Introduction Transpulmonary(PTP), and not airway (PAW), pressure is the force really acting on the lung, even during mechanical ventilation[1]. PTP can be measured at the bedside using two different methods. One (method A) requires the removal of any externally applied Positive End Expiratory Pressure (PEEP) [2], while the other one does not (method B) [3]. Aim To compare two methods for measuring PTPat the bedside in the presence of externally applied PEEP. Methods Three piglets with Acute Respiratory Distress Syndrome (ARDS) were ventilated with Tidal Volume (TV) 10 ml/Kg. In each animal PEEP was set at 5, 10 and 15 cmH2O, according to a random order. During each study period, PAW and esophageal pressure (PES) were recorded at end-expiration (PAW PEEP, PES PEEP), at end-inspiration (PAW PLAT, PES PLAT) and after lungs were allowed to deflate down to functional residual capacity (PAW ZEEP, PES ZEEP). PTP was computed as (PAW PLAT – PAW ZEEP [0 cmH2O]) – (PES PLAT – PES ZEEP) (method A) or PAW PLATx ΔPTP/ΔPAW (method B), with delta (Δ) indicating the increase in PTP or PAW associated with TV inflation. Figure. Bland & Altman plot. The X axis shows the mean of the two measurements and the Y axis the difference between PTP method A and method B.

How to measure transpulmonary pressure at the bedside : comparison between two methods / M. Milesi, A. Protti, G.E. Iapichino, M. Monti, D.T. Andreis, P. Pugni, G. Conte, L. Gattinoni. ((Intervento presentato al 24. convegno SMART : Simposio Mostra Anestesia Rianimazione e Terapia Intensiva tenutosi a Milano nel 2013.

How to measure transpulmonary pressure at the bedside : comparison between two methods

A. Protti;G.E. Iapichino;D.T. Andreis;L. Gattinoni
2013

Abstract

Introduction Transpulmonary(PTP), and not airway (PAW), pressure is the force really acting on the lung, even during mechanical ventilation[1]. PTP can be measured at the bedside using two different methods. One (method A) requires the removal of any externally applied Positive End Expiratory Pressure (PEEP) [2], while the other one does not (method B) [3]. Aim To compare two methods for measuring PTPat the bedside in the presence of externally applied PEEP. Methods Three piglets with Acute Respiratory Distress Syndrome (ARDS) were ventilated with Tidal Volume (TV) 10 ml/Kg. In each animal PEEP was set at 5, 10 and 15 cmH2O, according to a random order. During each study period, PAW and esophageal pressure (PES) were recorded at end-expiration (PAW PEEP, PES PEEP), at end-inspiration (PAW PLAT, PES PLAT) and after lungs were allowed to deflate down to functional residual capacity (PAW ZEEP, PES ZEEP). PTP was computed as (PAW PLAT – PAW ZEEP [0 cmH2O]) – (PES PLAT – PES ZEEP) (method A) or PAW PLATx ΔPTP/ΔPAW (method B), with delta (Δ) indicating the increase in PTP or PAW associated with TV inflation. Figure. Bland & Altman plot. The X axis shows the mean of the two measurements and the Y axis the difference between PTP method A and method B.
8-mag-2013
Settore MED/41 - Anestesiologia
Settore MED/21 - Chirurgia Toracica
How to measure transpulmonary pressure at the bedside : comparison between two methods / M. Milesi, A. Protti, G.E. Iapichino, M. Monti, D.T. Andreis, P. Pugni, G. Conte, L. Gattinoni. ((Intervento presentato al 24. convegno SMART : Simposio Mostra Anestesia Rianimazione e Terapia Intensiva tenutosi a Milano nel 2013.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/219814
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