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ORIGINAL ARTICLE Free access
Minerva Anestesiologica 2020 October;86(10):1047-56
DOI: 10.23736/S0375-9393.20.14458-4
Copyright © 2020 EDIZIONI MINERVA MEDICA
language: English
The assessment of esophageal pressure using different devices: a validation study
Davide CHIUMELLO 1, 2, 3 ✉, Alessio CACCIOPPOLA 1, Tommaso POZZI 1, Andrea C. LUSARDI 1, Valentina DE GIORGIS 1, Valentina GALANTI 1, Erica FERRARI 1, Silvia COPPOLA 1
1 Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy; 2 Department of Health Sciences, University of Milan, Milan, Italy; 3 Coordinated Research Center on Respiratory Failure, University of Milan, Milan, Italy
BACKGROUND: Although esophageal pressure measurement could help clinicians to improve the ventilatory management of acute respiratory distress syndrome (ARDS) patients, it has been mainly used in clinical research. Aim of this study was to compare the measurements of end-expiratory esophageal pressure, end-expiratory transpulmonary pressure and lung stress by three systems: a dedicated manual device, taken as gold standard, a new automatic system (Optivent) and a bedside equipment, consisting of a mechanical ventilator and a hemodynamic monitor.
METHODS: In sedated and paralyzed mechanically ventilated ARDS patients the esophageal pressure was measured at three PEEP levels in random fashion (baseline level, 50% higher and 50% lower).
RESULTS: Forty patients were enrolled (BMI 25 [23-28] kg/m2, PaO
CONCLUSIONS: Both Optivent and the bedside system showed clinically acceptability if compared to the gold standard device. The possibility to apply one of these systems could allow a wider use of esophageal pressure in clinical practice.
KEY WORDS: Respiratory mechanics; Respiratory distress syndrome, adult; Monitoring, physiologic