Cardiorespiratory monitoring based on diaphragm electromyography: Towards wireless and non-adhesive monitoring in newborn infants

The electrical activity of the main breathing muscle, the diaphragm, can be measured with transcutaneous electromyography (dEMG). As this technique provides insight in breathing effort, relevant information on the patient’s respiratory condition can be obtained. This thesis consists of two parts. The first part studied the clinical usability of dEMG in (preterm) infants. The second part investigated innovative dEMG techniques, which could ease routine diaphragm activity measurement, as it is currently measured with separate hardware and software, and could improve patient/healthcare provider friendliness. This thesis shows the great potential of dEMG in terms of cardiorespiratory monitoring based on breathing effort, assessing (changes in) diaphragmatic function and the potential to individualize respiratory support. The second part of the thesis shows that dEMG could be measured with the standard cardiorespiratory monitoring equipment by placing its electrodes at the height of the diaphragm. Next to using the standard monitoring equipment, dEMG could be measured with a wireless and non-adhesive cardiorespiratory monitoring belt based on dEMG. This belt could improve parent-infant interaction as it is wireless. Moreover, removal of adhesive electrodes is prevented which is likely to improve comfort. Both methods could facilitate widespread clinical implementation of dEMG. In conclusion, this thesis shows the great potential of dEMG and large steps were made to implement this technique in the clinical practice of the Neonatal Intensive Care Unit.