Esophageal and transdiaphragmatic pressure swings as indices of inspiratory effort
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Updated: Dec 6, 2025
Monitoring Lung Function with Electrical Impedance Tomography in the Intensive Care Unit
Published on: September 6, 2024
Katerina Vaporidi1, Stella Soundoulounaki1, Eleftherios Papadakis1
1Department of Intensive Care Medicine, University Hospital of Heraklion and School of Medicine, University of Crete, Greece.
Aim:
To describe the correlation between the inspiratory esophageal and transdiaphragmatic pressure swings (ΔPes and ΔPdi), easily measured indices of inspiratory effort, with the gold-standard, the transdiaphragmatic pressure time product (PTPPdi/min), and assess the accuracy of swing pressures in predicting very high or low effort.
Method:
Retrospective analysis of data from patients enrolled in four previous studies. ROC curves of ΔPes and ΔPdi values for specific PTPPdi/min thresholds (50, 150, 200 cmH2O × sec/min) were constructed, and the diagnostic accuracy of different thresholds of swing values were computed.
Results:
A threshold of inspiratory ΔP<7cmH2O can be used to identify most patients with low effort, as lower ΔP thresholds have low sensitivity. Thresholds of inspiratory ΔP>14-18cmH2O can be used to identify patients with very high inspiratory effort (PTPPdi/min> 200 cmH2O × sec/min).
Conclusions:
The results of this study can help clinicians better select and interpret thresholds of ΔP to evaluate inspiratory effort.
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