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

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..

Medienart:

E-Artikel

Erscheinungsjahr:

2016

Erschienen:

2016

Enthalten in:

Zur Gesamtaufnahme - volume:42

Enthalten in:

Intensive care medicine - 42(2016), 9 vom: 22. Juni, Seite 1360-1373

Sprache:

Englisch

Beteiligte Personen:

Mauri, Tommaso [VerfasserIn]
Yoshida, Takeshi [VerfasserIn]
Bellani, Giacomo [VerfasserIn]
Goligher, Ewan C. [VerfasserIn]
Carteaux, Guillaume [VerfasserIn]
Rittayamai, Nuttapol [VerfasserIn]
Mojoli, Francesco [VerfasserIn]
Chiumello, Davide [VerfasserIn]
Piquilloud, Lise [VerfasserIn]
Grasso, Salvatore [VerfasserIn]
Jubran, Amal [VerfasserIn]
Laghi, Franco [VerfasserIn]
Magder, Sheldon [VerfasserIn]
Pesenti, Antonio [VerfasserIn]
Loring, Stephen [VerfasserIn]
Gattinoni, Luciano [VerfasserIn]
Talmor, Daniel [VerfasserIn]
Blanch, Lluis [VerfasserIn]
Amato, Marcelo [VerfasserIn]
Chen, Lu [VerfasserIn]
Brochard, Laurent [VerfasserIn]
Mancebo, Jordi [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

BKL:

44.69$jIntensivmedizin

Themen:

Acute respiratory distress syndrome
Acute respiratory failure
Esophageal pressure
Mechanical ventilation
Physiologic monitoring

RVK:

RVK Klassifikation

Anmerkungen:

© Springer-Verlag Berlin Heidelberg and ESICM 2016

doi:

10.1007/s00134-016-4400-x

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2096944589