MedElevator
Войти в исследования Intensive care medicine · 2016
Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mauri Tommaso, Yoshida Takeshi, Bellani Giacomo, Goligher Ewan C, Carteaux Guillaume, Rittayamai Nuttapol, Mojoli Francesco, Chiumello Davide, Piquilloud Lise, Grasso Salvatore, Jubran Amal, Laghi Franco, Magder Sheldon, Pesenti Antonio, Loring Stephen, Gattinoni Luciano, Talmor Daniel, Blanch Lluis, Amato Marcelo, Chen Lu, Brochard Laurent, Mancebo Jordi, PLeUral pressure working Group (PLUG—Acute Respiratory Failure section of the European Society of Intensive Care Medicine)
Аннотация
PURPOSE: Esophageal pressure (Pes) is a minimally invasive advanced respiratory monitoring method with the potential to guide management of ventilation support and enhance specific diagnoses in acute respiratory failure patients. To date, the use of Pes in the clinical setting is limited, and it is often seen as a research tool only.
METHODS: This is a review of the relevant technical, physiological and clinical details that support the clinical utility of Pes.
RESULTS: After appropriately positioning of the esophageal balloon, Pes monitoring allows titration of controlled and assisted mechanical ventilation to achieve personalized protective settings and the desired level of patient effort from the acute phase through to weaning. Moreover, Pes monitoring permits accurate measurement of transmural vascular pressure and intrinsic positive end-expiratory pressure and facilitates detection of patient-ventilator asynchrony, thereby supporting specific diagnoses and interventions. Finally, some Pes-derived measures may also be obtained by monitoring electrical activity of the diaphragm.
CONCLUSIONS: Pes monitoring provides unique bedside measures for a better understanding of the pathophysiology of acute respiratory failure patients. Including Pes monitoring in the intensivist's clinical armamentarium may enhance treatment to improve clinical outcomes.
METHODS: This is a review of the relevant technical, physiological and clinical details that support the clinical utility of Pes.
RESULTS: After appropriately positioning of the esophageal balloon, Pes monitoring allows titration of controlled and assisted mechanical ventilation to achieve personalized protective settings and the desired level of patient effort from the acute phase through to weaning. Moreover, Pes monitoring permits accurate measurement of transmural vascular pressure and intrinsic positive end-expiratory pressure and facilitates detection of patient-ventilator asynchrony, thereby supporting specific diagnoses and interventions. Finally, some Pes-derived measures may also be obtained by monitoring electrical activity of the diaphragm.
CONCLUSIONS: Pes monitoring provides unique bedside measures for a better understanding of the pathophysiology of acute respiratory failure patients. Including Pes monitoring in the intensivist's clinical armamentarium may enhance treatment to improve clinical outcomes.