Understanding cardiopulmonary interactions through esophageal pressure monitoring
Esophageal pressure is the closest estimate of pleural pressure. Changes in esophageal pressure reflect changes in intrathoracic pressure and affect transpulmonary pressure, both of which have multiple effects on right and left ventricular performance. During passive breathing, increasing esophageal...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Physiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2023.1221829/full |
| _version_ | 1797777325452951552 |
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| author | Elena Spinelli Gaetano Scaramuzzo Douglas Slobod Tommaso Mauri Tommaso Mauri |
| author_facet | Elena Spinelli Gaetano Scaramuzzo Douglas Slobod Tommaso Mauri Tommaso Mauri |
| author_sort | Elena Spinelli |
| collection | DOAJ |
| description | Esophageal pressure is the closest estimate of pleural pressure. Changes in esophageal pressure reflect changes in intrathoracic pressure and affect transpulmonary pressure, both of which have multiple effects on right and left ventricular performance. During passive breathing, increasing esophageal pressure is associated with lower venous return and higher right ventricular afterload and lower left ventricular afterload and oxygen consumption. In spontaneously breathing patients, negative pleural pressure swings increase venous return, while right heart afterload increases as in passive conditions; for the left ventricle, end-diastolic pressure is increased potentially favoring lung edema. Esophageal pressure monitoring represents a simple bedside method to estimate changes in pleural pressure and can advance our understanding of the cardiovascular performance of critically ill patients undergoing passive or assisted ventilation and guide physiologically personalized treatments. |
| first_indexed | 2024-03-12T23:02:29Z |
| format | Article |
| id | doaj.art-234e0089acd44b28b0987f2d84027f3b |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-03-12T23:02:29Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-234e0089acd44b28b0987f2d84027f3b2023-07-19T07:47:24ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2023-07-011410.3389/fphys.2023.12218291221829Understanding cardiopulmonary interactions through esophageal pressure monitoringElena Spinelli0Gaetano Scaramuzzo1Douglas Slobod2Tommaso Mauri3Tommaso Mauri4Department of Anesthesia, Critical Care and Emergency, IRCCS (Institute for Treatment and Research) Ca’ Granda Maggiore Policlinico Hospital Foundation, Milan, ItalyDepartment of Translational Medicine, University of Ferrara, Ferrara, ItalyDepartment of Critical Care Medicine, McGill University, Montreal, QC, CanadaDepartment of Anesthesia, Critical Care and Emergency, IRCCS (Institute for Treatment and Research) Ca’ Granda Maggiore Policlinico Hospital Foundation, Milan, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, Milan, ItalyEsophageal pressure is the closest estimate of pleural pressure. Changes in esophageal pressure reflect changes in intrathoracic pressure and affect transpulmonary pressure, both of which have multiple effects on right and left ventricular performance. During passive breathing, increasing esophageal pressure is associated with lower venous return and higher right ventricular afterload and lower left ventricular afterload and oxygen consumption. In spontaneously breathing patients, negative pleural pressure swings increase venous return, while right heart afterload increases as in passive conditions; for the left ventricle, end-diastolic pressure is increased potentially favoring lung edema. Esophageal pressure monitoring represents a simple bedside method to estimate changes in pleural pressure and can advance our understanding of the cardiovascular performance of critically ill patients undergoing passive or assisted ventilation and guide physiologically personalized treatments.https://www.frontiersin.org/articles/10.3389/fphys.2023.1221829/fulltranspulmonary pressurehemodynamicsmechanical ventilationpleural pressureheart-lung interaction |
| spellingShingle | Elena Spinelli Gaetano Scaramuzzo Douglas Slobod Tommaso Mauri Tommaso Mauri Understanding cardiopulmonary interactions through esophageal pressure monitoring Frontiers in Physiology transpulmonary pressure hemodynamics mechanical ventilation pleural pressure heart-lung interaction |
| title | Understanding cardiopulmonary interactions through esophageal pressure monitoring |
| title_full | Understanding cardiopulmonary interactions through esophageal pressure monitoring |
| title_fullStr | Understanding cardiopulmonary interactions through esophageal pressure monitoring |
| title_full_unstemmed | Understanding cardiopulmonary interactions through esophageal pressure monitoring |
| title_short | Understanding cardiopulmonary interactions through esophageal pressure monitoring |
| title_sort | understanding cardiopulmonary interactions through esophageal pressure monitoring |
| topic | transpulmonary pressure hemodynamics mechanical ventilation pleural pressure heart-lung interaction |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2023.1221829/full |
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