Phenotypes based on respiratory drive and effort to identify the risk factors when P0.1 fails to estimate ∆PES in ventilated children.

Summary

Secondary analysis of physiological data from a randomised trial of lung and diaphragm protective ventilation in children with PARDS, comparing airway occlusion pressure (P0.1) with oesophageal pressure swings as a measure of respiratory effort and drive. The authors define phenotypes where predicted and actual effort align or mismatch, and use regression to identify factors associated with mismatch. High respiratory effort was commonly underestimated by P0.1, particularly with higher airway resistance, higher tidal volume and higher opioid doses. Relevant to bedside monitoring of respiratory drive and effort during paediatric mechanical ventilation.

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