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Diaphragm electrical activity during expiration in mechanically ventilated infants
Guillaume Emeriaud1, Jennifer Beck, Marisa Tucci
1Department of Pediatrics, Hôpital Sainte-Justine, Quebec, Canada, H3T 1C5.
Pediatric Research
|April 22, 2006
Summary
Diaphragm electrical activity (EAdi) persists during expiration in ventilated infants, impacting lung volume. Reducing positive end-expiratory pressure (PEEP) increases this expiratory EAdi, suggesting PEEP influences tonic diaphragm activity.
Area of Science:
- Pediatric critical care medicine
- Respiratory physiology
- Neonatology
Background:
- Diaphragm electrical activity (EAdi) during expiration is linked to maintaining end-expiratory lung volume (EELV).
- Expiratory EAdi has not been previously studied in intubated, mechanically ventilated infants.
Purpose of the Study:
- To quantify expiratory EAdi amplitude in mechanically ventilated infants.
- To assess the effect of removing positive end-expiratory pressure (PEEP) on expiratory EAdi.
Main Methods:
- Studied 16 intubated infants ready for weaning.
- Recorded EAdi using nasogastric tube sensors and airway pressure.
- Analyzed EAdi during neural expiration and during zero PEEP (ZEEP) trials in a subset of patients.
Main Results:
- Expiratory EAdi was present throughout expiration, with amplitudes decreasing across quartiles (Q1-Q4).
- EAdi in late expiration (Q3-Q4) significantly increased during ZEEP.
- This expiratory EAdi decreased upon PEEP reapplication.
Conclusions:
- Confirms partial diaphragm activity during expiration in ventilated infants.
- Demonstrates that PEEP removal impacts tonic expiratory diaphragm activity.
- Suggests implications for PEEP management in intubated infants.
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