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Esophageal Pressure Curve

  • Jean-Michel Arnal
Chapter
  • 1.2k Downloads

Abstract

Esophageal pressure is used to partition pressure to distend the lung and pressure to distend the chest wall. Esophageal pressure curve in passive patient shows a positive swing during insufflation. The correct position and optimal inflation of esophageal balloon are controlled on the curve. Transalveolar pressure at end inspiration and end expiration assesses the risk of stress and atelectrauma, respectively, and can be used to calculate transalveolar driving pressure. Esophageal pressure can also be used to display transpulmonary pressure-volume curve and to assess the transpulmonary pressure applied for a recruitment maneuver. In spontaneous breathing patient, esophageal pressure curve shows a negative swing during the patient inspiratory effort. Hence patient effort and patient-ventilator synchrony can be assessed.

Supplementary material

Video 7.1

Esophageal pressure passive patient (AVI 880189 kb)

Video 7.2

Positioning esophageal balloon (AVI 281112 kb)

Video 7.3

Occlusion test in passive patient (AVI 317976 kb)

Video 7.4

Inflation of esophageal balloon (AVI 518439 kb)

Video 7.5

PEEP setting according to end-expiratory PTA (AVI 529961 kb)

Video 7.6

Decremental PEEP trial according to end-expiratory PTA (AVI 221200 kb)

Video 7.7

Transpulmonary driving pressure (AVI 373274 kb)

Video 7.8

Transpulmonary PV loop non-recruiter (AVI 317975 kb)

Video 7.9

Transpulmonary PV loop recruiter (AVI 262675 kb)

Video 7.10

Transpulmonary pressure during recruitment maneuver (AVI 313367 kb)

Video 7.11

Increase in volume during recruitment maneuver (AVI 587561 kb)

Video 7.12

Reverse triggering in VC (AVI 276500 kb)

Video 7.13

Reverse triggering in PC (AVI 817978 kb)

Video 7.14

Esophageal pressure in PS (AVI 437791 kb)

Video 7.15

Esophageal pressure in NIV (AVI 1112912 kb)

Video 7.16

Occlusion test in spontaneous breathing patient (AVI 407837 kb)

Video 7.17

Ineffective inspiratory effort in NIV (AVI 447009 kb)

Video 7.18

Autotriggering in NIV (AVI 811069 kb)

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Jean-Michel Arnal
    • 1
    • 2
  1. 1.Service de Réanimation PolyvalenteHopital Sainte MusseToulonFrance
  2. 2.Applied Research and New TechnologyHamilton Medical AGBonaduzSwitzerland

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