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Comparative Study
. 2020 Nov-Dec;26(6):378-385.
doi: 10.1016/j.pulmoe.2020.02.008. Epub 2020 Apr 2.

The validity of surface EMG of extra-diaphragmatic muscles in assessing respiratory responses during mechanical ventilation: A systematic review

H Y AbuNurah  1 , D W Russell  2 , J D Lowman  3
Affiliations
Comparative Study

The validity of surface EMG of extra-diaphragmatic muscles in assessing respiratory responses during mechanical ventilation: A systematic review

H Y AbuNurah et al. Pulmonology. 2020 Nov-Dec.

Abstract

Purpose: Evidence supporting the utilization of surface EMG (sEMG) of extra-diaphragmatic muscles for monitoring of mechanical ventilation (MV) assistance is unclear. The purpose of this review was to assess the quality of literature available on using extra-diaphragmatic sEMG as an assessment technique of respiratory responses during MV.

Methods: Studies using sEMG of extra-diaphragmatic respiratory muscles during MV were selected by two independent researchers after performing a database search of PubMed, CINAHL, GOOGLE SCHOLAR. Exclusion criteria were studies of patients with neuromuscular disorders, receiving neuromuscular blocking agents, receiving non-invasive MV, using needle EMG, and studies written in languages other than English. Quality of identified studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). This study is registered with PROSPERO, number (CRD42018081341).

Results: 596 references were identified. Of the identified studies, 7 studies were included in the review. Findings demonstrate that sEMG of extra-diaphragmatic muscle activity is a valid and applicable tool to evaluate mechanical loading/unloading of respiratory muscles and respiratory drive or sensation. However, the quality of literature supporting sEMG as monitoring tool of respiratory responses were characterized by a high and unclear risk of bias.

Conclusions: Although it appears to be a valid and applicable tool, there is a scarcity of literature that directly demonstrates the diagnostic accuracy of sEMG of extra-diaphragmatic muscles in monitoring respiratory mechanics and respiratory drive or sensation during MV assistance across wide populations and conditions.

Keywords: diaphragm; extra-diaphragmatic muscles; mechanical ventilation; respiratory mechanics; respiratory muscles; surface electromyography.

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Conflict of interest statement

Conflicts of interest

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
PRISMA Flow Diagram of the Selection Process and The Study Search Results.
Figure 2
Figure 2
Quality Assessment of Risk of Bias & Applicability Concerns.
See this image and copyright information in PMC

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