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Jonkman AH, Warnaar RSP, Baccinelli W, Carbon NM, D'Cruz RF, Doorduin J, van Doorn JLM, Elshof J, Estrada-Petrocelli L, Graßhoff J, Heunks LMA, Koopman AA, Langer D, Moore CM, Nunez Silveira JM, Petersen E, Poddighe D, Ramsay M, Rodrigues A, Roesthuis LH, Rossel A, Torres A, Duiverman ML, Oppersma E. Analysis and applications of respiratory surface EMG: report of a round table meeting. Crit Care 2024; 28:2. [PMID: 38166968 PMCID: PMC10759550 DOI: 10.1186/s13054-023-04779-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
Surface electromyography (sEMG) can be used to measure the electrical activity of the respiratory muscles. The possible applications of sEMG span from patients suffering from acute respiratory failure to patients receiving chronic home mechanical ventilation, to evaluate muscle function, titrate ventilatory support and guide treatment. However, sEMG is mainly used as a monitoring tool for research and its use in clinical practice is still limited-in part due to a lack of standardization and transparent reporting. During this round table meeting, recommendations on data acquisition, processing, interpretation, and potential clinical applications of respiratory sEMG were discussed. This paper informs the clinical researcher interested in respiratory muscle monitoring about the current state of the art on sEMG, knowledge gaps and potential future applications for patients with respiratory failure.
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Affiliation(s)
- A H Jonkman
- Department of Intensive Care Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R S P Warnaar
- Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - W Baccinelli
- Netherlands eScience Center, Amsterdam, The Netherlands
| | - N M Carbon
- Department of Anesthesiology, Friedrich Alexander-Universität Erlangen-Nürnberg, Uniklinikum Erlangen, Erlangen, Germany
| | - R F D'Cruz
- Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J Doorduin
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J L M van Doorn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Elshof
- Department of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - L Estrada-Petrocelli
- Facultad de Ingeniería and Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) - Sistema Nacional de Investigación (SNI), Universidad Latina de Panamá (ULATINA), Panama, Panama
| | - J Graßhoff
- Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering, Lübeck, Germany
| | - L M A Heunks
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A A Koopman
- Division of Paediatric Critical Care Medicine, Department of Paediatrics, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - D Langer
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
| | - C M Moore
- Netherlands eScience Center, Amsterdam, The Netherlands
| | - J M Nunez Silveira
- Hospital Italiano de Buenos Aires, Unidad de Terapia Intensiva, Ciudad de Buenos Aires, Argentina
| | - E Petersen
- Technical University of Denmark (DTU), DTU Compute, 2800, Kgs. Lyngby, Denmark
| | - D Poddighe
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
| | - M Ramsay
- Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Rodrigues
- Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - L H Roesthuis
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Rossel
- Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - A Torres
- Institut de Bioenginyeria de Catalunya (IBEC), Barcelona Institute of Science and Technology (BIST) and Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Politècnica de Catalunya BarcelonaTech (UPC), Barcelona, Spain
| | - M L Duiverman
- Department of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - E Oppersma
- Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, Enschede, The Netherlands.
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Kramer JJ, Boon HTM, Leijten QH, Ter Laak H, Eshuis L, Kusters B, van Doorn JLM, Kamsteeg EJ, Eymard B, Doorduin J, Voermans NC. Dystrophic Myopathy of the Diaphragm with Recurrent Severe Respiratory Failure is Congenital Myasthenic Syndrome 11. J Neuromuscul Dis 2023; 10:271-277. [PMID: 36591657 PMCID: PMC10041432 DOI: 10.3233/jnd-221542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We here present the case of a patient with a congenital myasthenic syndrome (CMS) due to pathogenic variants in the RAPSN gene. During childhood he experienced recurrent episodes of respiratory failure during respiratory infections. This and other cases were reported as isolated dystrophy of the diaphragmatic musculature. In adulthood, whole exome sequencing revealed two heterozygous pathogenic variants in the RAPSN gene. This led to the revision of the diagnosis to rapsyn CMS11 (OMIM:616326, MONDO:0014588). EMG, muscle ultrasound and the revision of muscle biopsies taken in childhood support this diagnosis. After the revision of the diagnosis, treatment with pyridostigmine was started. This resulted in a reduction of fatigability and an improvement in functional abilities and quality of life.
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Affiliation(s)
- J J Kramer
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - H T M Boon
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Henk Ter Laak
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - L Eshuis
- Department of Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - B Kusters
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - J L M van Doorn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - E J Kamsteeg
- Department of Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - B Eymard
- Institute de Myologie, Paris, France
| | - J Doorduin
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - N C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
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Lagarde MLJ, van Doorn JLM, Weijers G, Erasmus CE, van Alfen N, van den Engel-Hoek L. Tongue movements and teat compression during bottle feeding: A pilot study of a quantitative ultrasound approach. Early Hum Dev 2021; 159:105399. [PMID: 34126586 DOI: 10.1016/j.earlhumdev.2021.105399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022]
Abstract
Nutritive sucking is a complex process, essential to proper growth and development. The complexity of this oral sensorimotor activity includes movements of the tongue and jaw. Tongue movements during nutritive sucking can only be visualized with instrumented methods such as ultrasound. Until now, studies using ultrasound during nutritive sucking performed measurements on each individual ultrasound image frame, which was quite time-consuming. The aim of this pilot study was to automatically process ultrasound video recordings in healthy infants during bottle feeding to measure teat compression and tongue movements. Tongue movements and teat compression during bottle feeding were visualized and recorded using 2D dynamic ultrasound imaging. A custom-made semi-automated analysis-routine was developed. Teat compression was expressed as the median difference in teat diameter during the recording. Tongue movements were expressed as the displacement of the tongue along four evenly distributed image lines and the corresponding time-shifts between those lines. The recordings of 12 out of 14 participants were adequate for the analysis of tongue movements. Teat compression could be analysed in the recordings of 6 participants. The reliability of our analysis-routine was considered to be good, and the analysis-routine was more time-efficient than manual frame-by-frame analysis. This quantitative analysis-routine is a promising tool, that can be used efficiently and accurately in the future to collect normative data that can serve as reference values to distinguish normal from abnormal tongue movements in infants with feeding difficulties.
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Affiliation(s)
- M L J Lagarde
- Radboud university medical center, Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands.
| | - J L M van Doorn
- Radboud university medical center, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - G Weijers
- Radboud university medical center, Medical Ultrasound Imaging Center (MUSIC), Department of Radiology and Nuclear Medicine, Nijmegen, the Netherlands
| | - C E Erasmus
- Radboud university medical center, Department of Pediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - N van Alfen
- Radboud university medical center, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - L van den Engel-Hoek
- Radboud university medical center, Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
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