One of the most challenging aspects of managing mechanical ventilation is balancing the positive effects of the patient’s breathing efforts with the risk of of lung injury that may accompany strong spontaneous efforts.
Ventilator assistance should be titrated according to the individual patients’s respiratory drive, lung mechanics and pressure output of the muscles; however, it is not always easy to assess the activity of the respiratory muscle pump. Measurement of some “gold-standard” parameters can be difficult to obtain and interpret. A simple method of estimating the pressure developed by the inspiratory muscle at the end of inspiration is called the Pressure Muscle Index (PMI). In this presentation, we discuss the background, theory and application of the PMI, including targets and limitations. Click on the image to watch the presentation.
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