Related Experiment Video
Updated: Mar 22, 2026
Acquisition and Semi-Automated Analysis of Respiratory Muscle Surface Electromyography
Published on: January 24, 2025
Parasternal intercostal electromyography: a novel tool to assess respiratory load in children
Victoria MacBean1, Caroline J Jolley1, Timothy G Sutton1
1Department of Respiratory Medicine, Division of Asthma Allergy and Lung Biology, King's College London, London, UK.
Insights
Parasternal intercostal muscle electromyography (EMGpara) is a feasible tool for assessing respiratory load in children. This novel method accurately reflects respiratory effort in healthy, wheezy, and critically ill pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Biomedical Engineering
Background:
- Assessing respiratory load in children, especially those unable to cooperate, presents significant challenges.
- Parasternal intercostal muscle electromyography (EMGpara) has emerged as a promising non-volitional technique for evaluating respiratory effort.
- This study investigates the utility of EMGpara across diverse pediatric populations.
Purpose of the Study:
- To evaluate the feasibility and application of EMGpara in healthy, wheezy, and critically ill children.
- To establish normative data and predictive equations for EMGpara in healthy children.
- To assess the responsiveness of EMGpara to clinical interventions and its correlation with respiratory load.
Main Methods:
- Surface EMGpara was recorded during tidal breathing in 92 healthy children, 20 wheezy preschool children (pre- and post-bronchodilator), and 25 mechanically ventilated children.
- Age-based equations were developed to predict EMGpara in healthy children, with patient data expressed as z-scores.
- Comparisons were made between groups and conditions to assess differences in EMGpara.
Main Results:
- EMGpara showed significant correlations with age, height, and weight in healthy children, leading to a predictive equation.
- Wheezy children exhibited higher EMGpara than healthy controls pre-bronchodilator, with levels normalizing post-treatment.
- Critically ill children demonstrated significantly elevated EMGpara during mechanical ventilation and CPAP compared to healthy controls.
Conclusions:
- EMGpara is a feasible and reliable method for assessing respiratory status in pediatric patients, including infants.
- Elevated EMGpara levels correlate with increased respiratory load in diseased states.
- EMGpara is responsive to therapeutic interventions, offering a valuable tool for managing respiratory conditions in challenging pediatric populations.
Background:
Parasternal intercostal muscle electromyography (EMGpara) represents a novel tool to assess respiratory load when volitional techniques are not possible. This study examined the application of EMGpara in healthy, wheezy, and critically ill children.
Methods:
Surface EMGpara was measured during tidal breathing in 92 healthy children, 20 wheezy preschool children (with measurements repeated following bronchodilator), and 25 mechanically ventilated children during supported ventilation and on continuous positive airways pressure.
Results:
EMGpara was related to age, height, and weight in the healthy group (r = -0.623, -0.625, -0.641 respectively, all P < 0.0001). An age-based equation for predicted EMGpara was developed and patient data expressed as z-scores. EMGpara was higher in wheezy children prebronchodilator than healthy controls (median interquartile range (IQR) z-score 0.53 (0.07-1.94), P = 0.0073), falling to levels not different to healthy children postbronchodilator (-0.08 (-0.50-1.00)). In the critically ill children, EMGpara was higher (P < 0.0001) than in healthy subjects during both mechanical ventilation (median (IQR) z-score 1.14 (0.33-1.93)) and continuous positive airways pressure (1.88 (0.91-3.03)).
Conclusion:
EMGpara is feasible in children and infants both healthy and diseased, is raised in those with elevated respiratory load, and is responsive to clinical interventions. EMGpara represents a potential method to assess respiratory status in patients conventionally challenging to assess.
More Related Videos
09:37Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment RMCA in Individuals with Chronic Spinal Cord Injury
Published on: July 19, 2013
05:56Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit
Published on: September 6, 2024
Related Concept Videos
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:24Physical Assessment of the Respiratory Tract II: Palpation
Thoracic Palpation
Thoracic palpation detects tenderness, masses, lesions, respiratory excursions, and vocal fremitus. The nurse assesses...
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
01:29Physical Assessment of the Respiratory Tract III: Percussion
Percussion in Respiratory Assessment
Percussion evaluates underlying tissue composition with audible and tactile vibrations,...
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration...