Pleural and abdominal pressure are clinically estimated by measuring the esophageal and bladder or intragastric pressure (IGP), respectively. A new nasogastric polyfunctional catheter is now commercially available, equipped with two balloons in the lower and distal part; this catheter allows simultaneous esophageal pressure (Pes) and IGP measurements and can be also used to feed the patient. We compared the Pes and IGP measured using this new device with those obtained with a standard balloon catheter taken as gold standard.
Twenty-four intubated patients requiring ventilator support (mean age 64.3 ± 16.8 years, body mass index 25.3 ± 3.0 kg/m2, and PaO2/FiO2 280.8 ± 123.4 mmHg) were enrolled. Esophageal pressure and IGP were measured with the new nasogastric polyfunctional catheter (Nutrivent, Sidam, Italy) and with a standard balloon catheter (Smart Cath Viasys, USA). The Smart Cath was first inserted in the stomach and then retracted to the esophagus to measure IGP and Pes, respectively. In each patient two paired measurements were averaged.
In the Bland–Altman analysis, the bias and agreement bands for Pes, ΔPes (computed as the difference of esophageal pressure between end-inspiration and expiration), and IGP were −0.25 (−2.65 to +2.15), 0.0 (−0.9 to +0.9), and −0.45 (−2.85 to + 1.95) cmH2O, respectively. No side effects or complications were recorded.
The new polyfunctional catheter showed a clinically acceptable validity in recording esophageal and intragastric pressure. This device should help physicians to better individualize the clinical patient management.
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D. Chiumello and L. Gattinoni participated in the development of Nutrivent, but do not have any patent or financial agreement, and received only an honorarium as members of the advisory board.
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Chiumello, D., Gallazzi, E., Marino, A. et al. A validation study of a new nasogastric polyfunctional catheter. Intensive Care Med 37, 791–795 (2011). https://doi.org/10.1007/s00134-011-2178-4
- Nasogastric catheter
- Esophageal pressure
- Intragastric pressure