Estimation of inspiratory effort using airway occlusion maneuvers in ventilated children: a secondary analysis of an ongoing randomized trial testing a lung and diaphragm protective ventilation strategy.

Summary

Secondary physiologic analysis from the REDvent randomised trial examining whether airway occlusion manoeuvres can estimate inspiratory effort in ventilated children aged 1 month to 18 years with acute respiratory distress syndrome. Oesophageal pressure swing during tidal breathing was compared with expiratory occlusion pressure (Pocc), P0.1 and the respiratory muscle pressure index, with exploration of candidate paediatric thresholds for excessive or insufficient effort. Pocc correlated most strongly with oesophageal pressure swing and showed little variation by age group or ventilation mode. Relevant to bedside monitoring for lung- and diaphragm-protective ventilation where oesophageal manometry is unavailable.

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