Analyse the Correlation Between sEMG and EMGdi

NCT03268616 | Completed

• 1 other identifier: 487201278
• Study Type: interventional
• Target: 20
• Locations: 0 countries
• Sites: N/A

Brief Summary

The most significant pathophysiology change of COPD patients is persistent incompletely reversible airflow obstruction and increased lung volume. As a result, the work of breathing(WB) and neural respiratory drive (NRD)increased. Noninvasive positive pressure ventilation (NPPV) can reduce the load of respiratory muscles. Detection of NRD can be the index of monitoring for titration of optimal level of ventilator support in the future. As electromyography(EMG) is the most reliable measurement in evaluating NRD that can be used for human. Currently the standard method for evaluation of NRD with EMG is using esophageal multi-paired electrodes catheter(EMGdi) ,it is reliable but invasive .Surface respiratory EMG (sEMG）is a noninvasive measurement. Although it subjected to contamination and less sensitive, recently, advance in technology with multiple pair of surface electrodes is possible to sufficient signals for evaluation of NRD.So the investigator compare the NRD measured by EMGdi and sEMG,and consider that the correlation between them is well in different levels.

Conditions

COPD

Keywords

neural respiratory drive; noninvasive positive pressure ventilation; electromyography

Outcome Measures

Primary Outcomes (1)

• correlation between sEMG and EMGdi

  the correlation between sEMG and EMGdi at different level of respiratory central drive was analyzed with Pearson correlation analysis

  through study completion, an average of 5 hours

Study Arms (2)

Healthy Subjects

EXPERIMENTAL

increase the inspiratory threshold load step by step(30%-80%MIP),in order to increase neural respiratory drive.

Device: inspiratory threshold load device and NPPV

Sever COPD Patients

EXPERIMENTAL

increase the pressure support ventilation step by step, in order to decrease neural respiratory drive.

Device: inspiratory threshold load device and NPPV

Interventions

inspiratory threshold load device and NPPV DEVICE

before experiment ,every subject use a flanged mouthpiece attached to a manually operated occlusion valve in order to measure maximal inspiratory pressure (MIP)at functional residual capacity . healthy subjects:increase the pressure in a water-sealed inspiratory threshold loading device in order to increase the neural respiratory drive. COPD patients:increase the pressure in a non-invasive positive pressure ventilation in order to decrease the neural respiratory drive

Healthy Subjects; Sever COPD Patients

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• normal cardio-pulmonary function
• without low inspiratory muscle strength
• non-smoker
• without history of the nervous system and respiratory system disease
• sever to very severe stable stage

You may not qualify if:

• systemic application of corticosteroids nearly 4 weeks

Sponsors & Collaborators

• The First Affiliated Hospital of Guangzhou Medical University: lead

Related Publications (25)

• Whitelaw WA, Derenne JP. Airway occlusion pressure. J Appl Physiol (1985). 1993 Apr;74(4):1475-83. doi: 10.1152/jappl.1993.74.4.1475.

  PMID: 8514660 BACKGROUND

• Luo YM, Moxham J, Polkey MI. Diaphragm electromyography using an oesophageal catheter: current concepts. Clin Sci (Lond). 2008 Oct;115(8):233-44. doi: 10.1042/CS20070348.

  PMID: 18782085 BACKGROUND

• Reilly CC, Ward K, Jolley CJ, Lunt AC, Steier J, Elston C, Polkey MI, Rafferty GF, Moxham J. Neural respiratory drive, pulmonary mechanics and breathlessness in patients with cystic fibrosis. Thorax. 2011 Mar;66(3):240-6. doi: 10.1136/thx.2010.142646. Epub 2011 Feb 1.

  PMID: 21285244 BACKGROUND

• Laghi F, Shaikh HS, Morales D, Sinderby C, Jubran A, Tobin MJ. Diaphragmatic neuromechanical coupling and mechanisms of hypercapnia during inspiratory loading. Respir Physiol Neurobiol. 2014 Jul 1;198:32-41. doi: 10.1016/j.resp.2014.03.004. Epub 2014 Apr 16.

  PMID: 24747754 BACKGROUND

• American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002 Aug 15;166(4):518-624. doi: 10.1164/rccm.166.4.518. No abstract available.

  PMID: 12186831 BACKGROUND

• Wanke T, Lahrmann H, Formanek D, Zwick H. Effect of posture on inspiratory muscle electromyogram response to hypercapnia. Eur J Appl Physiol Occup Physiol. 1992;64(3):266-71. doi: 10.1007/BF00626290.

  PMID: 1563372 BACKGROUND

• Jolley CJ, Luo YM, Steier J, Reilly C, Seymour J, Lunt A, Ward K, Rafferty GF, Polkey MI, Moxham J. Neural respiratory drive in healthy subjects and in COPD. Eur Respir J. 2009 Feb;33(2):289-97. doi: 10.1183/09031936.00093408. Epub 2008 Oct 1.

  PMID: 18829678 RESULT

• Li Y, Li YH, Li S, Luo YW, Xiao R, Huang YX, Huang JL, Chen YT, Zhi RC, Chen X. Efficiency of neural respiratory drive for the assessment of bronchodilator responsiveness in patients with chronic obstructive pulmonary disease: an exploratory study. J Thorac Dis. 2016 May;8(5):958-65. doi: 10.21037/jtd.2016.03.70.

  PMID: 27162672 RESULT

• Murphy PB, Kumar A, Reilly C, Jolley C, Walterspacher S, Fedele F, Hopkinson NS, Man WD, Polkey MI, Moxham J, Hart N. Neural respiratory drive as a physiological biomarker to monitor change during acute exacerbations of COPD. Thorax. 2011 Jul;66(7):602-8. doi: 10.1136/thx.2010.151332. Epub 2011 May 19.

  PMID: 21597112 RESULT

• Suh ES, Mandal S, Harding R, Ramsay M, Kamalanathan M, Henderson K, O'Kane K, Douiri A, Hopkinson NS, Polkey MI, Rafferty G, Murphy PB, Moxham J, Hart N. Neural respiratory drive predicts clinical deterioration and safe discharge in exacerbations of COPD. Thorax. 2015 Dec;70(12):1123-30. doi: 10.1136/thoraxjnl-2015-207188. Epub 2015 Jul 20.

  PMID: 26194996 RESULT

• Jensen D, O'Donnell DE, Li R, Luo YM. Effects of dead space loading on neuro-muscular and neuro-ventilatory coupling of the respiratory system during exercise in healthy adults: implications for dyspnea and exercise tolerance. Respir Physiol Neurobiol. 2011 Dec 15;179(2-3):219-26. doi: 10.1016/j.resp.2011.08.009. Epub 2011 Aug 22.

  PMID: 21888993 RESULT

• Duiverman ML, van Eykern LA, Vennik PW, Koeter GH, Maarsingh EJ, Wijkstra PJ. Reproducibility and responsiveness of a noninvasive EMG technique of the respiratory muscles in COPD patients and in healthy subjects. J Appl Physiol (1985). 2004 May;96(5):1723-9. doi: 10.1152/japplphysiol.00914.2003. Epub 2003 Dec 5.

  PMID: 14660508 RESULT

• Maarsingh EJ, van Eykern LA, Sprikkelman AB, Hoekstra MO, van Aalderen WM. Respiratory muscle activity measured with a noninvasive EMG technique: technical aspects and reproducibility. J Appl Physiol (1985). 2000 Jun;88(6):1955-61. doi: 10.1152/jappl.2000.88.6.1955.

  PMID: 10846005 RESULT

• Nava S, Ambrosino N, Rubini F, Fracchia C, Rampulla C, Torri G, Calderini E. Effect of nasal pressure support ventilation and external PEEP on diaphragmatic activity in patients with severe stable COPD. Chest. 1993 Jan;103(1):143-50. doi: 10.1378/chest.103.1.143.

  PMID: 8417869 RESULT

• Reilly CC, Jolley CJ, Ward K, MacBean V, Moxham J, Rafferty GF. Neural respiratory drive measured during inspiratory threshold loading and acute hypercapnia in healthy individuals. Exp Physiol. 2013 Jul;98(7):1190-8. doi: 10.1113/expphysiol.2012.071415. Epub 2013 Mar 15.

  PMID: 23504646 RESULT

• Ju C, Chen R. Factors associated with impairment of quadriceps muscle function in Chinese patients with chronic obstructive pulmonary disease. PLoS One. 2014 Feb 18;9(2):e84167. doi: 10.1371/journal.pone.0084167. eCollection 2014.

  PMID: 24558357 RESULT

• De Troyer A. Inspiratory elevation of the ribs in the dog: primary role of the parasternals. J Appl Physiol (1985). 1991 Apr;70(4):1447-55. doi: 10.1152/jappl.1991.70.4.1447.

  PMID: 1958250 RESULT

• Cardoso DM, Fregonezi GA, Jost RT, Gass R, Alberton CL, Albuquerque IM, Paiva DN, Barreto SS. Acute effects of Expiratory Positive Airway Pressure (EPAP) on different levels in ventilation and electrical activity of sternocleidomastoid and parasternal muscles in Chronic Obstructive Pulmonary Disease (COPD) patients: a randomized controlled trial. Braz J Phys Ther. 2016 Nov-Dec;20(6):525-534. doi: 10.1590/bjpt-rbf.2014.0190. Epub 2016 Sep 16.

  PMID: 27683840 RESULT

• Esteban A, Ferguson ND, Meade MO, Frutos-Vivar F, Apezteguia C, Brochard L, Raymondos K, Nin N, Hurtado J, Tomicic V, Gonzalez M, Elizalde J, Nightingale P, Abroug F, Pelosi P, Arabi Y, Moreno R, Jibaja M, D'Empaire G, Sandi F, Matamis D, Montanez AM, Anzueto A; VENTILA Group. Evolution of mechanical ventilation in response to clinical research. Am J Respir Crit Care Med. 2008 Jan 15;177(2):170-7. doi: 10.1164/rccm.200706-893OC. Epub 2007 Oct 25.

  PMID: 17962636 RESULT

• Thys F, Roeseler J, Reynaert M, Liistro G, Rodenstein DO. Noninvasive ventilation for acute respiratory failure: a prospective randomised placebo-controlled trial. Eur Respir J. 2002 Sep;20(3):545-55. doi: 10.1183/09031936.02.00287402.

  PMID: 12358327 RESULT

• Kohnlein T, Windisch W, Kohler D, Drabik A, Geiseler J, Hartl S, Karg O, Laier-Groeneveld G, Nava S, Schonhofer B, Schucher B, Wegscheider K, Criee CP, Welte T. Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med. 2014 Sep;2(9):698-705. doi: 10.1016/S2213-2600(14)70153-5. Epub 2014 Jul 24.

  PMID: 25066329 RESULT

• Casanova C, Celli BR, Tost L, Soriano E, Abreu J, Velasco V, Santolaria F. Long-term controlled trial of nocturnal nasal positive pressure ventilation in patients with severe COPD. Chest. 2000 Dec;118(6):1582-90. doi: 10.1378/chest.118.6.1582.

  PMID: 11115443 RESULT

• Dreher M, Storre JH, Schmoor C, Windisch W. High-intensity versus low-intensity non-invasive ventilation in patients with stable hypercapnic COPD: a randomised crossover trial. Thorax. 2010 Apr;65(4):303-8. doi: 10.1136/thx.2009.124263.

  PMID: 20388753 RESULT

• Zhang J, Luo Q, Zhang H, Chen R. Effect of noninvasive proportional assist vs pressure support ventilation on neuroventilatory coupling in chronic obstructive pulmonary patients with hypercapnia. Intensive Care Med. 2014 Sep;40(9):1390-1. doi: 10.1007/s00134-014-3378-5. Epub 2014 Jun 27. No abstract available.

  PMID: 24968715 RESULT

• Passam F, Hoing S, Prinianakis G, Siafakas N, Milic-Emili J, Georgopoulos D. Effect of different levels of pressure support and proportional assist ventilation on breathing pattern, work of breathing and gas exchange in mechanically ventilated hypercapnic COPD patients with acute respiratory failure. Respiration. 2003 Jul-Aug;70(4):355-61. doi: 10.1159/000072897.

  PMID: 14512669 RESULT

MeSH Terms

Conditions

Pulmonary Disease, Chronic Obstructive

Condition Hierarchy (Ancestors)

Lung Diseases, Obstructive; Lung Diseases; Respiratory Tract Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Rongchang Chen, professor

  The First Affiliated Hospital of Guangzhou Medical University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 24, 2017
• First Posted: August 31, 2017
• Study Start: September 1, 2016
• Primary Completion: March 7, 2017
• Study Completion: July 2, 2017
• Last Updated: September 1, 2017

Record last verified: 2017-08

Data Sharing

• IPD Sharing: Will not share