title: Is neural drive the missing piece in the puzzle of COPD exacerbation?
abstract: The decision to discharge in patients affected by acute exacerbation of COPD remains a common problem due to the complexity of the assessment of clinical recovery, with early readmission perceived as a marker of incompleteness of the received treatment. The neural respiratory drive, assessed by parasternal muscle electromyography, represents an estimate of the load imposed to the respiratory muscles and it may identify early clinical deterioration. The test is noninvasive, may be executed bedside, but requires experienced operators. Yet, feasibility and clinical interpretation outside reference centers seem to be the main unsolved issues in the implementation of the technique in clinical practice.
authors.affiliation: Respiratory Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, University of Milan, Milan, Italy - francesco.sferrazza@gmail.com.|Casa di Cura Privata del Policlinico Milano SpA, Department of Neurorehabilitation, Milan, Italy - francesco.sferrazza@gmail.com.
authors.forename: Giuseppe F
authors.initials: GF
authors.lastname: Sferrazza Papa
authors.affiliation: Casa di Cura Privata del Policlinico Milano SpA, Department of Neurorehabilitation, Milan, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: DE Giampaulis
authors.affiliation: Respiratory Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: Fabiano
authors.initials: F
authors.lastname: DI Marco
authors.affiliation: Casa di Cura Privata del Policlinico Milano SpA, Department of Neurorehabilitation, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Corbo
mesh_terms: D018450:Disease Progression; D004576:Electromyography; D006801:Humans; D010351:Patient Discharge; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000294:innervation / Q000503:physiopathology