Parasternal intercostal electromyography: a novel tool to assess respiratory load in children

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BACKGROUND: Parasternal intercostal muscle electromyography (EMGpara) represents a novel tool to assess respiratory load when volitional techniques are not possible. This study examined the application of EMGpara in healthy, wheezy and critically ill children.

METHODS: Surface EMGpara was measured during tidal breathing in 92 healthy children, 20 wheezy preschool children (with measurements repeated following bronchodilator), and 25 mechanically ventilated children during supported ventilation and on CPAP.

RESULTS: EMGpara was related to age, height and weight in the healthy group (r=-0.623, -0.625 -0.641 respectively, all p<0.0001). An age-based equation for predicted EMGpara was developed and patient data expressed as z-scores. EMGpara was higher in wheezy children pre-bronchodilator than healthy controls (median (IQR) z-score 0.53 (0.07 - 1.94), p=0.0073), falling to levels not different to healthy children post-bronchodilator (-0.08 (-0.50 - 1.00)). In the critically ill children, EMGpara was higher (p<0.0001) than in healthy subjects during both mechanical ventilation (median (IQR) z-score 1.14 (0.33 - 1.93)) and while on CPAP (1.88 (0.91 - 3.03)).

CONCLUSIONS: EMGpara is feasible in children and infants both in health and disease, is raised in those with elevated respiratory load, and is responsive to clinical interventions. EMGpara represents a potential method to assess respiratory status in patients conventionally challenging to assess.Pediatric Research (2016); doi:10.1038/pr.2016.89.

Original languageEnglish
Pages (from-to)407-414
JournalPediatric Research
Issue number3
Early online date11 May 2016
Publication statusPublished - Sept 2016


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