0000000000310218
AUTHOR
Alessandro Marchioni
Nasal pressure swings as the measure of inspiratory effort in spontaneously breathing patients with de novo acute respiratory failure.
Abstract Background Excessive inspiratory effort could translate into self-inflicted lung injury, thus worsening clinical outcomes of spontaneously breathing patients with acute respiratory failure (ARF). Although esophageal manometry is a reliable method to estimate the magnitude of inspiratory effort, procedural issues significantly limit its use in daily clinical practice. The aim of this study is to describe the correlation between esophageal pressure swings (ΔPes) and nasal (ΔPnos) as a potential measure of inspiratory effort in spontaneously breathing patients with de novo ARF. Methods From January 1, 2021, to September 1, 2021, 61 consecutive patients with ARF (83.6% related to COVID…
Accuracy of Nasal Pressure Swing to Predict Failure of High-Flow Nasal Oxygen in Patients with Acute Hypoxemic Respiratory Failure
In a real-life cohort of patients with AHRF undergoing HFNO, ΔPnose showed excellent accuracy in predicting early failure, similar of that displayed by ROX. Giving that the decision to upgrade to NIV or MV was based on clinical variables, the high accuracy of ROX in predicting failure of HFNO is not surprising. The similar accuracy of ΔPnose (the only measurement that remained blinded to our clinical decision), strengthened the association with outcome, avoiding incorporation bias.
Additional file 1 of Nasal pressure swings as the measure of inspiratory effort in spontaneously breathing patients with de novo acute respiratory failure
Additional file 1: eTable 1. Esophageal and nasal pressure swings according to acute respiratory failure etiology. Data are presented as median and interquartile ranges (IQR). eFigure 1. Pearson���s R showing correlations between ��Pes and ��Pnos at 24 hours after splitting the study population according to the NRS received. eFigure 2. Bland-Altman analysis assessing the agreement between ��Pes measured with esophageal manometry and estimated based on ��Pnos (��Pes, estimated) and computed as k����Pnos, where k is the average ratio of ��Pes to ��Pnos measured at baseline. At T2 Bland-Altman methods showed a bias of 0.1 cmH2O and 95% limits of agreement, LoA, from ���2.0 to 2.1 cmH2O (95.1% …