%0 Journal Article
%T Accessory and Expiratory Muscles Activation During Spontaneous Breathing Trial: A Physiological Study by Surface Electromyography.
%A Pozzi M
%A Rezoagli E
%A Bronco A
%A Rabboni F
%A Grasselli G
%A Foti G
%A Bellani G
%A Pozzi M
%A Rezoagli E
%A Bronco A
%A Rabboni F
%A Grasselli G
%A Foti G
%A Bellani G
%J Front Med (Lausanne)
%V 9
%N 0
%D 2022
%M 35372418
%F 5.058
%R 10.3389/fmed.2022.814219
%X <B>UNASSIGNED: </B>The physiological and prognostical significance of accessory and expiratory muscles activation is unknown during a spontaneous breathing trial (SBT). We hypothesized that, in patients experiencing weaning failure, accessory and expiratory muscles are activated to cope with an increased respiratory workload.<BR><B>UNASSIGNED: </B>To describe accessory and expiratory muscle activation non-invasively by surface electromyography (sEMG) during an SBT and to assess differences in electrical activity (EA) of the inspiratory and expiratory muscles in successful vs. failing weaning patients.<BR><B>UNASSIGNED: </B>Intubated patients on mechanical ventilation for more than 48 h undergoing an SBT were enrolled in a medical and surgical third-level ICU of the University Teaching Hospital. Baseline characteristics and physiological variables were recorded in a crossover physiologic prospective clinical study.<BR><B>UNASSIGNED: </B>Of 37 critically ill mechanically ventilated patients, 29 (78%) patients successfully passed the SBT. Rapid shallow breathing index (RSBI) was higher in patients who failed SBT compared with the successfully weaned patients at baseline and over time (group-by-time interaction p < 0.001). EA of both the diaphragm (EAdisurf) and of accessory muscles (ACCsurf) was higher in failure patients compared with success (group-by-time interaction p = 0.0174 and p < 0.001, respectively). EA of expiratory muscles (ESPsurf) during SBT increased more in failure than in weaned patients (group-by-time interaction p < 0.0001).<BR><B>UNASSIGNED: </B>Non-invasive respiratory muscle monitoring by sEMG was feasible during SBT. Respiratory muscles EA increased during SBT, regardless of SBT outcome, and patients who failed the SBT had a higher increase of all the inspiratory muscles EA compared with the patients who passed the SBT. Recruitment of expiratory muscles-as quantified by sEMG-is associated with SBT failure.