Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives Journal Article

Local Library Link: Find It @ Loyola

Authors: Mauri, T.; Yoshida, T; Bellani, G.; Goligher, E. C.; Carteaux, G.; Rittayamai, N.; Mojoli, F.; Chiumello, D.; Piquilloud, L.; Grasso, S.; Jubran, A.; Laghi, F.; Magder, S.; Pesenti, A.; Loring, S.; Gattinoni, L.; Talmor, D.; Blanch, L.; Amato, M.; Chen, L; Brochard, L.; Mancebo, J.; PLeUral pressure working Group (PLUG-Acute Respiratory Failure section of the European Society of Intensive Care Medicine)
Article Title: Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives
Abstract: PURPOSE: Esophageal pressure (Pes) is a minimally invasive advanced respiratory monitoring method with the potential to guide management of ventilation support and enhance specific diagnoses in acute respiratory failure patients. To date, the use of Pes in the clinical setting is limited, and it is often seen as a research tool only. METHODS: This is a review of the relevant technical, physiological and clinical details that support the clinical utility of Pes. RESULTS: After appropriately positioning of the esophageal balloon, Pes monitoring allows titration of controlled and assisted mechanical ventilation to achieve personalized protective settings and the desired level of patient effort from the acute phase through to weaning. Moreover, Pes monitoring permits accurate measurement of transmural vascular pressure and intrinsic positive end-expiratory pressure and facilitates detection of patient-ventilator asynchrony, thereby supporting specific diagnoses and interventions. Finally, some Pes-derived measures may also be obtained by monitoring electrical activity of the diaphragm. CONCLUSIONS: Pes monitoring provides unique bedside measures for a better understanding of the pathophysiology of acute respiratory failure patients. Including Pes monitoring in the intensivist's clinical armamentarium may enhance treatment to improve clinical outcomes.
Journal Title: Intensive care medicine
ISSN: 1432-1238; 0342-4642
Publisher: Unknown  
Date Published: 2016
Language: ENG
DOI/URL:

10.1007/s00134-016-4400-x
Notes: LR: 20160623; JID: 7704851; OTO: NOTNLM; 2016/02/28 [received]; 2016/05/17 [accepted]; 2016/06/22 [aheadofprint]; aheadofprint