Comparison of balloon and transducer catheters for estimating lung elasticity

Pleural pressure is usually estimated with a balloon catheter (BC) positioned in the middle third of the esophagus. An alternate method, which avoids potential inaccuracies associated with changes in balloon volume, is a catheter-mounted transducer (CMT) system. To assess the accuracy of a CMT system in defining the elastic properties of the lungs, we compared the static pressure-volume (PV) properties of the lungs measured sequentially with CMT and BC systems in six healthy subjects each on two occasions, relating static transpulmonary pressure (Pst,L) to lung volume during interrupted exhalations from total lung capacity (TLC). PV data were fitted with an exponential function (least-squares method), and the exponent (k) was used to define the shape of the PV curve; position was defined by Pst,L at TLC and at 90 and 60% TLC. These data were examined for agreement (paired t test) and repeatability (coefficient of repeatability). No significant differences were demonstrated: k was 0.10 +/- 0.02 and 0.11 +/- 0.03 (SD) and Pst,L at 60% TLC was 8.27 +/- 2.09 and 8.37 +/- 1.63 cmH2O for the CMT and BC systems, respectively. The coefficient of repeatability for each parameter was not significantly different but was consistently less with the BC, suggesting better repeatability. We conclude that a CMT system is an acceptable alternative to a BC system for defining the elastic properties of lungs.