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. 2023 Nov;68(11):1561-1564.
doi: 10.4187/respcare.10718. Epub 2023 May 30.

A New Dynamic Slow-Flow Esophageal Balloon Pressure-Volume Curve Calibration Method to Assess Transpulmonary Pressure Monitoring

Arnaud Mari  1 , Jérôme Cartailler  2 , Nicolas Barbarot  3 , François Legay  3 , Arthur Tinelli  3 , Jona Joachim  2 , Fabrice Vallée  2
Affiliations

A New Dynamic Slow-Flow Esophageal Balloon Pressure-Volume Curve Calibration Method to Assess Transpulmonary Pressure Monitoring

Arnaud Mari et al. Respir Care. 2023 Nov.
No abstract available

Keywords: esophageal air-filled catheter calibration; esophageal pressure; transpulmonary pressure monitoring.

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Conflict of interest statement

The authors have disclosed no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Synopsis of experimental protocol. Fig 1A: Set-up of experimental protocol for high-resolution dynamic esophageal balloon pressure-volume (PV) curve. Esophageal balloon was filled with air with a piloted syringe (filling balloon at rate of 100 mL/h, ie, 1.67 mL/min). Fig 1B: Air-filled esophageal balloon PV curve built with a continuous slow-flow inflation sequence (and subsequent occlusion test [OT] maneuver): recording and graphical/computerized analysis. Fig 1C–D: Continuous slow-flow PV curve graphics focus on VbestXP: recording and graphical/computerized analysis. C: Volume balloon with maximal Pes tidal variation. D: Analytics of dynamic PV curve leading to an estimate of VbestXP = 1.37 mL. Fig 1E–F: Detailed description focused on OT sequence. E: Computation of OT (as ΔPes/ΔPaw ratio) at each volume step (see text for detailed description of OT sequence). F: Maximal ratio defining VbestOT (top green triangle): here VbestOT = 1.5 mL, which closely match with VbestXP (1.37 mL) estimated by our experimental method (panel D). PV = pressure-volume; Pes = esophageal pressure; esp = expiratory; Paw = airway pressure; OT = occlusion test.
Fig. 2.
Fig. 2.
Reliability of experimental data versus reference. A: Scatterplot of the VbestOT versus VbestXP relationship (dots) superimposed with its associated linear fit (dashed line). B: Scatterplot of the Pes,expOT versus Pes,expXP relationship (dots) superimposed with its associated linear fit (dashed line). C: Scatterplot of the Pes,expOT versus Pes,expV4 relationship (dots) superimposed with its associated linear fit (dashed line). Linear coefficients, intercepts, and R2 statistics are displayed for each panel. V = volume; OT = occlusion test; XP = experimental slow-flow method variables; Pes = esophageal pressure; exp = expiratory; V4 = 4 mL volume.
See this image and copyright information in PMC

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