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Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment
BACKGROUND: Esophageal pressure, used as a surrogate for pleural pressure, is commonly measured by air-filled balloon, and the accuracy of measurement depends on the proper balloon volume. It has been found that larger filling volume is required at higher surrounding pressure. In the present study,...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540740/ https://www.ncbi.nlm.nih.gov/pubmed/28770541 http://dx.doi.org/10.1186/s40635-017-0148-z |
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author | Yang, Yan-Lin He, Xuan Sun, Xiu-Mei Chen, Han Shi, Zhong-Hua Xu, Ming Chen, Guang-Qiang Zhou, Jian-Xin |
author_facet | Yang, Yan-Lin He, Xuan Sun, Xiu-Mei Chen, Han Shi, Zhong-Hua Xu, Ming Chen, Guang-Qiang Zhou, Jian-Xin |
author_sort | Yang, Yan-Lin |
collection | PubMed |
description | BACKGROUND: Esophageal pressure, used as a surrogate for pleural pressure, is commonly measured by air-filled balloon, and the accuracy of measurement depends on the proper balloon volume. It has been found that larger filling volume is required at higher surrounding pressure. In the present study, we determined the balloon pressure-volume relationship in a bench model simulating the pleural cavity during controlled ventilation. The aim was to confirm whether an optimal balloon volume range existed that could provide accurate measurement at both end-expiration and end-inspiration. METHODS: We investigated three esophageal balloons with different dimensions and materials: Cooper, SmartCath-G, and Microtek catheters. The balloon was introduced into a glass chamber simulating the pleural cavity and volume-controlled ventilation was initiated. The ventilator was set to obtain respective chamber pressures of 5 and 20 cmH(2)O during end-expiratory and end-inspiratory occlusion. Balloon was progressively inflated, and balloon pressure and chamber pressure were measured. Balloon transmural pressure was defined as the difference between balloon and chamber pressure. The balloon pressure-volume curve was fitted by sigmoid regression, and the minimal and maximal balloon volume accurately reflecting the surrounding pressure was estimated using the lower and upper inflection point of the fitted sigmoid curve. Balloon volumes at end-expiratory and end-inspiratory occlusion were explored, and the balloon volume range that provided accurate measurement at both phases was defined as the optimal filling volume. RESULTS: Sigmoid regression of the balloon pressure-volume curve was justified by the dimensionless variable fitting and residual distribution analysis. All balloon transmural pressures were within ±1.0 cmH(2)O at the minimal and maximal balloon volumes. The minimal and maximal balloon volumes during end-inspiratory occlusion were significantly larger than those during end-expiratory occlusion, except for the minimal volume in Cooper catheter. Mean (±standard deviation) of optimal filling volume both suitable for end-expiratory and end-inspiratory measurement ranged 0.7 ± 0.0 to 1.7 ± 0.2 ml in Cooper, 1.9 ± 0.2 to 3.6 ± 0.3 ml in SmartCath-G, and 2.2 ± 0.2 to 4.6 ± 0.1 ml in Microtek catheter. CONCLUSIONS: In each of the tested balloon, an optimal filling volume range was found that provided accurate measurement during both end-expiratory and end-inspiratory occlusion. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40635-017-0148-z) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5540740 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-55407402017-08-18 Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment Yang, Yan-Lin He, Xuan Sun, Xiu-Mei Chen, Han Shi, Zhong-Hua Xu, Ming Chen, Guang-Qiang Zhou, Jian-Xin Intensive Care Med Exp Research BACKGROUND: Esophageal pressure, used as a surrogate for pleural pressure, is commonly measured by air-filled balloon, and the accuracy of measurement depends on the proper balloon volume. It has been found that larger filling volume is required at higher surrounding pressure. In the present study, we determined the balloon pressure-volume relationship in a bench model simulating the pleural cavity during controlled ventilation. The aim was to confirm whether an optimal balloon volume range existed that could provide accurate measurement at both end-expiration and end-inspiration. METHODS: We investigated three esophageal balloons with different dimensions and materials: Cooper, SmartCath-G, and Microtek catheters. The balloon was introduced into a glass chamber simulating the pleural cavity and volume-controlled ventilation was initiated. The ventilator was set to obtain respective chamber pressures of 5 and 20 cmH(2)O during end-expiratory and end-inspiratory occlusion. Balloon was progressively inflated, and balloon pressure and chamber pressure were measured. Balloon transmural pressure was defined as the difference between balloon and chamber pressure. The balloon pressure-volume curve was fitted by sigmoid regression, and the minimal and maximal balloon volume accurately reflecting the surrounding pressure was estimated using the lower and upper inflection point of the fitted sigmoid curve. Balloon volumes at end-expiratory and end-inspiratory occlusion were explored, and the balloon volume range that provided accurate measurement at both phases was defined as the optimal filling volume. RESULTS: Sigmoid regression of the balloon pressure-volume curve was justified by the dimensionless variable fitting and residual distribution analysis. All balloon transmural pressures were within ±1.0 cmH(2)O at the minimal and maximal balloon volumes. The minimal and maximal balloon volumes during end-inspiratory occlusion were significantly larger than those during end-expiratory occlusion, except for the minimal volume in Cooper catheter. Mean (±standard deviation) of optimal filling volume both suitable for end-expiratory and end-inspiratory measurement ranged 0.7 ± 0.0 to 1.7 ± 0.2 ml in Cooper, 1.9 ± 0.2 to 3.6 ± 0.3 ml in SmartCath-G, and 2.2 ± 0.2 to 4.6 ± 0.1 ml in Microtek catheter. CONCLUSIONS: In each of the tested balloon, an optimal filling volume range was found that provided accurate measurement during both end-expiratory and end-inspiratory occlusion. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40635-017-0148-z) contains supplementary material, which is available to authorized users. Springer International Publishing 2017-08-02 /pmc/articles/PMC5540740/ /pubmed/28770541 http://dx.doi.org/10.1186/s40635-017-0148-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Research Yang, Yan-Lin He, Xuan Sun, Xiu-Mei Chen, Han Shi, Zhong-Hua Xu, Ming Chen, Guang-Qiang Zhou, Jian-Xin Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment |
title | Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment |
title_full | Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment |
title_fullStr | Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment |
title_full_unstemmed | Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment |
title_short | Optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment |
title_sort | optimal esophageal balloon volume for accurate estimation of pleural pressure at end-expiration and end-inspiration: an in vitro bench experiment |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540740/ https://www.ncbi.nlm.nih.gov/pubmed/28770541 http://dx.doi.org/10.1186/s40635-017-0148-z |
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