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Oesophageal balloon calibration during pressure support ventilation: a proof of concept study.
Cammarota, Gianmaria; Verdina, Federico; Santangelo, Erminio; Lauro, Gianluigi; Boniolo, Ester; Tarquini, Riccardo; Spinelli, Elena; Zanoni, Marta; Garofalo, Eugenio; Bruni, Andrea; Pesenti, Antonio; Della Corte, Francesco; Navalesi, Paolo; Vaschetto, Rosanna; Mauri, Tommaso.
Afiliação
  • Cammarota G; Anaesthesia and General Intensive Care, "Maggiore della Carità" University Hospital, Corso Mazzini18, 28100, Novara, Italy. gmcamma@gmail.com.
  • Verdina F; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
  • Santangelo E; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
  • Lauro G; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
  • Boniolo E; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
  • Tarquini R; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
  • Spinelli E; Department of Anaesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Zanoni M; Anaesthesia and General Intensive Care, "Maggiore della Carità" University Hospital, Corso Mazzini18, 28100, Novara, Italy.
  • Garofalo E; Department of Medical and Surgical Science, Università Magna Greacia, Catanzaro, Italy.
  • Bruni A; Department of Medical and Surgical Science, Università Magna Greacia, Catanzaro, Italy.
  • Pesenti A; Department of Anaesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Della Corte F; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
  • Navalesi P; Department of Medical and Surgical Science, Università Magna Greacia, Catanzaro, Italy.
  • Vaschetto R; Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.
  • Mauri T; Department of Anaesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
J Clin Monit Comput ; 34(6): 1223-1231, 2020 Dec.
Article em En | MEDLINE | ID: mdl-31792760
Oesophageal balloon calibration improves the oesophageal pressure (Pes) assessment during invasive controlled mechanical ventilation. The primary aim of the present investigation was to ascertain the feasibility of oesophageal balloon calibration during pressure support ventilation (PSV). Secondarily, the calibrated Pes (Pescal) was compared to uncalibrated one acquired at 4 ml-filling volume (PesV4), as per manufacturer recommendation. After a naso-gastric tube equipped with oesophageal balloon was correctly positioned in 21 adult patients undergoing invasive volume-controlled ventilation (VCV) for acute hypoxemic respiratory failure, the balloon was progressively inflated, applying a series of end-inspiratory and end-expiratory holds at each filling volume during VCV and PSV. Upon optimal balloon filling volume (Vbest) was identified, Pescal was computed by correcting the Pes measured at Vbest for the oesophageal wall pressure elicited at same filling volume. Finally, end-expiratory and end-inspiratory PesV4 were recorded too. A total of 42 calibrations, 21 per ventilatory mode, were performed. Vbest was 1.9 ± 1.6 ml in VCV and 1.7 ± 1.6 ml in PSV (p = 0.5217). PesV4 was overestimated compared to Pescal at end-expiration and end-inspiration (p <0.0001 for all comparisons) in both VCV (13.4 ± 3.4 cmH2O and 15.4 ± 3 cmH2O vs. 8.5 ± 2.9 cmH2O and 11.4 ± 3 cmH2O) and PSV (14.7 ± 4.2 cmH2O and 17 ± 3.9 cmH2O vs. 8.9 ± 3.4 cmH2O and 12.4 ± 3.9 cmH2O). In PSV, oesophageal balloon calibration is feasible and allows to obtain a reliable Pes assessment compared to uncalibrated approach.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Mecânica Respiratória / Respiração com Pressão Positiva Tipo de estudo: Prognostic_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Mecânica Respiratória / Respiração com Pressão Positiva Tipo de estudo: Prognostic_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article