Ventilator management using esophageal balloon pressure measurements

Mechanical ventilation provides essential support for patients with acute respiratory failure and time these to recover from the primary disorder. Ventilator strategies need provide adequate oxygenation avoid barotrauma. This trauma develops when some regions of lungs are overinflated underinflated have cyclical opening closing during cycle. The ARDS network trial demonstrated that a low tidal volume pressure strategy improved outcomes. Subsequent trials tried determine optimal PEEP level in moderate severe ARDS. use esophageal balloons information about transpulmonary at end inspiration expiration. However, available studies date do not demonstrate definite improvement outcomes ventilator adjustments based on pressures. Beitler et al. randomized 200 into one group which titration was balloon measurements, second high FiO2/PEEP table studied earlier trials. There were no differences mortality between two groups. Reanalysis this after completed suggested pressures range -2 + 2 cm H2O expiration associated compared outside range.