Surface respiratory electromyography and dyspnea in acute heart failure patients

Luiso, Daniele; Villanueva, Jair A.; Belarte-Tornero, Laia Carla; Fort, Aleix; Blázquez-Bermejo, Zorba; Ruiz, Sonia; Farré, Ramón; Rigau, Jordi; Martí‐Almor, Julio; Farré, Núria

doi:10.1371/journal.pone.0232225

Cited by 10 publications

(6 citation statements)

References 35 publications

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“…Diaphragm and scalene EMG activity were found to be associated with increasing severity of dyspnoea in acute heart failure patients. 53 The authors of this study remarked that surface respiratory EMG could be a useful objective tool to improve assessment of dyspnoea in patients presenting with acute heart failure.…”

Section: Surface Respiratory Electromyography -A Non-invasive Measure...mentioning

confidence: 93%

Clinical Evaluation of Dyspnoea in Obstructive Lung Disease – Progressing from Psychometrics to Physiology

Ong

2024

MRAJ

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Dyspnoea is a common symptom that afflicts persons with myriad medical conditions. Among sufferers of lung disorders such as chronic obstructive pulmonary disease, dyspnoea, together with effort intolerance, are the major complaints. Dyspnoea is a marker of disease severity and adverse prognosis of chronic obstructive pulmonary disease, and the need for symptom alleviation in improving health status is ever-present, but the quantification of this symptom is challenging in clinical practice, and is mostly limited to the use of questionnaires and self-reports currently. Numerous psychometric tools have been developed to measure the severity of dyspnoea clinically, but their utility is vitiated by the complexity and multidimensional nature of the symptom. The lack of a universally accepted and accurate measurement tool is likely to hinder future progress in developing novel treatments for relieving dyspnoea. Physiological measurements have been used to complement or supplant psychometric evaluation of dyspnoea but simple stationary lung function tests do not correlate sufficiently well with dyspnoea severity in patients with chronic obstructive pulmonary disease, while complex exercise testing is impractical or limited to specialized research labs. In recent years, the use of non-invasive surface electromyography of the diaphragm and/or accessory muscles of respiration is gaining attention as a promising physiological assessment of dyspnoea with potential for widespread clinical applications. Although substantial technological gaps still exist between bench and bedside, the current interest, as evidenced by the number of med-tech collaborations in surface respiratory electromyography, appears to be well justified. This review aims to summarize the past and present methodologies as well as future developments in evaluating and quantifying dyspnoea, especially in patients with chronic obstructive pulmonary disease.

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Section: Surface Respiratory Electromyography -A Non-invasive Measure...mentioning

confidence: 93%

Clinical Evaluation of Dyspnoea in Obstructive Lung Disease – Progressing from Psychometrics to Physiology

Ong

2024

MRAJ

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“…Therefore, assessing for dyspnea after extubation could help predict the risk of extubation failure. The intensity of dyspnea is strongly correlated with the activity of extradiaphragmatic inspiratory muscles such as parasternal intercostal and scalene [6][7][8]. These muscles are commonly activated together with the diaphragm in acute respiratory failure and weaning failure [9,10].…”

Section: Introductionmentioning

confidence: 99%

Dyspnoea and respiratory muscle ultrasound to predict extubation failure

et al. 2021

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This study investigated dyspnea intensity and respiratory muscles ultrasound early after extubation to predict extubation failure.It was conducted prospectively in two intensive care units in France and Canada. Patients intubated for at least 48 h were studied within 2 h after an extubation following a successful spontaneous breathing trial. Dyspnea was evaluated by the Dyspnea-Visual Analog Scale from 0 to 10 cm (VAS) and the Intensive Care - Respiratory Distress Observational Scale (range 0–10). The ultrasound thickening fraction of the parasternal intercostal and the diaphragm were measured; limb muscle strength was evaluated using the Medical Research Council score (MRC) (range 0–60).Extubation failure occurred in 21 of the 122 enrolled patients (17%). Dyspnea-VAS and Intensive Care - Respiratory Distress Observational scale were higher in patients with extubation failure versus success: 7 (5–9) cm versus 3 (1–5) cm respectively (p<0.001) and 4.4 (2.5–6.5) versus 2.4 (2.1–2.8) respectively (p<0.001). The ratio of intercostal muscle to diaphragm thickening fraction was significantly higher and MRC was lower in patients with failure (0.9 [0.4–3.0] versus 0.3 [0.2–0.5], p<0.001, and 45 [36–50] versus 52 [44–60], p=0.012). The thickening fraction of the intercostal and its ratio to diaphragm thickening showed the highest area under the receiver operating characteristic curves for an early prediction of extubation failure (0.81). Areas under the receiver operating characteristic curves of Dyspnea-VAS and Intensive Care - Respiratory Distress Observational scale reached 0.78 and 0.74 respectively.Respiratory muscle ultrasound and dyspnea measured within 2 h after extubation predict subsequent extubation failure.

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“…There are also numerous studies conducted on healthy volunteers that measure the different effects of breathing exercises versus changes in the exhaled air [7,8]. Numerous published papers on sEMG include volunteers with acute cases [9].…”

Section: Introductionmentioning

confidence: 99%

Changes in power of surface electromyogram during breath-holding

et al. 2020

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Introduction/Objective. Numerous studies on surface electromyographic (sEMG) signals in response to different respiratory parameters, particularly on sternocleidomastoid (SCM) muscles and diaphragm (DIA), indicated the promising advantages of their simultaneous monitoring with possible applications in the analysis of their correlation. This motivated ? detailed statistical analysis of the average power (PAV) on sEMG signals during prolonged breath-holding, simultaneously measured in the SCM and DIA areas. Methods. The physiological breath-holding method was applied to 30 healthy volunteers, with sEMG of SCM and DIA regions measured before, during, and after the breath-holding exercise. All the subjects were sitting in an upward position, with nostrils closed by the right index finger and thumb during breath-hold. To synchronize the records, the user would press a special switch using the other hand at the beginning and at the end of breath-holding experiment. The average power of sEMG (PAV) was measured for each 500 ms signal window. Results. The PAV remains constant before and 3 seconds after the exercise. During the ending of breathholding, at least one region had the PAV afflux of a minimum of 91%. Student?s t-test between SCM signals shows a significant difference of p < 0.001, while the DIA lacks it. Although the results showed that SCM is the dominant region in 76.67% of cases, the exclusive PAV afflux in the DIA region was detected in precisely five cases (16.67% of the total namber of participants). Conclusions. Our research concludes that there is the necessity of simultaneous measurement of SCM and DIA to observe dominant changes in sEMG during breath-holding. The physiological response of the respiratory center can be observed by approximately doubling PAV in one of SCM or DIA regions.

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Surface respiratory electromyography and dyspnea in acute heart failure patients

Abstract: Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here:

Cited by 10 publications

References 35 publications

Clinical Evaluation of Dyspnoea in Obstructive Lung Disease – Progressing from Psychometrics to Physiology

Clinical Evaluation of Dyspnoea in Obstructive Lung Disease – Progressing from Psychometrics to Physiology

Dyspnoea and respiratory muscle ultrasound to predict extubation failure

Changes in power of surface electromyogram during breath-holding

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