Mechanical ventilation guided by esophageal pressure in acute lung injury.
A ventilator strategy using esophageal pressures to estimate the transpulmonary pressure significantly improves oxygenation and compliance and Multicenter clinical trials are needed to determine whether this approach should be widely adopted.
Tracheal collapsibility in healthy volunteers during forced expiration: assessment with multidetector CT.
- P. Boiselle, C. O'donnell, S. Loring
- 1 July 2009
Healthy volunteers demonstrate a wide range of forced expiratory tracheal collapse, frequently exceeding the current diagnostic criterion for tracheomalacia.
Respiratory restriction and elevated pleural and esophageal pressures in morbid obesity.
- Negin Behazin, Stephanie B. Jones, R. Cohen, S. Loring
- Medicine, BiologyJournal of applied physiology
It is concluded that many severely obese supine subjects at relaxation volume have positive P(pl) throughout the chest, which suggests high P(Pl) in such individuals.
Esophageal and transpulmonary pressures in acute respiratory failure*
In patients in acute respiratory failure, elevated esophageal pressures suggest that chest wall mechanical properties often contribute substantially and unpredictably to total respiratory impedance, and therefore Pao may not adequately predict PL or lung distention.
Esophageal pressures in acute lung injury: do they represent artifact or useful information about transpulmonary pressure, chest wall mechanics, and lung stress?
- S. Loring, C. O'donnell, D. Talmor
- MedicineJournal of applied physiology
- 1 March 2010
It is suggested that Pes can be used to estimate transpulmonary pressures that are consistent with known physiology and can provide meaningful information, otherwise unavailable, in critically ill patients.
Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives
- T. Mauri, Takeshi Yoshida, the PLeUral pressure working Group
- MedicineIntensive Care Medicine
- 22 June 2016
Pes monitoring provides unique bedside measures for a better understanding of the pathophysiology of acute respiratory failure patients and including Pes monitoring in the intensivist's clinical armamentarium may enhance treatment to improve clinical outcomes.
A simple and reliable method to calibrate respiratory magnetometers and Respitrace.
- R. Banzett, S. Mahan, D. M. Garner, A. Brughera, S. Loring
- MedicineJournal of applied physiology
- 1 December 1995
In 11 subjects, calibration with standard ratios was as accurate as the isovolume and linear regression techniques, and accuracy during normal breathing was nearly always within 10% (median 2%), but occasional large errors occurred with both instruments.
Effect of Titrating Positive End-Expiratory Pressure (PEEP) With an Esophageal Pressure–Guided Strategy vs an Empirical High PEEP-FIO2 Strategy on Death and Days Free From Mechanical Ventilation…
- J. Beitler, T. Sarge, D. Talmor
- 5 March 2019
Among patients with moderate to severe ARDS, PES-guided PEEP, compared with empirical high PEEP-FIO2, resulted in no significant difference in death and days free from mechanical ventilation, and these findings do not support PES's guided PEEP titration in ARDS.
Prone positioning reduces mortality from acute respiratory distress syndrome in the low tidal volume era: a meta-analysis
- J. Beitler, S. Shaefi, A. Malhotra
- Medicine, BiologyIntensive Care Medicine
- 17 January 2014
Prone positioning is associated with significantly reduced mortality from ARDS in the low tidal volume era and substantial heterogeneity across studies can be explained by differences in tidal volume.
The application of esophageal pressure measurement in patients with respiratory failure.
- E. Akoumianaki, S. Maggiore, L. Brochard
- MedicineAmerican Journal of Respiratory and Critical Care…
- 1 March 2014
The time is now right to apply the knowledge obtained with Pes to improve the management of critically ill and ventilator-dependent patients, as Pes measurements have enhanced the understanding of the pathophysiology of acute lung injury, patient-ventilator interaction, and weaning failure.