Mechanical Ventilation Clinical Trial
Official title:
A Simple Method for Confirming the Optimal Position of Esophageal Balloon in Patients With Mechanical Ventilation
Transpulmonary pressure is frequently monitored in patients with mechanical ventilation. Right position of the catheter balloon is the key factor in accurate measurement. A simple method for confirming the balloon position will be validate in this study.
Transpulmonary pressure, which is the pressure at the airway opening minus pleural pressure,
is frequently monitored in patients with mechanical ventilation. Because pleural pressure is
difficult to measure in most clinical situations, esophageal pressure (Pes) is used as a
surrogate. Catheter with air balloon is the most commonly used method to measure the Pes.
Right position of the balloon is the key factor in accurate measurement of Pes, and the
lower third part of esophagus is recommended as the target position of the balloon. The
catheter is usually inserted into the stomach first, and then slowly withdrawn into the
esophagus after inflation of the balloon. A negative pressure deflection replacing the
positive pressure deflection during inspiration generally indicates the balloon's entering
into the esophagus. This confirmation method depends on the normal function of diaphragm.
However, it may not always be possible to obtain the standard pressure deflections in
patients with mechanical ventilation, especially in those with diaphragmatic paralysis.
In present study, the investigators developed a simple method to confirm the balloon
position by using a modified SmartcathG esophageal balloon catheter. The objective was to
evaluate the validity of this method and to investigate the relationship between the cardiac
artifacts of the Pes tracings and the position of the balloon.
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Observational Model: Case-Only, Time Perspective: Prospective
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