Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Intensive Care Medicine
Published in: Intensive Care Medicine 2/2018

01-02-2018 | What's New in Intensive Care

Ten tips to facilitate understanding and clinical use of esophageal pressure manometry

Authors: Takeshi Yoshida, Laurent Brochard

Published in: Intensive Care Medicine | Issue 2/2018

Login to get access

Excerpt

Esophageal pressure (P es) is a valid surrogate for pleural pressure (P pl) that has been shown to be a useful parameter for more than 50 years of research. One application is to measure transpulmonary pressure (P L), which is the distending pressure of the lungs; another application is the assessment of patient effort when the respiratory muscles are active. The recent LUNG SAFE international study revealed that P es was employed in less than 1% of patients with acute respiratory distress syndrome (ARDS) [1]. There is, therefore, a large potential for the inclusion of esophageal manometry in clinical practice. Here, we present and describe ten tips to be taken into account to adequately measure and interpret P es in patients with ARDS. …
Literature
1.
Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Pesenti A (2016) Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 315:788–800CrossRefPubMed
2.
Mojoli F, Chiumello D, Pozzi M, Algieri I, Bianzina S, Luoni S, Volta CA, Braschi A, Brochard L (2015) Esophageal pressure measurements under different conditions of intrathoracic pressure. An in vitro study of second generation balloon catheters. Minerva Anestesiol 81:855–864PubMed
3.
Niknam J, Chandra A, Adams AB, Nahum A, Ravenscraft SA, Marini JJ (1994) Effect of a nasogastric tube on esophageal pressure measurement in normal adults. Chest 106:137–141CrossRefPubMed
4.
Mojoli F, Iotti GA, Torriglia F, Pozzi M, Volta CA, Bianzina S, Braschi A, Brochard L (2016) In vivo calibration of esophageal pressure in the mechanically ventilated patient makes measurements reliable. Crit Care 20:98CrossRefPubMedPubMedCentral
5.
Mauri T, Yoshida T, Bellani G, Goligher EC, 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 (2016) Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives. Intensive Care Med 42:1360–1373CrossRefPubMed
6.
Baydur A, Behrakis PK, Zin WA, Jaeger M, Milic-Emili J (1982) A simple method for assessing the validity of the esophageal balloon technique. Am Rev Respir Dis 126:788–791PubMed
7.
8.
D’Angelo E, Sant’Ambrogio G, Agostoni E (1974) Effect of diaphragm activity or paralysis on distribution of pleural pressure. J Appl Physiol 37:311–315CrossRefPubMed
9.
Yoshida T, Nakahashi S, Nakamura MA, Koyama Y, Roldan R, Torsani V, De Santis RR, Gomes S, Uchiyama A, Amato MB, Kavanagh BP, Fujino Y (2017) Volume controlled ventilation does not prevent injurious inflation during spontaneous effort. Am J Respir Crit Care Med. doi: 10.​1164/​rccm.​201610-1972OC
10.
Talmor D, Sarge T, Malhotra A, O’Donnell CR, Ritz R, Lisbon A, Novack V, Loring SH (2008) Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med 359:2095–2104CrossRefPubMedPubMedCentral
11.
Chiumello D, Cressoni M, Colombo A, Babini G, Brioni M, Crimella F, Lundin S, Stenqvist O, Gattinoni L (2014) The assessment of transpulmonary pressure in mechanically ventilated ARDS patients. Intensive Care Med 40:1670–1678CrossRefPubMed
12.
Gulati G, Novero A, Loring SH, Talmor D (2013) Pleural pressure and optimal positive end-expiratory pressure based on esophageal pressure versus chest wall elastance: incompatible results*. Crit Care Med 41:1951–1957CrossRefPubMed
13.
Goligher EC, Fan E, Herridge MS, Murray A, Vorona S, Brace D, Rittayamai N, Lanys A, Tomlinson G, Singh JM, Bolz SS, Rubenfeld GD, Kavanagh BP, Brochard LJ, Ferguson ND (2015) Evolution of diaphragm thickness during mechanical ventilation. Impact of inspiratory effort. Am J Respir Crit Care Med 192:1080–1088CrossRefPubMed
14.
Mauri T, Langer T, Zanella A, Grasselli G, Pesenti A (2016) Extremely high transpulmonary pressure in a spontaneously breathing patient with early severe ARDS on ECMO. Intensive Care Med 42:2101–2103CrossRefPubMed
15.
Yoshida T, Uchiyama A, Matsuura N, Mashimo T, Fujino Y (2013) The comparison of spontaneous breathing and muscle paralysis in two different severities of experimental lung injury. Crit Care Med 41:536–545CrossRefPubMed
16.
Baedorf Kassis E, Loring SH, Talmor D (2016) Mortality and pulmonary mechanics in relation to respiratory system and transpulmonary driving pressures in ARDS. Intensive Care Med 42:1206–1213CrossRefPubMed
17.
Beda A, Guldner A, Carvalho AR, Zin WA, Carvalho NC, Huhle R, Giannella-Neto A, Koch T, de Abreu MG (2014) Liquid- and air-filled catheters without balloon as an alternative to the air-filled balloon catheter for measurement of esophageal pressure. PLoS One 9:e103057CrossRefPubMedPubMedCentral
Metadata
Title
Ten tips to facilitate understanding and clinical use of esophageal pressure manometry
Authors
Takeshi Yoshida
Laurent Brochard
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 2/2018
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-017-4906-x

Other articles of this Issue 2/2018

Intensive Care Medicine 2/2018 Go to the issue

Focus Editorial

Focus on paediatrics: 2017

Letter

Lack of concordance between ECDC and CDC systems for surveillance of ventilator associated pneumonia

Letter

Early oseltamivir therapy improves the outcome in critically ill patients with influenza: a propensity analysis

Imaging in Intensive Care Medicine

When acrocyanosis in intensive care unit is not due to vasopressor support

Conference Reports and Expert Panel

Antimicrobial resistance and antibiotic stewardship programs in the ICU: insistence and persistence in the fight against resistance. A position statement from ESICM/ESCMID/WAAAR round table on multi-drug resistance

Letter

Potential role of IgM-enriched immunoglobulin as adjuvant treatment for invasive meningococcal disease