Comparative analysis of novel esophageal pressure monitoring catheters versus commercially available alternatives in a biomechanical model of the thoracic cavity.

Autor: Abbate G; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Department of Anesthesia Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Colombo SM; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Department of Anesthesia Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Semenzin C; School of Engineering and Built Environment, Griffith University, Southport, Australia., Sato N; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia., Liu K; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia., Ainola C; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia., Milani A; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia., Fior G; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Department of Anesthesia Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia., Obonyo N; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Initiative to Develop African Research Leaders/KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya., White N; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia., Chiumello D; San Paolo Hospital, Milan, Italy., Pauls J; School of Engineering and Built Environment, Griffith University, Brisbane, QLD, Australia., Suen JY; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia.; School of Pharmacy and Medical Sciences, Griffith University, Southport, Australia., Fraser JF; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia.; Intensive Care Unit, St Andrew's War Memorial Hospital, Spring Hill, QLD, Australia., Li Bassi G; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia. g.libassi@uq.edu.au.; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia. g.libassi@uq.edu.au.; Intensive Care Unit, St Andrew's War Memorial Hospital, Spring Hill, QLD, Australia. g.libassi@uq.edu.au.; Intensive Care Unit, The Wesley Hospital, Auchenflower, QLD, Australia. g.libassi@uq.edu.au.; Wesley Research Institute, Auchenflower, QLD, Australia. g.libassi@uq.edu.au.; Critical Care Research Group, The Prince Charles Hospital, 627 Rode Rd, Chermside, QLD, 4032, Australia. g.libassi@uq.edu.au.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Apr 29; Vol. 14 (1), pp. 9771. Date of Electronic Publication: 2024 Apr 29.
DOI: 10.1038/s41598-024-59790-1
Abstrakt: Transpulmonary pressure can be estimated using esophageal balloon (EB) catheters, which come in a variety of manufacturing configurations. We assessed the performance of novel polyurethane EB designs, Aspisafe NG and NG+, against existing alternatives. We created a biomechanical model of the chest cavity using a plastic chamber and an ex-vivo porcine esophagus. The chamber was pressurized (- 20 and + 20 cmH 2 O) to simulate pleural pressures. We conducted tests with various EB inflation volumes and measured transesophageal pressure (TEP). TEP measurement was defined as accurate when the difference between pressure within the EB and chamber was 0 ± 1 cmH 2 O. We computed the minimal (V accuracy-min ) and maximal (V accuracy-max ) EB inflation volumes of accuracy. Inflation volumes were further validated using a surrogate method derived by the clinically validated positive pressure occlusion test (PPOT). When the esophageal balloons were filled with inflation volumes within the range provided by the manufacturers, the accuracy of TEP measurements was marginal. Our tests found median V accuracy-min across EB of 0.00-0.50 mL (p = 0.130), whereas V accuracy-max ranged 0.50-2.25 mL (p = 0.002). Post PPOT validation, median TEP was - 0.4 cmH 2 O (- 1.5 to 0.3) (p < 0.001 among catheters). The Aspisafe NG and NG+ were accurate in 81.7% and 77.8% of the measurements, respectively. We characterized two new EBs, which demonstrated good benchtop accuracy in TEP measurements. However, accuracy was notably influenced by the precise selection of EB inflation volumes.
(© 2024. The Author(s).)
Databáze: MEDLINE
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