![]() As a potential surrogate for the detecting the change in Ppl (ΔPpl) or strong inspiratory efforts, the change in central venous pressure (ΔCVP) has been repeatedly examined. However, the measurement of Pes is complicated by technical issues, including those related to the correct positioning of the esophageal catheter, interpretation of absolute Pes values, and balloon volume. In clinical practice, esophageal pressure (Pes), determined using an esophageal balloon catheter, is used as a surrogate for Ppl. Respiratory effort can be estimated by measuring the pleural pressure (Ppl). Therefore, it is important to maintain optimal respiratory effort to protect both the lung and the diaphragm during mechanical ventilation. Similarly, vigorous respiratory efforts and insufficient respiratory muscle unloading by mechanical ventilation can cause patient self-inflicted lung injury (P-SILI) and damage the respiratory muscles, which also prolongs mechanical ventilation. However, excessive unloading of the respiratory muscles by mechanical ventilation causes ventilator-induced diaphragmatic dysfunction (VIDD), which in turn prolongs the need for mechanical ventilation. Mechanical ventilation is a life-saving measure in patients with respiratory failure.
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