Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives
| Autor: | Tommaso Mauri, Giacomo Bellani, Salvatore Grasso, Takeshi Yoshida, Lluis Blanch, Amal Jubran, Antonio Pesenti, Lise Piquilloud, Daniel Talmor, Luciano Gattinoni, Franco Laghi, Sheldon Magder, Guillaume Carteaux, Nuttapol Rittayamai, Lu Chen, Davide Chiumello, Jordi Mancebo, Marcelo B. P. Amato, Francesco Mojoli, Ewan C. Goligher, Laurent Brochard, Stephen H. Loring |
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| Přispěvatelé: | Mauri, T, Yoshida, T, Bellani, G, Goligher, E, 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 |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Monitoring medicine.medical_treatment Diaphragm Intensivist Socio-culturale Acute respiratory distress syndrome Acute respiratory failure Esophageal pressure Mechanical ventilation Physiologic monitoring Catheterization Esophagus Humans Monitoring Physiologic Positive-Pressure Respiration Respiration Artificial Respiratory Distress Syndrome Adult Respiratory Insufficiency Respiratory Mechanics Ventilator Weaning Respiratory monitoring Respiratory physiology Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Anesthesiology Medicine Medical diagnosis Intensive care medicine Physiologic Respiratory Distress Syndrome business.industry Medicine (all) Respiration 030208 emergency & critical care medicine 3. Good health body regions 030228 respiratory system Artificial Breathing business human activities Transpulmonary pressure |
| Popis: | Purpose: Esophageal pressure (Pes) is a minimally invasive advanced respiratory monitoring method with the potential to guide management of ventilation support and enhance specific diagnoses in acute respiratory failure patients. To date, the use of Pes in the clinical setting is limited, and it is often seen as a research tool only. Methods: This is a review of the relevant technical, physiological and clinical details that support the clinical utility of Pes. Results: After appropriately positioning of the esophageal balloon, Pes monitoring allows titration of controlled and assisted mechanical ventilation to achieve personalized protective settings and the desired level of patient effort from the acute phase through to weaning. Moreover, Pes monitoring permits accurate measurement of transmural vascular pressure and intrinsic positive end-expiratory pressure and facilitates detection of patient–ventilator asynchrony, thereby supporting specific diagnoses and interventions. Finally, some Pes-derived measures may also be obtained by monitoring electrical activity of the diaphragm. Conclusions: Pes monitoring provides unique bedside measures for a better understanding of the pathophysiology of acute respiratory failure patients. Including Pes monitoring in the intensivist’s clinical armamentarium may enhance treatment to improve clinical outcomes. |
| Databáze: | OpenAIRE |
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