Surface electromyography signal processing and evaluation on respiratory muscles of critically ill patients: A systematic review

• Published in: PloS one Vol. 18; no. 4; p. e0284911
• Main Authors: Silva Junior, Emanuel Fernandes Ferreira da, Campos, Shirley Lima, Leite, Wagner Souza, Melo, Pedro Vanderlei de Sousa, Lins, Rômulo Aquino Coelho, Araújo, Maria das Graças Rodrigues de, Guerino, Marcelo Renato
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 27.04.2023; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Check lists; Critical Illness; Data analysis; Data processing; Diaphragm; Electrodes; Electromyography; Electromyography - methods; Emergency procedures; Engineering and Technology; Evaluation; Evidence-based medicine; Humans; Information management; Intensive care; Medicine and Health Sciences; Muscle contraction; Muscle function; Muscle, Skeletal; Muscles; Observational studies; Patients; Placement; Quality assessment; Quality control; Reproducibility of Results; Research and Analysis Methods; Respiratory intensive care; Respiratory Muscles - physiology; Signal processing; Standardization; Systematic review; Ventilation; Brazil; Ontario
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0284911

Surface Electromyography (sEMG) has been used to monitor respiratory muscle function and contractility in several clinical situations, however there is the lack of standardization for the analysis and processing of the signals. To summarize the respiratory muscles most assessed by sEMG in the critical care setting and the assessment procedure details employed on those muscles regarding electrode placement, signal acquisition, and data analysis. A systematic review of observational studies was registered on PROSPERO (number CRD42022354469). The databases included PubMed; SCOPUS; CINAHL, Web of Science and ScienceDirect. Two independent reviewers ran the quality assessment of the studies using the Newcastle-Ottawa Scale and Downs & Black checklists. A total of 311 participants were involved across the 16 studies, from which 62.5% (10) assessed the diaphragm muscle and 50% (8) assessed the parasternal muscle with similar electrode placement in both of them. We did not identify common patterns for the location of the electrodes in the sternocleidomastoid and anterior scalene muscles. 12/16 reported sample rate, 10/16 reported band-pass and 9/16 reported one method of cardiac-interference filtering technique. 15/16 reported Root Mean Square (RMS) or derivatives as sEMG-obtained variables. The main applicabilities were the description of muscle activation in different settings (6/16), testing of reliability and correlation to other respiratory muscles assessment techniques (7/16), and assessment of therapy response (3/16). They found sEMG feasible and useful for prognosis purposes (2/16), treatment guidance (6/16), reliable monitoring under stable conditions (3/16), and as a surrogate measure (5/16) in mechanically ventilated patients in elective or emergency invasive procedures (5/16) or in acute health conditions (11/16). The diaphragm and parasternal muscles were the main muscles studied in the critical care setting, and with similar electrodes placement. However, several different methods were observed for other muscles electrodes placement, sEMG signals acquisition and data analysis.