2021 Workshop Handout Bundle-EMG and US Respiratory

EMG and US Respiratory - Litchy/Boon

Pdf Summary

Electrodiagnostic studies of the respiratory system are often performed in the clinical setting to evaluate patients with respiratory dysfunction or failure to wean from a ventilator. These studies can help determine the diagnosis, prognosis, and management of these patients. The most commonly studied group of patients includes those in the medical and surgical ICU who are on mechanical ventilation and are unable to be weaned. Other groups of patients who may require electrodiagnostic studies include those with neuromuscular diseases, traumatic injuries, or phrenic nerve impairment.<br /><br />In addition to routine nerve conduction studies and needle electromyography, phrenic nerve conduction studies and needle electromyography of the diaphragm are often necessary for a full electrodiagnostic consultation in patients with respiratory dysfunction. Ultrasound has also been shown to be a useful adjunct in evaluating these patients.<br /><br />Respiration relies on the integrity of the lungs and the neuromuscular respiratory system. The diaphragm is the most important muscle of respiration, and accessory muscles include the sternocleidomastoids, scaleni, intercostals, and abdominal muscles. Failure of the diaphragm can lead to respiratory dysfunction and the need for mechanical ventilation.<br /><br />Phrenic nerve conduction studies involve stimulating the phrenic nerve and recording the diaphragmatic compound muscle action potential. Needle electromyography of the diaphragm can help assess its innervation and detect signs of denervation or myopathy. Ultrasound can aid in localizing the diaphragm and assessing its contractile function and motion.<br /><br />Electrodiagnostic consultations of the respiratory muscles and nerves can provide valuable information in diagnosing and managing various respiratory conditions, including critical illness neuropathy/myopathy, traumatic injuries, and inflammatory damage to the phrenic nerve. These studies can also help evaluate the central respiratory drive and determine the viability of the phrenic nerve before implanting a pacemaker.<br /><br />Overall, electrodiagnostic studies play a crucial role in assessing respiratory function and guiding treatment decisions in patients with respiratory dysfunction.

Keywords

electrodiagnostic studies

respiratory dysfunction

ventilator

diagnosis

prognosis

mechanical ventilation

phrenic nerve

needle electromyography

diaphragm

respiration