Methods

• In esophageal-pressure guided group, mechanical ventilation settings

determined by initial esophageal pressure measurements.

• Tidal volume set at 6ml per kg predicted body weight.

• PEEP set to achieve a transpulmonary pressure of 0-10cm H2O at end

expiration, according to a sliding scale based on PaO2 and FiO2 – see

figure 1.

• Also limited tidal volume to keep transpulmonary pressure <25cmH2O at

end-inspiration (limit rarely approached during study and tidal volume was

never reduced for this purpose)……..

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Mechanical Ventilation Guided by Esophageal Pressure in Acutex

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