Abstract
Esophageal pressure (Pes) is the closest surrogate for pleural pressure available in clinical practice. Pes closely reflects absolute values of pleural pressure in the dependent lung region and accurately tracks changes in pleural pressure due to ventilation.
Pes is useful to assess transpulmonary pressure and the risk of ventilator-induced lung injury. End-expiratory Pes could guide personalized positive end-expiratory pressure settings, while driving and end-inspiratory transpulmonary pressure measured with the elastance ratio method could help in avoiding overdistension.
In active patients, Pes swings are closely correlated with the respiratory effort, which is useful to avoid over and under assistance and the related risk of patient self-inflicted lung injury and diaphragm myotrauma.
Finally, patient-ventilator asynchronies are major determinants of patients’ outcome and can be more easily and precisely diagnosed and quantified when Pes monitoring is in place.
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NC, FDC, and TM conceived and drafted the text; all authors approved the final draft of the report.
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Corcione, N., Corte, F.D., Mauri, T. (2021). Measurement of Pleural Pressure. In: Magder, S., Malhotra, A., Hibbert, K.A., Hardin, C.C. (eds) Cardiopulmonary Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-030-73387-2_33
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