Understanding cardiopulmonary interactions through esophageal pressure monitoring

Autor: Elena Spinelli, Gaetano Scaramuzzo, Douglas Slobod, Tommaso Mauri
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Physiology, Vol 14 (2023)
Druh dokumentu: article
ISSN: 1664-042X
DOI: 10.3389/fphys.2023.1221829
Popis: Esophageal pressure is the closest estimate of pleural pressure. Changes in esophageal pressure reflect changes in intrathoracic pressure and affect transpulmonary pressure, both of which have multiple effects on right and left ventricular performance. During passive breathing, increasing esophageal pressure is associated with lower venous return and higher right ventricular afterload and lower left ventricular afterload and oxygen consumption. In spontaneously breathing patients, negative pleural pressure swings increase venous return, while right heart afterload increases as in passive conditions; for the left ventricle, end-diastolic pressure is increased potentially favoring lung edema. Esophageal pressure monitoring represents a simple bedside method to estimate changes in pleural pressure and can advance our understanding of the cardiovascular performance of critically ill patients undergoing passive or assisted ventilation and guide physiologically personalized treatments.
Databáze: Directory of Open Access Journals