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CORRELATION BETWEEN ESOPHAGEAL PRESSURE AND PULMONARY COMPLIANCE WITH CLINICAL OUTCOMES IN MECHANICALLY VENTILATED PATIENTS WITH ARDS
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Abstract
Objective: To analyze the correlation between esophageal pressure and pulmonary compliance with clinical outcomes in patients with ARDS undergoing invasive mechanical ventilation. Subjects and Methods: This was a descriptive and analytical study involving 54 patients diagnosed with acute respiratory distress syndrome (ARDS) who required invasive mechanical ventilation in the Intensive Care Unit of Military Hospital 175 from December 2023 to December 2024. Results: The mean age of the patients was 62.4 ± 11.3 years, with 64.8% being male. Pneumonia was the most common cause of ARDS (53.7%). The average PaO₂/FiO₂ at admission was 128.6 ± 34.2 mmHg, and the mean SOFA score on day 1 was 8.2 ± 2.5. Esophageal pressure, transpulmonary pressure, and pulmonary compliance showed slight improvement after 72 hours. In the mortality group, transpulmonary pressure and driving pressure were significantly higher, while PaO₂/FiO₂ and pulmonary compliance were lower (p < 0.05). Logistic regression analysis indicated that transpulmonary pressure ≥ 12 cmH₂O, driving pressure > 14 cmH₂O, pulmonary compliance < 30 ml/cmH₂O, and PaO₂/FiO₂ < 150 mmHg were associated with increased mortality risk. Transpulmonary pressure was positively correlated with mechanical ventilation duration and SOFA score, and negatively correlated with PaO₂/FiO₂ and pulmonary compliance. Conclusion: Transpulmonary pressure, driving pressure, and pulmonary compliance are closely associated with clinical outcomes in mechanically ventilated patients with ARDS. A transpulmonary pressure ≥ 12 cmH₂O may serve as a warning indicator of increased mortality risk.
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Keywords
Acute respiratory distress syndrome, esophageal pressure, pulmonary compliance, invasive mechanical ventilation.
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