A5022743320- Respiratory Support and Mechanisms
- Intensive Care Unit Cognitive Disorders
- Neuroscience of respiration and sleep
- Neonatal Respiratory Health Research
- Cardiac Arrest and Resuscitation
- Infant Development and Preterm Care
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Family and Patient Care in Intensive Care Units
- Congenital Diaphragmatic Hernia Studies
- Muscle activation and electromyography studies
- Non-Invasive Vital Sign Monitoring
- ECG Monitoring and Analysis
- Airway Management and Intubation Techniques
- Cardiovascular and exercise physiology
- Tracheal and airway disorders
- Mechanical Circulatory Support Devices
- EEG and Brain-Computer Interfaces
- Heart Rate Variability and Autonomic Control
- Anesthesia and Sedative Agents
- Pulmonary Hypertension Research and Treatments
- Phonocardiography and Auscultation Techniques
- Cardiac Valve Diseases and Treatments
- Children's Physical and Motor Development
- Appendicitis Diagnosis and Management
- Infant Health and Development
University of Toronto
2011-2025
St. Michael's Hospital
2014-2024
Toronto Metropolitan University
2015-2024
Centre Hospitalier Universitaire Sainte-Justine
2000-2012
St Michaels Hospital
2012
Health Sciences Centre
2004-2010
Sunnybrook Health Science Centre
2004-2010
Women's College Hospital
2007
McGill University
1995-2005
Université de Montréal
1997-2005
Intersubject comparison of the crural diaphragm electromyogram, as measured by an esophageal electrode, requires a reliable means for normalizing signal. The present study set out 1) to evaluate which voluntary respiratory maneuvers provide high and reproducible electromyogram root-mean-square (RMS) values 2) determine relative activation mechanical ventilatory outputs during breathing at rest in healthy subjects ( n = 5), patients with severe chronic obstructive pulmonary disease (COPD,...
To compare the effect of pressure support ventilation and neurally adjusted ventilatory assist on breathing pattern, patient-ventilator synchrony, diaphragm unloading, gas exchange. Increasing level can increase tidal volume, reduce respiratory rate, lead to delayed ventilator triggering cycling. Neurally uses electrical activity control timing delivery is expected enhance synchrony.Prospective, comparative, crossover study.Adult critical care unit in a tertiary university hospital.Fourteen...
Although it has been postulated that central inhibition of respiratory drive may prevent development diaphragm fatigue in patients with chronic obstructive pulmonary disease (COPD) during exercise, this premise not validated. We evaluated electrical activation (EAdi) relative to maximum 10 moderately severe COPD at rest and incremental exhaustive bicycle exercise. Flow was measured a pneumotachograph volume by integration flow. EAdi transdiaphragmatic pressures (Pdi) were using an esophageal...
Rationale: Acquired diaphragm muscle weakness is a key feature in several chronic conditions, including obstructive pulmonary disease, congestive heart failure, and difficult weaning from mechanical ventilation. No drugs are available to improve respiratory function these patients. Recently, we have shown that the calcium sensitizer levosimendan enhances force-generating capacity of isolated fibers.Objectives: To investigate effects on vivo human function.Methods: In double-blind,...
Abstract Introduction Based on the hypothesis that failure of weaning from mechanical ventilation is caused by respiratory demand exceeding capacity muscles, we evaluated whether extubation could be characterized increased drive and impaired efficiency to generate inspiratory pressure ventilation. Methods Airway pressure, flow, volume, breathing frequency, diaphragm electrical activity were measured in a heterogeneous group patients deemed ready for spontaneous trial. Efficiency convert...
Sinderby, Christer A., Jennifer C. Beck, Lars H. Lindström, and Alejandro E. Grassino. Enhancement of signal quality in esophageal recordings diaphragm EMG. J. Appl. Physiol. 82(4): 1370–1377, 1997.—The crural electromyogram (EMGdi) is recorded from a sheet muscle, the fiber direction which mostly perpendicular to an bipolar electrode. The region action potentials are elicited, electrically active (EAR di ) center this ctr may vary during voluntary contractions terms their position with...
To evaluate the influence of neurally adjusted ventilatory assist (NAVA) and positive end-expiratory pressure (PEEP) on control breathing in rabbits with acute lung injury.Prospective animal study.Experimental laboratory a university hospital.Male White New Zealand (n = 18).Spontaneously hydrochloric acid-induced injury were ventilated NAVA underwent changes gain PEEP (six nonvagotomized five vagotomized). Seven other 4 hrs ventilation hourly titration PEEP, Fio2, gain.We studied diaphragm...
We aimed to describe how the human diaphragm electromyogram (EMGdi) is filtered at different positions within esophageal hiatus, i.e., in close proximity of diaphragm, when obtained with an array bipolar electrode pairs mounted on catheter. defined electrically active crural musculature that covers esophagus as region (EARdi) and its center EARdi center. EMGdi signals were via a multiple-array catheter consisting seven sequential three configurations. Subjects (n = 5) performed voluntary...
It has been suggested that esophageal recordings of the diaphragm electromyogram (EMGdi) are influenced by changes in chest wall configuration. Whether physiological or artifactual origin is unclear. For example, distance between electrode and likely to alter with configuration may lead misinterpretations EMGdi. The aims this study were 1) evaluate quantify effect muscle-to-electrode (ME) filter on EMGdi, as obtained a multiple-array electrode, 2) take advantage ME locate position respect 3)...
The gold standard treatment for apnea of prematurity is caffeine citrate, which known its effect on diaphragm muscle activity. purpose this study was to investigate the electrical activity in preterm newborns, measured 30 minutes before and 60 after administration a loading dose citrate. In prospective, observational, longitudinal at tertiary-level neonatal ICU, data were collected from 36 patients (13 females, 23 males) with mean gestational age 31 2/7 ± 2 1/7 weeks birth weight 1532 439...
In nonsedated newborn lambs, nasal pressure support ventilation (nPSV) can lead to an active glottal closure in early inspiration, which limit lung and divert air into the digestive system, with potentially deleterious consequences. During volume control (nVC), is delayed end of suggesting that it reflexly linked maximum value inspiratory pressure. Accordingly, aim present study was test whether develops at inspiration during neurally adjusted ventilatory assist (nNAVA), increasingly used...
Abstract Introduction Intrinsic positive end-expiratory pressure (PEEPi) is a “threshold” load that must be overcome to trigger conventional pneumatically-controlled support (PS P ) in chronic obstructive pulmonary disease (COPD). Application of extrinsic PEEP (PEEPe) reduces delays and mechanical inspiratory efforts. Using the diaphragm electrical activity (EAdi), neurally controlled N could hypothetically eliminate asynchrony reduce effort, hence substituting need for PEEPe. The primary...
The purpose of this study was to evaluate the influence velocity shortening on relationship between diaphragm activation and pressure generation in humans. This achieved by relating root mean square (RMS) electromyogram transdiaphragmatic (Pdi) generated during dynamic contractions at different inspiratory flow rates. Five healthy subjects inspired from functional residual capacity total lung rates while reproducing identical Pdi chest wall configuration profiles. To change rate, performed...