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

TY - JOUR

T1 - Parasternal intercostal electromyography

T2 - a novel tool to assess respiratory load in children

AU - MacBean, Vicky

AU - Jolley, Caroline

AU - Sutton, Timothy G

AU - Deep, Akash

AU - Greenough, Anne

AU - Moxham, John

AU - Rafferty, Gerrard F

PY - 2016/9

Y1 - 2016/9

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84983742553&partnerID=8YFLogxK

U2 - 10.1038/pr.2016.89

DO - 10.1038/pr.2016.89

M3 - Article

C2 - 27074127

SN - 0031-3998

VL - 80

SP - 407

EP - 414

JO - Pediatric Research

JF - Pediatric Research

IS - 3

ER -