Erroneous calibration of esophageal pressure in case of airway closure
Rattachement africain : ca, fr, it, se. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Airway closure results in a lack of communication between proximal and distal airways unless the airway pressure (Paw) overcomes the airway opening pressure (AOP). This has been described in patients undergoing mechanical ventilation with acute respiratory distress syndrome, obesity, hydrostatic pulmonary edema and during cardiopulmonary resuscitation. In these categories of patients, esophageal pressure (Pes) can guide the personalization of mechanical ventilation and calibration of the esophageal balloon is necessary to obtain reliable Pes measurements. The impact of airway closure has never been envisaged. This study investigated the impact of airway closure on the calibration of the esophageal balloon by the ∆Paw/∆Pes following a positive pressure occlusion test during passive mechanical ventilation. The calibration test was performed in twelve human cadavers with airway closure at end-expiration at different levels of positive end-expiratory pressure (PEEP) and at end-inspiration. The ∆Paw/∆Pes measured at end-expiration and at end-inspiration were significantly different when total PEEP was lower than AOP (estimated means 0.42 [0.40; 0.44] vs. 0.95 [0.92; 0.97], P < 0.001), while this difference was not observed when total PEEP was higher than AOP (estimated means 0.99 [0.92; 1.05] vs. 0.99 [0.92; 1.06], P = 0.854). These results were corroborated by observations during esophageal balloon calibration in two patients requiring Pes monitoring for clinical management. In case of airway closure, compression of the chest is not fully transmitted to the airways. This can lead to a conspicuous underestimation of the ∆Paw/∆Pes and poor reliability of this monitoring technique when the test takes place below AOP. Our results favor a positive pressure occlusion test performed during an end-inspiratory occlusion as the new standard of operative procedures for positioning and calibrating the esophageal balloon.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Erroneous calibration of esophageal pressure in case of airway closure
- Date Crossref
- 02/05/2025
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Toronto Interdepartmental Division of Critical Care Medicine pays non établi dans la noticeUniversité ou école supérieure
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Unity Health Toronto pays non établi dans la noticeÉtablissement de santé
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Université d'Angers pays non établi dans la noticeUniversité ou école supérieure
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Air Liquide (France) pays non établi dans la noticeEntreprise
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McMaster University Department of Anesthesia pays non établi dans la noticeUniversité ou école supérieure
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University of Milano-Bicocca pays non établi dans la noticeUniversité ou école supérieure
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University of Manitoba pays non établi dans la noticeUniversité ou école supérieure
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Azienda Ospedaliera San Gerardo pays non établi dans la noticeÉtablissement de santé
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Istituti di Ricovero e Cura a Carattere Scientifico pays non établi dans la noticeÉtablissement de santé
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Muscular Dystrophy Canada pays non établi dans la noticeOrganisation à but non lucratif
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Health Solutions (Sweden) pays non établi dans la noticeEntreprise
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Li Ka Shing Knowledge Institute Keenan Centre for Biomedical Research pays non établi dans la noticeStructure de recherche
Interdepartmental Division of Critical Care Medicine — University of Toronto, Unity Health Toronto et Université d'Angers, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.