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Diaphragm electromyographic activity as a predictor of weaning failure

Diaphragm electromyographic activity as a predictor of weaning failure

Intensive Care Medicine journal: December Article Picks 

The article Diaphragm electromyographic activity as a predictor of weaning failurehas been selected by the Chair of the Editorial and Publications Committee, and Editor of Intensive Care Medicine journal as one of the "Articles of the Month" for December 2012.

The corresponding author of the article, Alexandre Demoule submitted the following Clinical Implications of the prospective observational study that included 57 ready-to-wean patients:

Driving mechanical ventilation from the electromyographic activity of the diaphragm (EAdi) requires the placement of an esophageal probe equipped with multiple recording electodes (neurally adjusted ventilatory assist, NAVA). This opens unique opportunities to study the activity of the diaphragm beyond ventilatory assistance, e.g. during weaning. Here we show that several EAdi-derived indices recorded during spontaneous breathing trials provide reliable early predictors of weaning outcome. Although EAdi variables did not outperform the well-established rapid shallow breathing index (RR/VT), this study is among the very first to provide a direct description of diaphragmatic neuromechanical coupling during weaning from mechanical ventilation. 

PHOTO: Martin Dres, first author of the article

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