Nasal pressure swings as the measure of inspiratory effort in spontaneously breathing patients with de novo acute respiratory failure

Autor: Roberto Tonelli, Andrea Cortegiani, Alessandro Marchioni, Riccardo Fantini, Luca Tabbì, Ivana Castaniere, Emanuela Biagioni, Stefano Busani, Chiara Nani, Caterina Cerbone, Morgana Vermi, Filippo Gozzi, Giulia Bruzzi, Linda Manicardi, Maria Rosaria Pellegrino, Bianca Beghè, Massimo Girardis, Paolo Pelosi, Cesare Gregoretti, Lorenzo Ball, Enrico Clini
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Critical Care, Vol 26, Iss 1, Pp 1-9 (2022)
Druh dokumentu: article
ISSN: 1364-8535
DOI: 10.1186/s13054-022-03938-w
Popis: Abstract Background Excessive inspiratory effort could translate into self-inflicted lung injury, thus worsening clinical outcomes of spontaneously breathing patients with acute respiratory failure (ARF). Although esophageal manometry is a reliable method to estimate the magnitude of inspiratory effort, procedural issues significantly limit its use in daily clinical practice. The aim of this study is to describe the correlation between esophageal pressure swings (ΔP es) and nasal (ΔP nos) as a potential measure of inspiratory effort in spontaneously breathing patients with de novo ARF. Methods From January 1, 2021, to September 1, 2021, 61 consecutive patients with ARF (83.6% related to COVID-19) admitted to the Respiratory Intensive Care Unit (RICU) of the University Hospital of Modena (Italy) and candidate to escalation of non-invasive respiratory support (NRS) were enrolled. Clinical features and tidal changes in esophageal and nasal pressure were recorded on admission and 24 h after starting NRS. Correlation between ΔP es and ΔP nos served as primary outcome. The effect of ΔP nos measurements on respiratory rate and ΔP es was also assessed. Results ΔP es and ΔP nos were strongly correlated at admission (R 2 = 0.88, p
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