To determine a reliable quantitative method of measuring diaphragmatic EMG (EMGdi), electrical activity of the diaphragm was obtained via an esophageal electrode during CO2 rebreathing in 6 normal males and processed three different ways: 1) integration (area), 2) as a moving time average, and 3) as a moving time variance. Integrated activity was quantified in terms of total activity and inspiratory activity. In addition, average total activity and average inspiratory activity were calculated. Moving average and moving variance were analyzed in terms of rate of rise (slope) and peak activities. All integration parameters, except average inspiratory activity, were poorly correlated to changes in PCO2, minute ventilation, and inspiratory muscle force, during rebreathing. Moving average and variance responses to rebreathing were linear with high correlation coefficients, with the slope measures showing the overall best correlations. There was no significant difference between average and variance EMGdi parameters in their responses to rebreathing. Time-related quantification of EMGdi, including average inspiratory activity, and particularly moving average and moving variance, appear to be reliable methods for quantitating neural drive to the respiratory muscles during CO2 rebreathing.

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We determined the relationship between mouth occlusion pressure and diaphragmatic electromyography during CO2 rebreathing with and without inspiratory flow resistance. Diaphragmatic electromyography was measured as a moving time average; occlusion pressures were measured 150 msec after onset of an inspiratory effort against a closed airway (P.15). P.15 versus diaphragmatic electromyographic plots during CO2 rebreathing with and without inspiratory flow resistance were linear. In 3 subjects the slope of P.15 versus diaphragmatic electromyography was unchanged with inspiratory flow resistance whereas in 3 others the slope increased, indicating greater inspiratory force for a given degree of diaphragmatic activity. We concluded that under unloaded conditions P.15 is a reliable index of respiratory neural output but may no longer reflect only inspiratory motoneuron drive during mechanical loading.

The effects of electrode position and gastric-balloon anchoring on esophageal diaphragmatic EMG (EMGdi) responses to CO2 rebreathing were studied in seven normal sitting humans using an esophageal catheter that consisted of four platinum wire coils enabling simultaneous recording of three EMGdi signals from three different sites in the esophagus. A gastric balloon attached to the distal end of the catheter allowed anchoring of the catheter. EMGdi signals were quantitated as a moving time average. Two rebreathing experiments were performed with and without balloon anchoring on the same day. Changes in electrode position of at least 2 cm above the site of maximum EMGdi activity caused minimal changes in the moving average EMGdi and did not significantly effect the quantitated EMGdi response to CO2 rebreathing. The maximum EMGdi activity was approximately 2 cm above the gastroesophageal junction in sitting humans. Stabilization of the catheter with an inflated gastric balloon did not improve the reproducibility of the EMGdi data. Finally, the EMGdi response to two CO2 rebreathing runs done at the same sitting showed intraindividual reproducibility.

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