Correct placement of the esophageal catheter and balloon is critical for ensuring accurate transpulmonary pressure monitoring (TPM).
One of the greatest challenges when mechanically ventilating patients is finding the correct setting for positive end-expiratory pressure (PEEP). This task can be made easier by using transpulmonary pressure monitoring to distinguish between the pressure in the lungs and the chest wall components.
A recent physiological study demonstrated that esophageal pressure estimates the pleural pressure at mid-thorax at all levels of PEEP. Therefore, an absolute measurement of esophageal pressure is useful for setting PEEP and monitoring transpulmonary pressure.
While mechanical ventilation has been shown to result in a rapid loss of diaphragmatic strength in animals, there is less known about the time course of basis of ventilator-induced diaphragmatic weakness in humans.
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