TY - JOUR
T1 - Transcutaneous electromyography of the diaphragm: A cardio-respiratory monitor for preterm infants
AU - Kraaijenga, Juliette V.
AU - Hutten, Gerard J.
AU - de Jongh, Frans H.
AU - van Kaam, Anton H.
PY - 2015
Y1 - 2015
N2 - Chest impedance (CI) is the current standard for cardio-respiratory monitoring in preterm infants but fails to provide direct and quantitative information on diaphragmatic activity. Transcutaneous electromyography (dEMG) is able to measure diaphragmatic activity, but its feasibility and repeatability to monitor respiratory rate (RR) and heart rate (HR) in preterm infants needs to be established. RR and HR were measured simultaneously by dEMG and CI for 1-hour on day 1, 3, and 7 of life in 31 preterm infants (gestational age 29.6 ± 1.8 weeks; birth weight 1380 ± 350 g) on non-invasive respiratory support. Six fixed 1-minute time intervals were selected from each 1-hour recording and both RR and HR were calculated using all intervals or only those with stable dEMG and CI recordings. dEMG was well tolerated and signal quality was good. Both RR and HR measured by dEMG and CI were significantly correlated (RR: r = 0.85, HR: r = 0.98) and showed good agreement by the Bland-Altman plot (mean difference (limits of agreement): RR: -2.3 (-17.3 to 12.7) breaths/min and HR: -0.3 (-5.3 to 4.7) beats/min. When analyzing only stable recordings, the correlation (r = 0.92) and agreement (-1.8 (-12.3 to 8.7) breaths/min) for RR improved. Subgroup analyses for postnatal age, gestational age, and mode of support showed similar results suggesting good repeatability of dEMG. This study shows that monitoring RR and HR with transcutaneous dEMG is feasible and repeatable in preterm infants
AB - Chest impedance (CI) is the current standard for cardio-respiratory monitoring in preterm infants but fails to provide direct and quantitative information on diaphragmatic activity. Transcutaneous electromyography (dEMG) is able to measure diaphragmatic activity, but its feasibility and repeatability to monitor respiratory rate (RR) and heart rate (HR) in preterm infants needs to be established. RR and HR were measured simultaneously by dEMG and CI for 1-hour on day 1, 3, and 7 of life in 31 preterm infants (gestational age 29.6 ± 1.8 weeks; birth weight 1380 ± 350 g) on non-invasive respiratory support. Six fixed 1-minute time intervals were selected from each 1-hour recording and both RR and HR were calculated using all intervals or only those with stable dEMG and CI recordings. dEMG was well tolerated and signal quality was good. Both RR and HR measured by dEMG and CI were significantly correlated (RR: r = 0.85, HR: r = 0.98) and showed good agreement by the Bland-Altman plot (mean difference (limits of agreement): RR: -2.3 (-17.3 to 12.7) breaths/min and HR: -0.3 (-5.3 to 4.7) beats/min. When analyzing only stable recordings, the correlation (r = 0.92) and agreement (-1.8 (-12.3 to 8.7) breaths/min) for RR improved. Subgroup analyses for postnatal age, gestational age, and mode of support showed similar results suggesting good repeatability of dEMG. This study shows that monitoring RR and HR with transcutaneous dEMG is feasible and repeatable in preterm infants
U2 - https://doi.org/10.1002/ppul.23116
DO - https://doi.org/10.1002/ppul.23116
M3 - Article
C2 - 25327880
SN - 8755-6863
VL - 50
SP - 889
EP - 895
JO - Pediatric pulmonology
JF - Pediatric pulmonology
IS - 9
ER -