Pediatric research
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The presence of diaphragm electrical activity (EAdi) during expiration is believed to be involved in the maintenance of end-expiratory lung volume (EELV) and has never been studied in intubated and mechanically ventilated infants. The aim of this study was to quantify the amplitude of diaphragm electrical activity present during expiration in mechanically ventilated infants and to measure the impact of removing positive end-expiratory pressure (PEEP) on this activity. We studied the EAdi in 16 ready-to-be weaned intubated infants who were breathing on their prescribed ventilator and PEEP settings. ⋯ EAdi for Q3-Q4 significantly increased during ZEEP, and decreased after reapplication of PEEP. These findings confirm that the diaphragm remains partially active during expiration in intubated and mechanically ventilated infants and that removal of PEEP affects this tonic activity. This could have potential implications on the management of PEEP in intubated infants.