ArticleCritical care (London, England)2025
Advanced serial analysis of the diaphragm surface EMG: insights into the effect of pressure support on the neuro-ventilatory response during the ICU stay.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Rehabilitating the diaphragm: an integrated approach to intensive care unit-acquired dysfunction in critical illness-a narrative review.Acute and critical care · 2026Article
- ReSurfEMG: A Python Package for Comprehensive Analysis of Respiratory Surface EMG.Sensors (Basel, Switzerland) · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVentilatory support levels in ICU patients should be tailored to both optimal gas exchange and respiratory muscle loading, as over- and underassistance may cause diaphragm dysfunction. The diaphragm's capacity to overcome mechanical load and deliver ventilatory output is reflected by the patient's neural respiratory drive (NRD), tidal volume (TV) and respiratory rate (RR). Surface electromyography of the diaphragm (sEMGdi) offers a continuous, non-invasive measure of NRD. We investigated the effect of pressure support (PS) level on the coupling of diaphragm electrical activity (sEAdi) and ventilatory output during the ICU stay.
methodsIn clinically stable ICU patients (N = 17), four PS-levels were applied on alternate days, based on the clinical value (- 3, + 0, + 3, and + 6 cmH
resultsOn group level (13 patients, 26 PS-trials), ETPdi and RR increased with decreasing PS-levels (2.4 and 1.6 percentage point (pp)/cmH
conclusionAdvanced sEMGdi analysis allows for non-invasive quantification of NVC, reflecting the diaphragm's capacity to overcome mechanical load. In patients approaching liberation from MV, increasing NVC indicates the shift from near-passive to active breathing. This study demonstrates the potential of NVC to inform tailoring of ventilatory support levels. TRIAL REGISTRATION NUMBER: Dutch Trial Register NL9654. Registered August 05, 2021.
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