The monitoring of esophageal pressure and its application in positive end expiratory pressure titration / 中华实用儿科临床杂志

ABSTRACT

Esophageal pressure(Pes)is usually measured via a catheter with an air - filled thin - walled latex balloon inserted nasally or orally. To validate Pes measurement,a dynamic occlusion test measures the ratio of change in Pes to change in Paw during inspiratory efforts against a closed airway. This report summarizes current physiological and technical knowledge on esophageal pressure measurements in patients receiving mechanical ventilation. The respiratory changes in Pes are representative of changes in pleural pressure. The difference between airway pressure(Paw)and Pes is a valid estimate of transpulmonary pressure. Because of the nonuniformity of lesion of pulmonary in patient with acute respiratory distress syndrome,Paw and volume can not represent the stress to expand the pulmonary. How to adjust posi-tive end expiratory pressure(PEEP)is still lack of gold standard. The use of Pes for PEEP titration may help improve oxygenation and compliance,or even has the possibility to improve the patient outcome.