Is Transpulmonary Pressure well enough understood?

Mechanical ventilation in the intensive care unit (ICU) is usually guided by arterial blood gases, and the parameters
used to maintain these blood gases are limited by standards for lung protective ventilation.1 Airway pressures and tidal
volume are minimized for lung protection despite evidence that they may be inadequate surrogates for lung stress
and strain.2 Transpulmonary pressure represents true lung pressure, and physiologically is ≥ 0 cmH2O at end-exhalation.
Transpulmonary pressure < 0 cmH2O results in a lower FRC, lower compliance, and airways are prone to collapse on exhalation.3 The respiratory therapists hypothesized that a patient admitted to St. Joseph’s Healthcare ICU from an external facility was being ventilated with insufficient positive end-expiratory pressure (PEEP), causing a negative transpulmonary pressure. Click on the following video

Randy Clare

Randy Clare

Randy Clare brings to The Sleep and Respiratory Scholar more than 25 years of extensive knowledge and experience in the sleep and pulmonary function field. He has held numerous management positions throughout his career and has demonstrated a unique view of the alternate care diagnostic and therapy model. He is considered by many an expert in the use of a Sleep Bruxism Monitor in a dental office. He is also very involved with physician office spirometry for the early detection of COPD and Asthma Mr. Clare's extensive sleep industry experience assists Sleep Scholar in providing current, relevant, data-proven information on sleep diagnostics and sleep therapies that are effective for the treatment of sleep disorders.

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