{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T01:40:58Z","timestamp":1791510058541,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T00:00:00Z","timestamp":1417478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20120618"],"award-info":[{"award-number":["20120618"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005689","name":"Gothenburg Medical Society","doi-asserted-by":"crossref","award":["2013-332761"],"award-info":[{"award-number":["2013-332761"]}],"id":[{"id":"10.13039\/501100005689","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Transpulmonary pressure is a key factor for protective ventilation. This requires measurements of oesophageal pressure that is rarely used clinically. A simple method may be found, if it could be shown that tidal and positive end\u2010expiratory pressure (<jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content>) inflation of the lungs with the same volume increases transpulmonary pressure equally. The aim of the present study was to compare tidal and <jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content> inflation of the respiratory system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 12 patients with acute respiratory failure were subjected to <jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content> trials of 0\u20104\u20108\u201012\u201016\u2009<jats:styled-content style=\"fixed-case\">cmH<jats:sub>2<\/jats:sub>O<\/jats:styled-content>. Changes in end\u2010expiratory lung volume (\u0394<jats:styled-content style=\"fixed-case\">EELV<\/jats:styled-content>) following a <jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content> step were determined from cumulative differences in inspiratory\u2010expiratory tidal volumes. Oesophageal pressure was measured with a balloon catheter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Following a <jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content> increase from 0 to 16\u2009<jats:styled-content style=\"fixed-case\">cmH<jats:sub>2<\/jats:sub>O<\/jats:styled-content> end\u2010expiratory oesophageal pressure did not increase (0.5\u2009\u00b1\u20094.0\u2009<jats:styled-content style=\"fixed-case\">cmH<jats:sub>2<\/jats:sub>O<\/jats:styled-content>). Average increase in <jats:styled-content style=\"fixed-case\">EELV<\/jats:styled-content> following a <jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content> step of 4\u2009<jats:styled-content style=\"fixed-case\">cmH<jats:sub>2<\/jats:sub>O<\/jats:styled-content> was 230\u2009\u00b1\u2009132\u2009ml. The increase in <jats:styled-content style=\"fixed-case\">EELV<\/jats:styled-content> was related to the change in <jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content> divided by lung elastance (El) derived from oesophageal pressure as \u0394<jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content>\/El. There was a good correlation between transpulmonary pressure by oesophageal pressure and transpulmonary pressure based on El determined as \u0394<jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content>\/\u0394<jats:styled-content style=\"fixed-case\">EELV<\/jats:styled-content>, <jats:italic>r<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.80, <jats:italic>y<\/jats:italic>\u2009=\u20090.96x, mean bias \u22120.4\u2009\u00b1\u20093.0\u2009<jats:styled-content style=\"fixed-case\">cmH<jats:sub>2<\/jats:sub>O<\/jats:styled-content> with limits of agreement from 5.4 to \u22126.2\u2009<jats:styled-content style=\"fixed-case\">cmH<jats:sub>2<\/jats:sub>O<\/jats:styled-content> (2 standard deviations).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content> inflation of the respiratory system is extremely slow, and allows the chest wall complex, especially the abdomen, to yield and adapt to intrusion of the diaphragm. As a consequence a change in transpulmonary pressure is equal to the change in <jats:styled-content style=\"fixed-case\">PEEP<\/jats:styled-content> and transpulmonary pressure can be determined without oesophageal pressure measurements.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12442","type":"journal-article","created":{"date-parts":[[2014,12,2]],"date-time":"2014-12-02T07:55:50Z","timestamp":1417506950000},"page":"185-196","source":"Crossref","is-referenced-by-count":24,"title":["Transpulmonary pressure and lung elastance can be estimated by a <scp>PEEP<\/scp>\u2010step manoeuvre"],"prefix":"10.1111","volume":"59","author":[{"given":"S.","family":"LUNDIN","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"GRIVANS","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care 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