Mechanical Ventilation Clinical Trial
Official title:
Effect of Positive End-expiratory Pressure on Optimal Balloon Volume During Esophageal Pressure Monitoring in Mechanical Ventilated Patients: A Clinical Feasibility Study
Esophageal pressure (PES), which has been used as a surrogate for pleural pressure. The volume of esophageal balloon can influence the accuracy of monitoring esophageal pressure. The optimal balloon volume is directly dependent on surrounding pressure. In the present study,the investigators will observe the optimal volume of esophageal balloon during the different PEEP in bench and clinical study.
The esophageal pressure (Pes) is used as a surrogate for pleural pressure to obtain
transpulmonary pressure. Catheter with air balloon is the most commonly used method to
measure the Pes. The optimal injected volume of the balloon is the key factor in accurate
measurement of Pes. The recoil pressure of the balloon turns up while the balloon is
over-filled, resulting in over-estimation of the PES; on the other hand, an under-filled
balloon also cannot properly transmit the surrounding pressure of balloon. However, the
researchers showed the optimal balloon volumes is related to the surrounding pressure and
even is not correspond with manufacturer's recommendations. Theoretically, when balloon
transmural pressure(PTM) is zero, representing the balloon in a condition with equivalent
pressure inside and outside of the balloon, it was defined as optimal volume. However, in
clinical settings, it is difficult to determine the balloon PTM, and therefore the optimal
volume cannot be obtained, because the surrounding pressure of the balloon cannot be
conveniently measured.
In the present study, the investigators will develop a simple method to obtain the optimal
balloon volume and observe the effect of positive end-expiratory pressure on optimal balloon
volume during esophageal pressure monitoring. The investigators want to validate the accuracy
of method in the bench study and clinical feasibility in mechanical ventilated patients.
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