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Evaluation of Indirect Measures of Neural Inspiratory Time from Invasive and Noninvasive Recordings of Respiratory Activity

文献类型： 会议论文

第一作者： Daniel Garcia-Castellote

作者： Daniel Garcia-Castellote 1 ; Abel Torres 2 ; Luis Estrada 2 ; Leonardo Sarlabous 2 ; Raimon Jane 2 ;

作者机构： 1.Universitat Politecnica de Catalunya (UPC)

2.Institut de Bioenginyeria de Catalunya (IBEC) and the Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN)

会议名称： Annual International Conference of the IEEE Engineering in Medicine and Biology Society

主办单位：

页码： 341-344

摘要： Measuring diaphragmatic electromyography (EMGdi) provides an indirect quantification of neural respiratory drive and allows the delimitation of diaphragm neural activation and deactivation during inspiration. EMGdi recordings have been incorporated in novel modes of assisted mechanical ventilation, such as neurally adjusted ventilatory assist (NAVA), to trigger and cycle-off the ventilator. The EMGdi signal improves the assistance delivered by more conventional ventilatory modes, in which the ventilator is synchronized with the patient employing a pneumatic triggering. In this work, we evaluate the time delay between the onset and offset of inspiratory activity estimated from EMGdi and three respiratory mechanical signals: the respiratory flow (FL), the transdiaphragmatic pressure (Pdi) and the diaphragm length (Ldi) signals. To this purpose, these signals were acquired in three mongrel dogs surgically instrumented under general anesthesia. Onsets and offsets were estimated manually and by automatic algorithms on these signals. The highest delays were obtained between EMGdi and FL (100 ms) while the lowest delays were obtained between EMGdi and Pdi (8 ms). Moreover, differences between manual and automatic estimations showed a mean absolute error lower than 45 ms. In conclusion, our study points out that both EMGdi and Pdi signals detect the onset and offset of inspiratory activity earlier than the FL signal, and would therefore be better for the improvement of patient-ventilator synchrony.

分类号： Q81-53

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