Calculation of transpulmonary pressure by monitoring with an esophageal balloon during the total support phase of the invasive mechanical ventilation

Abstract

Transpulmonary pressure (Ptp) is the difference between the pressure in the airway (Paw) and the pleural pressure (Ppl). The measurement of the esophageal pressure (Pes), as subrogated from the pleural pressure, allows us to calculate the transpulmonary pressure differentiating the pulmonary mechanics and the chest wall mechanics. In order to do this, there are two methods, the Talmor method and the one defined by Gattinoni. Both methods provide useful information, particularly in people with acute respiratory distress syndrome (ARDS) to individualize the strategy of pulmonary protection. The objective of the following step by step is to describe the calculation of the transpulmonary pressure with both methods during the total support phase of the invasive mechanical ventilation.