Innovative technology for personalized ventilation
Transpulmonary pressure monitoring is an important part of clinical monitoring for patients with acute respiratory distress syndrome (ARDS), COPD, COVID-19,morbid obesity, and other respiratory diseases that require invasive ventilation. It enables personalized ventilation and can be used with the aim of reducing lung stress. By monitoring transpulmonary pressure, medical staff can determine the optimal pressures for effective lung ventilation and provide lung-protective ventilation.
Challenges in measuring transpulmonary pressure
The most common method for measuring transpulmonary pressure uses an air-filled balloon integrated into an esophageal catheter. The balloon must be carefully inserted to the correct depth for each patient and its filling volume precisely titrated. Regular checks are required to ensure accurate measurements.
“Otherwise, if the measured value changes, it is impossible to tell whether the lung situation has changed or whether the balloon calibration is no longer valid,” explains Andreas Conzelmann, Product Sales Manager Critical Care, Getinge.
Standardized maneuvers are used to validate balloon positioning and filling. These involve selectively occluding the airway and assessing the relationship between the esophageal pressure measured via the catheter and the airway pressure from the ventilator. If the balloon is correctly positioned and filled, both pressure values correlate.
Simple and safe implementation of transpulmonary pressure monitoring "for everyone"
To simplify pressure monitoring and improve accuracy, Getinge has developed an automated maneuver to validate balloon positioning and filling.
“Getinge has always aimed to make complex therapy methods easy and safe for everyone to perform. The workflow we have developed guides the user through each step intuitively to ensure that the catheter provides accurate values,” says Andreas Conzelmann.
Another advantage is that pressure curves and key parameters are displayed clearly, simply and comprehensively on the screen, enabling objective assessment of lung recruitment, lung stress, and spontaneous breathing.
Respiratory therapist Michael Hartmann recalls: “The introduction of Getinge’s software at the Ostallgäu-Kaufbeuren Clinic was like Christmas. It is very easy to use, with intuitive and clear structures, and you know whether the probe is in the right place because you have a very good positioning aid.”
Significant cost saving possible
Another benefit is cost efficiency. By simply connecting a sensor module, Getinge Servo ventilators can be upgraded for esophageal pressure monitoring when needed. There is no need to purchase dedicated ventilators for this purpose.
According to Andreas Conzelmann, “For patients who require transpulmonary monitoring, the module can be easily connected to the ventilator during operation – without having to replace the device and expose the patient to risks such as PEEP loss or an increased risk of infection.”