Dataset Information

Estimation of change in pleural pressure in assisted and unassisted spontaneous breathing pediatric patients using fluctuation of central venous pressure: A preliminary study.

ABSTRACT:

Background

It is important to evaluate the size of respiratory effort to prevent patient self-inflicted lung injury and ventilator-induced diaphragmatic dysfunction. Esophageal pressure (Pes) measurement is the gold standard for estimating respiratory effort, but it is complicated by technical issues. We previously reported that a change in pleural pressure (?Ppl) could be estimated without measuring Pes using change in CVP (?CVP) that has been adjusted with a simple correction among mechanically ventilated, paralyzed pediatric patients. This study aimed to determine whether our method can be used to estimate ?Ppl in assisted and unassisted spontaneous breathing patients during mechanical ventilation.

Methods

The study included hemodynamically stable children (aged <18 years) who were mechanically ventilated, had spontaneous breathing, and had a central venous catheter and esophageal balloon catheter in place. We measured the change in Pes (?Pes), ?CVP, and ?Ppl that was calculated using a corrected ?CVP (c?CVP-derived ?Ppl) under three pressure support levels (10, 5, and 0 cmH2O). The c?CVP-derived ?Ppl value was calculated as follows: c?CVP-derived ?Ppl = k × ?CVP, where k was the ratio of the change in airway pressure (?Paw) to the ?CVP during airway occlusion test.

Results

Of the 14 patients enrolled in the study, 6 were excluded because correct positioning of the esophageal balloon could not be confirmed, leaving eight patients for analysis (mean age, 4.8 months). Three variables that reflected ?Ppl (?Pes, ?CVP, and c?CVP-derived ?Ppl) were measured and yielded the following results: -6.7 ± 4.8, - -2.6 ± 1.4, and - -7.3 ± 4.5 cmH2O, respectively. The repeated measures correlation between c?CVP-derived ?Ppl and ?Pes showed that c?CVP-derived ?Ppl had good correlation with ?Pes (r = 0.84, p< 0.0001).

Conclusions

?Ppl can be estimated reasonably accurately by ?CVP using our method in assisted and unassisted spontaneous breathing children during mechanical ventilation.

SUBMITTER: Okuda N

PROVIDER: S-EPMC7920368 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Estimation of change in pleural pressure in assisted and unassisted spontaneous breathing pediatric patients using fluctuation of central venous pressure: A preliminary study.

Okuda Nao N Kyogoku Miyako M Inata Yu Y Isaka Kanako K Moon Kazue K Hatachi Takeshi T Shimizu Yoshiyuki Y Takeuchi Muneyuki M

PloS one 20210301 3

<h4>Background</h4>It is important to evaluate the size of respiratory effort to prevent patient self-inflicted lung injury and ventilator-induced diaphragmatic dysfunction. Esophageal pressure (Pes) measurement is the gold standard for estimating respiratory effort, but it is complicated by technical issues. We previously reported that a change in pleural pressure (ΔPpl) could be estimated without measuring Pes using change in CVP (ΔCVP) that has been adjusted with a simple correction among mec ...[more]

PMID: 33647041

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Dataset Information

Estimation of change in pleural pressure in assisted and unassisted spontaneous breathing pediatric patients using fluctuation of central venous pressure: A preliminary study.

Background

Methods

Results

Conclusions

Publications

Estimation of change in pleural pressure in assisted and unassisted spontaneous breathing pediatric patients using fluctuation of central venous pressure: A preliminary study.

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