- Author
-
C.G. de Waal
- Title
- Transcutaneous electromyography of the diaphragm
- Subtitle
- Monitoring breathing and the effect of respiratory support in preterm infants
- Supervisors
-
A.H.L.C. van Kaam
- Co-supervisors
-
F.H.C. de Jongh
G.J. Hutten - Award date
- 12 October 2018
- Number of pages
- 197
- ISBN
- 9789463750929
- Document type
- PhD thesis
- Faculty
- Faculty of Medicine (AMC-UvA)
- Abstract
-
This thesis focusses on the respiratory condition of preterm infants. Due to the immaturity of the respiratory system, preterm infants are prone for respiratory failure and they often need respiratory support. Accurate monitoring of breathing and monitoring of the effect of respiratory support is warranted to obtain objective information about the respiratory condition of each individual preterm infant.
Transcutaneous electromyography of the diaphragm (dEMG) is a non-invasive bedside tool to monitor the function of the diaphragm, the main respiratory muscle, and provides information on neural breathing effort.
The aim of this thesis was to investigate the possible use of transcutaneous dEMG in clinical care for preterm infants suffering from common respiratory diagnoses. It is shown that transcutaneous dEMG can be used to monitor breathing patterns and can improve the classification of apnea of prematurity. Furthermore, it can provide information on the working mechanism of pharmacological treatments for common respiratory diagnoses and it gives insight in the effect of weaning from respiratory support as well as the level of support given by different modes of non-invasive respiratory support. In addition, the interaction between spontaneous breathing and ventilator inflations is described and transcutaneous dEMG might be used for synchronisation of ventilator inflations with spontaneous breathing in future.
Based on the results presented in this thesis, transcutaneous dEMG seems to be a promising technique to improve and individualize respiratory treatment of preterm infants. - Persistent Identifier
- https://hdl.handle.net/11245.1/502462bd-83a4-4d1d-a53c-2db570d159c4
- Downloads
-
Thesis (complete)
Front matter
Chapter 1: General introduction and outline of the thesis
Chapter 2: Classifying apnea of prematurity by transcutaneous electromyography of the diaphragm
Chapter 3: The effect of minimally invasive surfactant therapy on diaphragmatic activity
Chapter 4: Doxapram treatment and diaphragmatic activity in preterm infants
Chapter 5: Diaphragmatic activity during weaning from respiratory support in preterm infants
Chapter 6: Electrical activity of the diaphragm during nCPAP and high flow nasal cannula
Chapter 7: Patient-ventilator asynchrony in preterm infants on nasal intermittent positive pressure ventilation
Chapter 8: Breath detection by transcutaneous electromyography of the diaphragm and the Graseby capsule in preterm infants
Chapter 9: General discussion and conclusion
Chapter 10: Future perspectives
Chapter 11: Summary
Chapter 12: Nederlandse samenvatting
Chapter 13: List of abbreviations; Authors and affiliations; PhD portfolio; Curriculum vitae; Dankwoord
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