The forgotten tale of spontaneous plateau pressure

Abhijeet Anand

Cite

Anand A. The forgotten tale of spontaneous plateau pressure. J Mech Vent 2023; 4(3):115-118.

Metrics

1023 Downloads

Abstract

This article highlights the significance of measuring plateau pressure in spontaneously breathing patients as it provides valuable information about PMI (Pmusc Index), which serves as a surrogate for the patient’s efforts during mechanical ventilation.

The PMI value obtained from the difference between the end-inspiratory occlusion plateau pressure and the airway pressure before the occlusion (PEEP + PS) enables clinicians to estimate the patient’s inspiratory effort accurately.

The accurate measurement of patient efforts is crucial in optimizing pressure support during lung protective weaning strategies. By titrating pressure support based on PMI values, clinicians can provide personalized care to patients, reducing the risk of ventilator-induced lung injury and enhancing the likelihood of successful weaning.

Keywords

PMI, Pmus, Plateau pressure

References

1. Freebairn R, Hickling K. Spontaneous breathing during mechanical ventilation in ARDS. Crit Care & Shock 2005: 8:61-66.
2. Foti G, Cereda M, Banfi G, et al. End-inspiratory airway occlusion: A method to assess the pressure developed by inspiratory muscles in patients with acute lung injury undergoing pressure support. Am J Respir Crit Care Med 1997; 156(4):1210-1216.
https://doi.org/10.1164/ajrccm.156.4.96-02031
PMid:9351624
3. Bellani G, Grassi A, Sosio S, et al. Plateau and driving pressure in the presence of spontaneous breathing. Intensive Care Med 2019; 45(1):97-98.
https://doi.org/10.1007/s00134-018-5311-9
PMid:30006893
4. Sajjad H, Schmidt GA, Brower RG, et al. Can the plateau be higher than the peak pressure? Ann Am Thorac Soc 2018; 15(6):754-759.
https://doi.org/10.1513/AnnalsATS.201707-553CC
PMid:29856252
5. CoEMV. Can we measure Plateau pressure during pressure support? And what does it indicate? [Internet]. Can we measure Plateau pressure during pressure support? And what does it indicate? 2023 [cited 2023 May 6]. Available from: https://coemv.blog/can-we-measure-plateau-pressure-during-pressure-support-and-what-does-it-indicate/