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Esophageal pressure: benefit and limitations
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
2012 (English)In: Minerva Anestesiologica, ISSN 0375-9393, E-ISSN 1827-1596, Vol. 78, no 8, 959-966 p.Article in journal (Refereed) Published
Abstract [en]

The recording of esophageal pressure (Pes) in supine position as a Substitute for pleural pressure is difficult and fraught with potential errors. Pes is affected by the: 1) elastance and weight of the lung; 2) elastance and weight of the rib cage; 3) weight of the mediastinal organs; 4) elastance and weight of the diaphragm and abdomen; 5) elastance of the esophageal wall; and 6) elastance of the esophageal balloon (if filled with too much air). If the purpose is to measure lung compliance in the intensive care patient, reasonably useful information might be obtained by measuring airway pressure alone, considering chest wall compliance to be a weight that is forced away by the ventilation. Such weight requires a constant pressure for displacement. The transpulmonary pressure, whether calculated with Pes or by another measure of abdominal pressure, may guide in PEEP titration. It may also enable calculation of stresses applied to the lung and these may be more important in guiding an optimal ventilator setting than an optimum compliance or oxygenation of blood. Diaphragm function can be estimated by esophageal minus gastric pressure and with even more precision, when combined with diaphragm electromyography. (Minerva Anestesiol 2012;78:959-66)

Place, publisher, year, edition, pages
2012. Vol. 78, no 8, 959-966 p.
Keyword [en]
Esophagus, Pressure, Respiratory system
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-183909ISI: 000309080200013PubMedID: 22699701OAI: oai:DiVA.org:uu-183909DiVA: diva2:565369
Available from: 2012-11-07 Created: 2012-11-05 Last updated: 2017-12-07Bibliographically approved

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Hedenstierna, Göran

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