Towards innovative electrodiagnosis tests to investigate neuromuscular excitability dysfunction in critically ill patients: an agreement study

• Published in: Research on biomedical engineering Vol. 39; no. 4; pp. 949 - 958
• Main Authors: Silva, Paulo Eugênio, Martins, Henrique Resende, de Deus Macedo, José Roberto, de Queiroz, Alessandra Vasconcelos, Ultra de Aguiar, Agda, Martins, Emerson Fachin
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2023
• Subjects: Biomaterials; Biomedical Engineering and Bioengineering; Biomedical Engineering/Biotechnology; Engineering; Original Article; Chronaxie; Agreement; Intensive care unit-acquired weakness; Strength-duration test; Neuromuscular electrical stimulation
• ISSN: 2446-4740; 2446-4740
• DOI: 10.1007/s42600-023-00318-3

Purpose Early diagnosis of ICU-acquired weakness can support the ICU team in applying appropriate interventions which may lead to better results at clinical and functional outcomes. Thus, interest has increased in non-invasive and more feasible methods to diagnose neuromuscular dysfunction, such as the stimulus electrodiagnosis test (SET) and strength-duration test (SDT). The aim of the present study was to assess the agreement of the SET and SDT carried out automatically using an innovative method. Methods We performed a prospective observational study to determine the agreement of SET and SDT, performed automatically using a biofeedback circuit to detect muscle contractions, comprised of an accelerometer module connected to an electrical stimulator. These tests were applied in healthy and critically ill participants. Results Twenty-one participants were analyzed in the study, and 168 assessments of SET and SDT were performed. The Bland-Altman analysis of automatic SET and SDT in the control group showed a low bias of −25 (95% CI, −94.3 to 44.3 μs) and 0.6 (95% CI, −1.9 to 3.1 μC) respectively. In the critically ill group, automatic SET and SDT presented a low bias of −104.5 (95% CI, −1716 to 1507μs) and −12.6 (95% CI, −119.4 to 94.1 μC) respectively. Conclusions We demonstrated that an innovative method to carry out SET and SDT automatically presents low agreement bias and good to excellent reliability.