Pressures of the respiratory system – Part 2 of 2

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Aman Thind
Critical care medicine fellow at the Cleveland Clinic. Interests: Cardiopulmonary physiology, shock, POCUS, mechanical ventilation, and ARDS. Music genres: Blues, Rock, and Heavy metal

Clinical correlates of transpulmonary pressure

  • In the absence of airflow, transairway (resistive) pressure is zero. Hence, transpulmonary pressure equals transalveolar pressure and is thus a true marker of lung stress.
  • End-inspiratory transpulmonary pressure is thus a better marker of inspiratory lung stress compared to plateau pressure.
  • End-inspiratory transpulmonary pressure can be used to guide selection of optimal PEEP
  • From the mechanics standpoint, the alveolus does not care whether a given transalveolar pressure is generated by PPV, NPV or a combination of the two.

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