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 (PTP_Pdi/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 PTP_Pdi/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 (PTP_Pdi/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.

中文翻译：

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食管和横膈膜压力波动作为吸气努力的指标

目的

描述吸气食管和经膈压力波动（ΔPes 和 ΔPdi）之间的相关性，容易测量的吸气努力指数，与黄金标准，经膈压力时间乘积（PTP _Pdi / min），并评估波动压力的准确性在预测非常高或低的努力。

方法

对之前四项研究中招募的患者的数据进行回顾性分析。构建特定PTP _Pdi /min阈值（_{50、150、200 cmH 2} O × sec/min）的ΔPes和ΔPdi值的ROC曲线，并计算不同摆动值阈值的诊断准确性。

结果

吸气阈值 ΔP<7cmH ₂ O 可用于识别大多数无需努力的患者，因为较低的 ΔP 阈值具有低灵敏度。吸气阈值 ΔP>14–18cmH ₂ O 可用于识别吸气努力非常高的患者 (PTP _Pdi /min> 200 _{cmH 2} O × sec/min)。

结论

这项研究的结果可以帮助临床医生更好地选择和解释 ΔP 阈值以评估吸气努力。