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Assessment of respiratory drive with esophageal diaphragmatic electromyography in patients with acute respiratory distress syndrome treated with prone position ventilation

  
@article{JTD32528,
	author = {Qing-Wen Sun and Xiao-Cong Li and Zhi-Min Lin and Wen Jiang and Yuan-Ming Luo and Wen-Zheng Huang and Tai-Min Guo and Yuan-Da Xu and Nan-Shan Zhong},
	title = {Assessment of respiratory drive with esophageal diaphragmatic electromyography in patients with acute respiratory distress syndrome treated with prone position ventilation},
	journal = {Journal of Thoracic Disease},
	volume = {11},
	number = {10},
	year = {2019},
	keywords = {},
	abstract = {Background: Prone position ventilation (PPV) is an important strategy for patients with severe acute respiratory distress syndrome (ARDS). This prospective study investigated the use of electromyography of the diaphragm (EMGdi) for monitoring respiratory drive in patients with moderate to severe ARDS during long-term PPV 
Methods: An integrated nostril-gastric feeding tube containing an esophageal electrode and balloon was placed in 14 patients with severe ARDS prior to PPV. EMGdi and trans-pulmonary pressure (∆PL) data were collected before PPV (baseline), every 2 h during PPV, and 2 h after the restoration of supine position ventilation (post-2 h SPV).
Results: In ARDS patients, the static compliance of the chest wall was significantly decreased after PPV. EMGdi levels were slightly lower in the early, middle, and late stages of PPV compared with baseline. Patients who received neuromuscular blocker experienced a greater drop in EMGdi from baseline than those who did not.
Conclusions: For ARDS patients, EMGdi was slightly decreased after prolonged PPV. This is contrary to the change in diaphragm electromyography during normal body position changes. Monitoring EMGdi regularly during PPV in ARDS patients is feasible and can be used as a reference for lung protective ventilation strategies.},
	issn = {2077-6624},	url = {https://jtd.amegroups.org/article/view/32528}
}