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Relative impact of respiratory muscle activity on tidal flow and end expiratory volume in healthy neonates

Gerard J Hutten1, Leo A van Eykern, Philipp Latzin

  • 1Division of Paediatric Respiratory Medicine, Department of Pediatrics, University of Bern, Bern, Switzerland.

Pediatric Pulmonology
|August 1, 2008
PubMed

Insights

Neonatal respiratory muscles dynamically regulate breathing. This study shows transcutaneous electromyography (rEMG) of respiratory muscles is feasible and repeatable for assessing infant breathing patterns.

Area of Science:

  • Neonatal physiology
  • Respiratory mechanics
  • Bioengineering

Background:

  • Infants dynamically regulate tidal flow and end-expiratory volume.
  • The interplay between respiratory muscle activity, airflow, and lung volume in sleeping neonates is not well understood.
  • Assessing this requires matching transcutaneous electromyography of respiratory muscles (rEMG) with lung function measurements.

Purpose of the Study:

  • To determine the feasibility and repeatability of rEMG in healthy, spontaneously sleeping neonates.
  • To measure the relative impact of intercostal and diaphragmatic rEMG activity on tidal flow and functional residual capacity (FRC).

Main Methods:

  • Feasibility and repeatability of rEMG were assessed in 20 spontaneously sleeping healthy neonates.
  • Intercostal and diaphragmatic rEMG activity were measured concurrently with airflow and FRC.
  • The impact of a face mask's resistive load on rEMG amplitude was evaluated.

Main Results:

  • rEMG measurements demonstrated good feasibility, repeatability, and correlation with airflow timing.
  • Diaphragmatic and intercostal muscle activity preceded airflow onset and continued through expiration.
  • The dynamic and variable contribution of intercostal and diaphragmatic muscles to airflow was observed.
  • rEMG amplitude was significantly influenced by the face mask's resistive load.

Conclusions:

  • This study established the feasibility and repeatability of non-invasive rEMG for intercostal and diaphragm muscles in sleeping neonates.
  • It provides the first quantitative data on the temporal relationship between muscle activity and airflow in this population.
  • Findings indicate that lung mechanical function is dynamically regulated on a breath-by-breath basis.
  • Non-invasive rEMG, alone or with lung function tests, can offer a comprehensive view of pulmonary mechanics and inform future respiratory support strategies.
Abstract

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