Electromyography-based respiratory onset detection in COPD patients on non-invasive mechanical ventilation

To optimize long-term nocturnal non-invasive ventilation in patients with chronic obstructive pulmonary disease, surface diaphragm electromyography (EMGdi) might be helpful to detect patient-ventilator asynchrony. However, visual analysis is labor-intensive and EMGdi is heavily corrupted by electroc...

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Bibliographic Details
Authors: Sarlabous Uranga, Leonardo|||0000-0002-0495-8422, Estrada Petrocelli, Luis Carlos, Cerezo Hernández, Ana, Leest, Sietske V. D., Torres Cebrián, Abel|||0000-0003-2678-1303, Jané Campos, Raimon|||0000-0002-6541-8729, Duiverman, Marieke, Garde Martínez, Ainara
Format: article
Publication Date:2019
Country:España
Institution:Universitat Politècnica de Catalunya (UPC)
Repository:UPCommons. Portal del coneixement obert de la UPC
Language:English
OAI Identifier:oai:upcommons.upc.edu:2117/176753
Online Access:https://hdl.handle.net/2117/176753
https://dx.doi.org/10.3390/e21030258
Access Level:Open access
Keyword:Electromyography
Fixed sample entropy
Adaptive filtering
Root mean square
Diaphragm electromyography
Non-invasive mechanical ventilation
Chronic obstructive pulmonary disease
Electromiografia
Àrees temàtiques de la UPC::Enginyeria biomèdica
Description
Summary:To optimize long-term nocturnal non-invasive ventilation in patients with chronic obstructive pulmonary disease, surface diaphragm electromyography (EMGdi) might be helpful to detect patient-ventilator asynchrony. However, visual analysis is labor-intensive and EMGdi is heavily corrupted by electrocardiographic (ECG) activity. Therefore, we developed an automatic method to detect inspiratory onset from EMGdi envelope using fixed sample entropy (fSE) and a dynamic threshold based on kernel density estimation (KDE). Moreover, we combined fSE with adaptive filtering techniques to reduce ECG interference and improve onset detection. The performance of EMGdi envelopes extracted by applying fSE and fSE with adaptive filtering was compared to the root mean square (RMS)-based envelope provided by the EMG acquisition device. Automatic onset detection accuracy, using these three envelopes, was evaluated through the root mean square error (RMSE) between the automatic and mean visual onsets (made by two observers). The fSE-based method provided lower RMSE, which was reduced from 298 ms to 264 ms when combined with adaptive filtering, compared to 301 ms provided by the RMS-based method. The RMSE was negatively correlated with the proposed EMGdi quality indices. Following further validation, fSE with KDE, combined with adaptive filtering when dealing with low quality EMGdi, indicates promise for detecting the neural onset of respiratory drive.