Rationale: Monitoring and controlling respiratory drive and effort may help to minimize lung and diaphragm injury. Airway occlusion pressure (P0.1) is a noninvasive measure of respiratory drive.Objectives: To determine 1) the validity of "ventilator" P0.1 (P0.1vent) displayed on the screen as a measure of drive, 2) the ability of P0.1 to detect potentially injurious levels of effort, and 3) how P0.1vent displayed by different ventilators compares to a "reference" P0.1 (P0.1ref) measured from airway pressure recording during an occlusion.Methods: Analysis of three studies in patients, one in healthy subjects, under assisted ventilation, and a bench study with six ventilators. P0.1vent was validated against measures of drive (electrical activity of the diaphragm and muscular pressure over time) and P0.1ref. Performance of P0.1ref and P0.1vent to detect predefined potentially injurious effort was tested using derivation and validation datasets using esophageal pressure-time product as the reference standard.Measurements and Main Results: P0.1vent correlated well with measures of drive and with the esophageal pressure-time product (within-subjects R2 = 0.8). P0.1ref >3.5 cm H2O was 80% sensitive and 77% specific for detecting high effort (≥200 cm H2O ⋅ s ⋅ min-1); P0.1ref ≤1.0 cm H2O was 100% sensitive and 92% specific for low effort (≤50 cm H2O ⋅ s ⋅ min-1). The area under the receiver operating characteristics curve for P0.1vent to detect potentially high and low effort were 0.81 and 0.92, respectively. Bench experiments showed a low mean bias for P0.1vent compared with P0.1ref for most ventilators but precision varied; in patients, precision was lower. Ventilators estimating P0.1vent without occlusions could underestimate P0.1ref.Conclusions: P0.1 is a reliable bedside tool to assess respiratory drive and detect potentially injurious inspiratory effort.

中文翻译：

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辅助通气时呼吸道驱动力和吸气量的估算值。

理由：监测和控制呼吸驱动力和努力可能有助于最大程度地减少肺和diaphragm肌损伤。气道阻塞压力（P0.1）是呼吸驱动的一种非侵入性测量。目的：确定1）屏幕上显示的“呼吸机” P0.1（P0.1vent）作为驱动测量的有效性，2）能力P0.1以检测潜在的有害努力程度，以及3）不同呼吸机显示的P0.1vent与闭塞期间气道压力记录所测量的“参考” P0.1（P0.1ref）相比如何。方法：在辅助通气下对患者进行了三项研究，在健康受试者中进行了一项研究，对六台呼吸机进行了基准研究。P0.1vent已针对驱动力（横measures膜的电活动和肌肉压力随时间变化）和P0.1ref进行了验证。P0的性能。以食管压力时间乘积为参考标准，使用派生和验证数据集对1ref和P0.1vent进行检测，以测试预定义的潜在伤害行为。测量和主要结果：P0.1vent与驱动力测量值和食管压力时间密切相关乘积（对象内R2 = 0.8）。P0.1ref> 3.5 cm H2O对于检测高强度气体（≥200cm H2O s s min-1）敏感度为80％，特异性为77％；P0.1ref≤1.0cm H2O具有100％的敏感性，而对于低耗力（≤50cm H2O s s min-1）的特异性为92％。P0.1vent用于检测潜在的高努力和低努力的接收器工作特性曲线下的面积分别为0.81和0.92。基准实验表明，对于大多数呼吸机，P0.1vent的平均偏差低于P0.1ref，但精度各不相同。在患者中，精度较低。