Home parasternal electromyography tracks patient-reported and physiological measures of recovery from severe COPD exacerbation

Exacerbations of COPD remain a leading cause for emergency hospitalisation worldwide, and up to 28% of patients are readmitted within 30 days of discharge [1]. Recent analyses of over 2.3 million COPD hospitalisations highlight the dynamic and time-dependent nature of readmission risk, which peaks within the first 72 h of discharge [2, 3]. Effective readmission prevention strategies remain elusive and recognition of re-exacerbations beyond daily symptom variability is challenging for both patients and clinicians. Promotion of transitional care services and 30-day readmission penalties implemented by policymakers worldwide have had limited impact [4]. Telemonitoring strategies incorporating symptom and vital observation monitoring (oxygen saturation (SpO2), heart rate, respiratory frequency ( fR )) have consistently failed to demonstrate beneficial effects on hospitalisation risk [5]. Objective physiological monitoring has been explored using the forced oscillation technique, however this also failed to prolong time to first hospitalisation [6]. Footnotes This manuscript has recently been accepted for publication in the ERJ Open Research . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article. Conflict of interest: E-S. Suh reports grants to his institution and fees for CPD approved activity from Philips Research outside the submitted work. Conflict of interest: Dr. Kaltsakas has nothing to disclose. Conflict of interest: Dr. Dewar has nothing to disclose. Conflict of interest: Dr. Shah reports grants from Breas, with the funds held and managed by Guy's & St Thomas’ NHS Foundation Trust, outside the submitted work. Conflict of interest: Dr. Priori is an employee of Philips Research. Conflict of interest: Dr. Douiri has nothing to disclose. Conflict of interest: Prof. Rose has nothing to disclose. Conflict of interest: N. Hart reports an unrestricted grant for the OPIP Trial from Philips Respironics, nonfinancial support for development of the Myotrace technology from Philips Respironics RT Meeting (Myotrace), and unrestricted research grants for the HoT-HMV Trial from RESMED and Philips Respironics, outside the submitted work; in addition, he has patents for Myotrace issued in Europea and pending in the USA. His research group has received unrestricted grants (managed by Guy's & St Thomas’ Foundation Trust) from Philips and RESMED. Philips are contributing to the development of the Myotrace technology. Conflict of interest: P.B. Murphy reports grants to his institution and fees for CPD approved activity from Philips, ResMed, F&P and Electromedical, personal fees for an advisory board from Santhera, and grants to his institution from GSK, outside the submitted work. Conflict of interest: R.F. D'Cruz reports a Clinical Training Fellowship and Doctoral Research Fellowship (NIHR-INF-0415 and DRF-2018-11-ST2-037) from the National Institute for Health Research during the conduct of the study.