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Electrical activity of diaphragm

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https://www.readbyqxmd.com/read/28413621/recent-advances-in-pediatric-ventilatory-assistance
#1
REVIEW
Nicolas Nardi, Guillaume Mortamet, Laurence Ducharme-Crevier, Guillaume Emeriaud, Philippe Jouvet
In this review on respiratory assistance, we aim to discuss the following recent advances: the optimization and customization of mechanical ventilation, the use of high-frequency oscillatory ventilation, and the role of noninvasive ventilation. The prevention of ventilator-induced lung injury and diaphragmatic dysfunction is now a key aspect in the management of mechanical ventilation, since these complications may lead to higher mortality and prolonged length of stay in intensive care units. Different physiological measurements, such as esophageal pressure, electrical activity of the diaphragm, and volumetric capnography, may be useful objective tools to help guide ventilator assistance...
2017: F1000Research
https://www.readbyqxmd.com/read/28390638/treatment-of-idiopathic-diaphragm-flutter-a-case-study
#2
Michael Chiou, María Victoria Herrero, John R Bach, Jeffrey L Cole, Enrique Luis Gonzales
Diaphragm flutter is a rare disorder defined by dyspnea and often thoracoabdominal pain associated with rapid rhythmic involuntary contractions of the diaphragm with no effective treatment. A 35-year-old woman's flutter was triggered by increasing the depth of breathing and by (electrical) stimulation of the diaphragm. Medical therapy, phrenic nerve crush, and diaphragm pacer stimulation were ineffective. Since increasing diaphragm activity was a trigger, resting the diaphragm was tried. A manual resuscitator and, subsequently, mouthpiece and nasal noninvasive ventilatory support (NVS) instantaneously halted the flutter for 3 months and almost instantaneously for another 6 months...
April 2017: Chest
https://www.readbyqxmd.com/read/28292963/electrical-activity-of-the-diaphragm-during-ncpap-and-high-flow-nasal-cannula
#3
C G de Waal, G J Hutten, J V Kraaijenga, F H de Jongh, A H van Kaam
OBJECTIVE: To determine if the electrical activity of the diaphragm, as measure of neural respiratory drive and breathing effort, changes over time in preterm infants transitioned from nasal continuous positive airway pressure (nCPAP) to high flow nasal cannula (HFNC). DESIGN: Prospective observational study. SETTING: Neonatal intensive care unit. PATIENTS: Stable preterm infants transitioned from nCPAP to HFNC using a 1:1 pressure to flow ratio...
March 14, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28269565/evaluating-respiratory-muscle-activity-using-a-wireless-sensor-platform
#4
Luis Estrada, Abel Torres, Leonardo Sarlabous, Raimon Jane
Wireless sensors are an emerging technology that allows to assist physicians in the monitoring of patients health status. This approach can be used for the non-invasive recording of the electrical respiratory muscle activity of the diaphragm (EMGdi). In this work, we acquired the EMGdi signal of a healthy subject performing an inspiratory load test. To this end, the EMGdi activity was captured from a single channel of electromyography using a wireless platform which was compared with the EMGdi and the inspiratory mouth pressure (Pmouth) recorded with a conventional lab equipment...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28237936/onset-and-offset-estimation-of-the-neural-inspiratory-time-in-surface-diaphragm-electromyography-a-pilot-study-in-healthy-subjects
#5
Luis Estrada, Abel Torres-Cebrian, Leonardo Sarlabous, Raimon Jane
This study evaluates the onset and offset of neural inspiratory time estimated from surface diaphragm electromyographic (EMGdi) recordings. EMGdi and airflow signals were recorded in ten healthy subjects according to two respiratory protocols based on respiratory rate (RR) increments, from 15 to 40 breaths per minute (bpm), and fractional inspiratory time (Ti/Ttot) decrements, from 0.54 to 0.18. The analysis of diaphragm electromyographic (EMGdi) signal amplitude is an alternative approach for the quantification of neural respiratory drive (NRD)...
February 22, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28227820/evaluating-respiratory-muscle-activity-using-a-wireless-sensor-platform
#6
Luis Estrada, Abel Torres, Leonardo Sarlabous, Raimon Jane, Luis Estrada, Abel Torres, Leonardo Sarlabous, Raimon Jane, Raimon Jane, Luis Estrada, Leonardo Sarlabous, Abel Torres
Wireless sensors are an emerging technology that allows to assist physicians in the monitoring of patients health status. This approach can be used for the non-invasive recording of the electrical respiratory muscle activity of the diaphragm (EMGdi). In this work, we acquired the EMGdi signal of a healthy subject performing an inspiratory load test. To this end, the EMGdi activity was captured from a single channel of electromyography using a wireless platform which was compared with the EMGdi and the inspiratory mouth pressure (Pmouth) recorded with a conventional lab equipment...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28180985/crossover-study-of-assist-control-ventilation-and-neurally-adjusted-ventilatory-assist
#7
Sandeep Shetty, Katie Hunt, Janet Peacock, Kamal Ali, Anne Greenough
Some studies of infants with acute respiratory distress have demonstrated that neurally adjusted ventilator assist (NAVA) had better short-term results compared to non-triggered or other triggered models. We determined if very prematurely born infants with evolving or established bronchopulmonary dysplasia (BPD) had a lower oxygenation index (OI) on NAVA compared to assist control ventilation (ACV). Infants were studied for 1 h each on each mode. At the end of each hour, blood gas analysis was performed and the OI calculated...
April 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28063121/monitoring-of-electrical-activity-of-the-diaphragm-shows-failure-of-t-piece-trial-earlier-than-protocol-based-parameters-in-prolonged-weaning-in-non-communicative-neurological-patients
#8
Oliver Trapp, Mascha Fiedler, Michael Hartwich, Martin Schorl, Armin Kalenka
BACKGROUND: The weaning target in tracheotomised patients is not extubation, but spontaneous breathing without the support of a ventilator. Overloading the respiratory pump during such spontaneous breathing trials is unfavorable, prolongs weaning time, and increases morbidity and mortality. The goal of this study was to evaluate the electrical activity of the diaphragm during a t-piece trial in non-communicative neurological patients and the comparison to clinical parameters of exhaustion...
January 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28013057/neural-control-of-ventilation-prevents-both-over-distension-and-de-recruitment-of-experimentally-injured-lungs
#9
Lukas Brander, Onnen Moerer, Göran Hedenstierna, Jennifer Beck, Jukka Takala, Arthur S Slutsky, Christer Sinderby
BACKGROUND: Endogenous pulmonary reflexes may protect the lungs during mechanical ventilation. We aimed to assess integration of continuous neurally adjusted ventilatory assist (cNAVA), delivering assist in proportion to diaphragm's electrical activity during inspiration and expiration, and Hering-Breuer inflation and deflation reflexes on lung recruitment, distension, and aeration before and after acute lung injury (ALI). METHODS: In 7 anesthetised rabbits with bilateral pneumothoraces, we identified adequate cNAVA level (cNAVAAL) at the plateau in peak ventilator pressure during titration procedures before (healthy lungs with endotracheal tube, [HLETT]) and after ALI (endotracheal tube [ALIETT] and during non-invasive ventilation [ALINIV])...
March 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27940767/effective-neurally-adjusted-ventilatory-assist-nava-ventilation-in-a-child-with-jeune-syndrome
#10
Gianluca Cosi, Giulia Genoni, Alice Monzani, Barbara Pilan, Maria Lavrano, Federica Ferrero
Jeune syndrome (asphyxiating thoracic dystrophy) is a rare skeletal dysplasia mainly characterized by dystrophy of the thoracic cage. Neurally adjusted ventilatory assist (NAVA) is a respiratory support in which pressure assistance is provided in proportion to and synchronous with the electrical activity of the diaphragm. We present the case of a 4-month-old infant with asphyxiating thoracic dystrophy and respiratory failure successfully ventilated with NAVA. In this case, NAVA improved patient-ventilator synchrony, reducing endotracheal secretion and gastric overdistention...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27922742/the-diaphragm-acts-as-a-brake-during-expiration-to-prevent-lung-collapse
#11
Mariangela Pellegrini, Göran Hedenstierna, Agneta Roneus, Monica Segelsjö, Anders Larsson, Gaetano Perchiazzi
RATIONALE: The diaphragm is the major inspiratory muscle and is assumed to relax during expiration. However, electrical post-inspiratory activity has been observed. Whether or not there is an expiratory diaphragmatic contraction that preserves lung patency has yet to be explored. OBJECTIVE: We hypothesized the occurrence of an expiratory diaphragmatic contraction directed at stabilizing peripheral airways and preventing or reducing cyclic expiratory lung collapse...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27891095/differential-rna-expression-profile-of-skeletal-muscle-induced-by-experimental-autoimmune-myasthenia-gravis-in-rats
#12
Henry J Kaminski, Keiichi Himuro, Jumana Alshaikh, Bendi Gong, Georgiana Cheng, Linda L Kusner
The differential susceptibility of skeletal muscle by myasthenia gravis (MG) is not well understood. We utilized RNA expression profiling of extraocular muscle (EOM), diaphragm (DIA), and extensor digitorum (EDL) of rats with experimental autoimmune MG (EAMG) to evaluate the hypothesis that muscles respond differentially to injury produced by EAMG. EAMG was induced in female Lewis rats by immunization with acetylcholine receptor purified from the electric organ of the Torpedo. Six weeks later after rats had developed weakness and serum antibodies directed against the AChR, animals underwent euthanasia and RNA profiling performed on DIA, EDL, and EOM...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27850693/1055-titrating-nava-levels-affects-peak-pressure-and-electrical-activity-of-diaphragm-in-picu-patients
#13
Laura Nguyen, Erica Morgan, Rajat Kaul, Susan Tourner, Howard Stein
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27821162/physiological-effects-of-invasive-ventilation-with-neurally-adjusted-ventilatory-assist-nava-in-a-crossover-study
#14
Jean-Michel Liet, François Barrière, Bénédicte Gaillard-Le Roux, Pierre Bourgoin, Arnaud Legrand, Nicolas Joram
BACKGROUND: Neurally Adjusted Ventilatory Assist (NAVA) is a mode of assisted mechanical ventilation that delivers inspiratory pressure proportionally to the electrical activity of the diaphragm. To date, no pediatric study has focused on the effects of NAVA on hemodynamic parameters. This physiologic study with a randomized cross-over design compared hemodynamic parameters when NAVA or conventional ventilation (CV) was applied. METHODS: After a baseline period, infants received NAVA and CV in a randomized order during two consecutive 30-min periods...
November 8, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27799323/diaphragmatic-activity-during-weaning-from-respiratory-support-in-preterm-infants
#15
Juliette V Kraaijenga, Cornelia G de Waal, Gerard J Hutten, Frans H de Jongh, Anton H van Kaam
OBJECTIVE: To determine if weaning from nasal continuous positive airway pressure (nCPAP) to lesser supportive low flow nasal cannula (LFNC) results in a change in electrical activity of the diaphragm in preterm infants. DESIGN: Prospective observational study. SETTING: Neonatal intensive care unit. PATIENTS: Stable preterm infants weaned from nCPAP to LFNC (1 L/min). MAIN OUTCOME MEASURES: Change in diaphragmatic activity, expressed as amplitude, peak and tonic activity, measured by transcutaneous electromyography (dEMG) from 30 min before (baseline) until 180 min after weaning...
October 31, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27784315/intraoperative-hemidiaphragm-electrical-stimulation-reduces-oxidative-stress-and-upregulates-autophagy-in-surgery-patients-undergoing-mechanical-ventilation-exploratory-study
#16
Robert T Mankowski, Shakeel Ahmed, Thomas Beaver, Marvin Dirain, Chul Han, Phillip Hess, Tomas Martin, Barbara K Smith, Shinichi Someya, Christiaan Leeuwenburgh, A Daniel Martin
BACKGROUND: Mechanical ventilation (MV) during a cardio-thoracic surgery contributes to diaphragm muscle dysfunction that impairs weaning and can lead to the ventilator- induced diaphragm dysfunction. Especially, it is critical in older adults who have lower muscle reparative capacity following MV. Reports have shown that the intraoperative intermittent hemidiaphragm electrical stimulation can maintain and/or improve post-surgery diaphragm function. In particular, from a molecular point of view, intermittent ES may reduce oxidative stress and increase regulatory autophagy levels, and therefore improve diaphragm function in animal studies...
October 26, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27748627/partial-neuromuscular-blockade-during-partial-ventilatory-support-in-sedated-patients-with-high-tidal-volumes
#17
Jonne Doorduin, Joeke L Nollet, Lisanne H Roesthuis, Hieronymus W H van Hees, Laurent J Brochard, Christer A Sinderby, Johannes G van der Hoeven, Leo M A Heunks
RATIONALE: Controlled mechanical ventilation is used to deliver lung-protective ventilation in patients with acute respiratory distress syndrome. Despite recognized benefits, such as preserved diaphragm activity, partial support ventilation modes may be incompatible with lung-protective ventilation due to high tidal volume and high transpulmonary pressure. As an alternative to high dose sedatives and controlled mechanical ventilation, pharmacologically induced neuromechanical uncoupling of the diaphragm should facilitate lung-protective ventilation under partial support modes...
October 17, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27649505/new-setting-of-neurally-adjusted-ventilatory-assist-during-noninvasive-ventilation-through-a-helmet
#18
Gianmaria Cammarota, Federico Longhini, Raffaella Perucca, Chiara Ronco, Davide Colombo, Antonio Messina, Rosanna Vaschetto, Paolo Navalesi
BACKGROUND: Compared to pneumatically controlled pressure support (PSP), neurally adjusted ventilatory assist (NAVA) was proved to improve patient-ventilator interactions, while not affecting comfort, diaphragm electrical activity (EAdi), and arterial blood gases (ABGs). This study compares neurally controlled pressure support (PSN) with PSP and NAVA, delivered through two different helmets, in hypoxemic patients receiving noninvasive ventilation for prevention of extubation failure. METHODS: Fifteen patients underwent three (PSP, NAVA, and PSN) 30-min trials in random order with both helmets...
December 2016: Anesthesiology
https://www.readbyqxmd.com/read/27629375/comparing-changing-neurally-adjusted-ventilatory-assist-nava-levels-in-intubated-and-recently-extubated-neonates
#19
B LoVerde, K S Firestone, H M Stein
OBJECTIVE: Neurally adjusted ventilatory assist (NAVA) is a mode of mechanical ventilation that delivers ventilatory support in synchrony to the patient's respiratory needs using NAVA level, a proportionality constant that converts the electrical activity of the diaphragm (Edi) into a peak pressure (PIP). Recent published studies suggest that neonates can control the delivered ventilatory support through neural feedback. Systematically increasing the NAVA level initially increases the PIP while maintaining a constant Edi until an inflection point or breakpoint (BrP) is reached, at which time the PIP plateaus and the Edi signal decreases...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27405054/impact-of-feeding-method-on-diaphragm-electrical-activity-and-central-apnea-in-preterm-infants-feadi-study
#20
Eugene Ng, Patti Schurr, Maureen Reilly, Michael Dunn, Jennifer Beck
BACKGROUND: In preterm infants, it is unknown whether feeding affects neural breathing pattern. OBJECTIVES: By measuring the diaphragm electrical activity (Edi) waveform, we evaluated the effect of enteral feeding and compared the effects of feeding methods on neural breathing pattern and central apnea in very low birth weight preterm infants. METHODS: In a prospective, randomized, crossover study, ten non-ventilated preterm infants with birth weights<1250g and tolerating full feeds were randomized to either bolus feeding (BF) or slow infusion feeding (SF) over 90min, followed by crossover to the other method at the next feed...
October 2016: Early Human Development
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