Transcutaneous electromyography as a tool to assess recovery of hemidiaphragmatic paresis: A case report

Article type: Case Report

Authors: Scholten, A.W.J.^{a; b; 1} | van Leuteren, R.W.^{a; b; 2} | de Jongh, F.H.^{a; c; 3} | van Kaam, A.H.^{a; b; 4} | Markhorst, D.G.^d | Hutten, J.^{a; b; 5; *}

Affiliations: [a] Department of Neonatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands | [b] Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands | [c] Faculty of Science and Technology, University of Twente, Enschede, The Netherlands | [d] Pediatric Intensive Care Unit, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

Correspondence: [*] Address for correspondence: G.J. Hutten, Department of Neonatology, Amsterdam UMC, location AMC, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands. Tel.: +31 0205669111; E-mail: g.j.hutten@amsterdamumc.nl

Note: [1] ORCID: https://orcid.org/0000-0002-6175-1436

Note: [2] ORCID: https://orcid.org/0000-0001-8468-2544

Note: [3] ORCID: https://orcid.org/0000-0002-6052-7504

Note: [4] ORCID: https://orcid.org/0000-0003-4030-7085

Note: [5] ORCID: https://orcid.org/0000-0003-4368-6519

Abstract: In this case report, we describe two repeated transcutaneous electromyography of the diaphragm (dEMG) measurements in an infant with suspected paresis of the right hemidiaphragm after cardiac surgery. The first measurement, performed at the time of diagnosis, showed a lower electrical activity of the right side of the diaphragm in comparison with the left side. The second measurement, performed after a period of expectative management, showed that electrical activity of the affected side had increased and was similar to the activity of the left diaphragm. This finding was accompanied by an improvement in the clinical condition. In conclusion, repeated measurement of diaphragmatic activity using transcutaneous dEMG enables the observation and quantification of spontaneous recovery over time. This information may assist the clinician in identifying patients not responding to expectative management and in determining the optimal timing of diaphragmatic surgery.

Keywords: Diaphragm, infants

DOI: 10.3233/NPM-230110

Journal: Journal of Neonatal-Perinatal Medicine, vol. 16, no. 4, pp. 725-729, 2023