ArticleAnnals of intensive care2016
The occlusion tests and end-expiratory esophageal pressure: measurements and comparison in controlled and assisted ventilation.
Article in Annals of intensive care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 34 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Noninvasive Assessment of Inspiratory Effort and Tidal Distension During Noninvasive Ventilation. The INSPIRE Study.
Analysis of Advanced Physiological Ventilatory Parameters During Spontaneous Breathing Effort in Patients with Acute Hypoxemic Respiratory Failure
Who cites it
34 citing papers in PubMed.
- Peep titration based on the open lung approach during one lung ventilation in thoracic surgery: a physiological study.BMC anesthesiology · 2018Trial
- Esophageal pressures in supine and prone position: evaluation using high-resolution manometry.Journal of clinical monitoring and computing · 2026Article
- Dissociation between airway and transpulmonary pressures during external chest wall restriction: a prospective self-controlled physiological study.Journal of thoracic disease · 2026Article
- Impact of Baydur ratio correction on the reliability of esophageal pressure measurement.Journal of applied physiology (Bethesda, Md. : 1985) · 2026Article
- The P0.1 maneuver as an alternative method for assessing the validity of esophageal pressure measurements during assisted ventilation: an exploratory analysis.Intensive care medicine experimental · 2026Article
- CPAP and high-flow nasal oxygen also reduce lung, diaphragm, and accessory muscle injury in experimental self-inflicted lung injury.Scientific reports · 2026Article
- The invasive and non-invasive monitoring of inspiratory effort and drive during assisted mechanical ventilation.Annals of intensive care · 2026Review
- Evaluation of indexing pulse pressure variation during low tidal ventilation : An experimental pilot study.Die Anaesthesiologie · 2025Article
- Erroneous calibration of esophageal pressure in case of airway closure.Critical care (London, England) · 2025Article
- Comparison of airway pressure release ventilation (APRV) versus biphasic positive airway pressure (BIPAP) ventilation in COVID-19 associated ARDS using transpulmonary pressure monitoring.BMC anesthesiology · 2025Article
- Reverse triggering in patients with acute brain injury undergoing controlled ventilation.Journal of thoracic disease · 2024Article
- Stress-strain curve and elastic behavior of the fibrotic lung with usual interstitial pneumonia pattern during protective mechanical ventilation.Scientific reports · 2024Article
- Transpulmonary pressure monitoring in critically ill patients: pros and cons.Critical care (London, England) · 2024Review
- Phenotypes of esophageal pressure response to the change of positive end-expiratory pressure in patients with moderate acute respiratory distress syndrome.Journal of thoracic disease · 2024Article
- Physiological effects of lung-protective ventilation in patients with lung fibrosis and usual interstitial pneumonia pattern versus primary ARDS: a matched-control study.Critical care (London, England) · 2023Article
- Ineffective Effort in Patients With Acute Brain Injury Undergoing Invasive Mechanical Ventilation.Respiratory care · 2023Article
- Esophageal Pressure Measurement: A Primer.Respiratory care · 2023Article
- Machine learning predicts lung recruitment in acute respiratory distress syndrome using single lung CT scan.Annals of intensive care · 2023Article
- Assessment of Inspiratory Effort in Spontaneously Breathing COVID-19 ARDS Patients Undergoing Helmet CPAP: A Comparison between Esophageal, Transdiaphragmatic and Central Venous Pressure Swing.Diagnostics (Basel, Switzerland) · 2023Article
- Central venous pressure swing outperforms diaphragm ultrasound as a measure of inspiratory effort during pressure support ventilation in COVID-19 patients.Journal of clinical monitoring and computing · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEsophageal pressure is used as a reliable surrogate of the pleural pressure. It is conventionally measured by an esophageal balloon placed in the lower part of the esophagus. To validate the correct position of the balloon, a positive pressure occlusion test by compressing the thorax during an end-expiratory pause or a Baydur test obtained by occluding the airway during an inspiratory effort is used. An acceptable catheter position is defined when the ratio between the changes in esophageal and airway pressure (∆Pes/∆Paw) is close to unity. Sedation and paralysis could affect the accuracy of esophageal pressure measurements. The aim of this study was to evaluate, in mechanically ventilated patients, the effects of paralysis, two different esophageal balloon positions and two PEEP levels on the ∆Pes/∆Paw ratio measured by the positive pressure occlusion and the Baydur tests and on the end-expiratory esophageal pressure and respiratory mechanics (lung and chest wall).
methodsTwenty-one intubated and mechanically ventilated patients (mean age 64.8 ± 14.0 years, body mass index 24.2 ± 4.3 kg/m(2), PaO2/FiO2 319.4 ± 117.3 mmHg) were enrolled. In step 1, patients were sedated and paralyzed during volume-controlled ventilation, and in step 2, they were only sedated during pressure support ventilation. In each step, two esophageal balloon positions (middle and low, between 25-30 cm and 40-45 cm from the mouth) and two levels of PEEP (0 and 10 cmH2O) were applied. The ∆Pes/∆Paw ratio and end-expiratory esophageal pressure were evaluated.
resultsThe ∆Pes/∆Paw ratio was slightly higher (+0.11) with positive occlusion test compared with Baydur's test. The level of PEEP and the esophageal balloon position did not affect this ratio. The ∆Pes and ∆Paw were significantly related to a correlation coefficient of r = 0.984 during the Baydur test and r = 0.909 in the positive occlusion test. End-expiratory esophageal pressure was significantly higher in sedated and paralyzed patients compared with sedated patients (+2.47 cmH2O) and when esophageal balloon was positioned in the low position (+2.26 cmH2O). The esophageal balloon position slightly influenced the lung elastance, while the PEEP reduced the chest wall elastance without affecting the lung and total respiratory system elastance.
conclusionsParalysis and balloon position did not clinically affect the measurement of the ∆Pes/∆Paw ratio, while they significantly increased the end-expiratory esophageal pressure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.