The validity of surface EMG of extra-diaphragmatic muscles in assessing respiratory responses during mechanical ventilation: A systematic review.
The validity of surface EMG of extra-diaphragmatic muscles in assessing respiratory responses during mechanical ventilation: A systematic review.
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DOI：
10.1016/j.pulmoe.2020.02.008
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发表时间：
2020-11
期刊：
影响因子：
11.7
通讯作者：
Lowman JD
中科院分区：
文献类型：
--
作者：
AbuNurah HY;Russell DW;Lowman JD
支持利用颅外肌表面EMG（sEMG）监测机械通气（MV）辅助的证据尚不清楚。本综述的目的是评估使用脑外表面肌电图作为MV期间呼吸反应评估技术的文献质量。在PubMed、CINAHL、GOOGLE SCHOLAR进行数据库检索后，由两名独立研究人员选择了在MV期间使用脑外呼吸肌sEMG的研究。排除标准是神经肌肉疾病患者的研究，接受神经肌肉阻滞剂，接受非侵入性MV，使用针EMG，以及用英语以外的语言撰写的研究。采用诊断准确性研究质量评估（QUADAS-2）评估已识别研究的质量。本研究在PROSPERO注册，编号（CRD 42018081341）。已识别596篇参考文献。在确定的研究中，7项研究被纳入综述。研究结果表明，隔外肌活动的sEMG是评估呼吸肌机械负荷/卸载以及呼吸驱动或感觉的有效且适用的工具。然而，支持sEMG作为呼吸反应监测工具的文献质量的特点是偏倚风险高且不明确。虽然它似乎是一种有效和适用的工具，但缺乏文献直接证明在广泛人群和条件下，在MV辅助期间监测呼吸力学和呼吸驱动或感觉时肌外肌sEMG的诊断准确性。
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. 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). 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. 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.
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