review
- Pattern of extra-diaphragmatic respiratory muscle activity during exercise in patients with unilateral diaphragm dysfunction.Physiological reports · 2025Article
- ReSurfEMG: A Python Package for Comprehensive Analysis of Respiratory Surface EMG.Sensors (Basel, Switzerland) · 2025Article
- Electromyographic Diaphragm and Electrocardiographic Signal Analysis for Weaning Outcome Classification in Mechanically Ventilated Patients.Sensors (Basel, Switzerland) · 2025Article
- Estimation of Respiratory Effort Through Diaphragmatic Electromyography Features.Sensors (Basel, Switzerland) · 2025Article
- Assessing inspiratory drive and effort in critically ill patients at the bedside.Critical care (London, England) · 2025Review
- 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
- Chronic sustained hypoxia alters the pattern of diaphragm electrical activity in anaesthetized rats.Experimental physiology · 2025Article
- Emerging Wearable Acoustic Sensing Technologies.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Review
- 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
- Analysis and applications of respiratory surface EMG: report of a round table meeting.Critical care (London, England) · 2024Review
- Individual response in patient's effort and driving pressure to variations in assistance during pressure support ventilation.Annals of intensive care · 2023Article
- Patient Self-Inflicted Lung Injury-A Narrative Review of Pathophysiology, Early Recognition, and Management Options.Journal of personalized medicine · 2023Review
- Highlights from the Respiratory Failure and Mechanical Ventilation 2022 Conference.ERJ open research · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInspiratory patient effort under assisted mechanical ventilation is an important quantity for assessing patient-ventilator interaction and recognizing over and under assistance. An established clinical standard is respiratory muscle pressure [Formula: see text], derived from esophageal pressure ([Formula: see text]), which requires the correct placement and calibration of an esophageal balloon catheter. Surface electromyography (sEMG) of the respiratory muscles represents a promising and straightforward alternative technique, enabling non-invasive monitoring of patient activity.
methodsA prospective observational study was conducted with patients under assisted mechanical ventilation, who were scheduled for elective bronchoscopy. Airway flow and pressure, esophageal/gastric pressures and sEMG of the diaphragm and intercostal muscles were recorded at four levels of pressure support ventilation. Patient efforts were quantified via the [Formula: see text]-time product ([Formula: see text]), the transdiaphragmatic pressure-time product ([Formula: see text]) and the EMG-time products (ETP) of the two sEMG channels. To improve the signal-to-noise ratio, a method for automatically selecting the more informative of the sEMG channels was investigated. Correlation between ETP and [Formula: see text] was assessed by determining a neuromechanical conversion factor [Formula: see text] between the two quantities. Moreover, it was investigated whether this scalar can be reliably determined from airway pressure during occlusion maneuvers, thus allowing to quantify inspiratory effort based solely on sEMG measurements.
resultsIn total, 62 patients with heterogeneous pulmonary diseases were enrolled in the study, 43 of which were included in the data analysis. The ETP of the two sEMG channels was well correlated with [Formula: see text] ([Formula: see text] and [Formula: see text] for diaphragm and intercostal recordings, respectively). The proposed automatic channel selection method improved correlation with [Formula: see text] ([Formula: see text]). The neuromechanical conversion factor obtained by fitting ETP to [Formula: see text] varied widely between patients ([Formula: see text]) and was highly correlated with the scalar determined during occlusions ([Formula: see text], [Formula: see text]). The occlusion-based method for deriving [Formula: see text] from ETP showed a breath-wise deviation to [Formula: see text] of [Formula: see text] across all datasets.
conclusionThese results support the use of surface electromyography as a non-invasive alternative for monitoring breath-by-breath inspiratory effort of patients under assisted mechanical ventilation.
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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.