Investigating the Esophageal Pressure Measurement to Adjust NIPPV to Prevent Pulmonary Barotrauma in Patients with COVID- 19 under Respiratory Support Admitted to the ICU

Hossein Naderi Boldaji; Ibrahim Hazrati; Behroz Kheradmand; Mohamadreza Rafiei

doi:10.18502/jimc.v7i3.15736

Hossein Naderi Boldaji School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Ibrahim Hazrati Department of Anesthesiology, Surgical and Trauma Research Center, AJA University of Medical Sciences, Tehran, Iran
Behroz Kheradmand Department of Anesthesiology, Surgical and Trauma Research Center, AJA University of Medical Sciences, Tehran, Iran
Mohamadreza Rafiei Department of Anesthesiology, Surgical and Trauma Research Center, AJA University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v7i3.15736

Keywords: Barotrauma, COVID-19, Intensive care units, Positive-pressure respiration, Respiratory insufficiency

Abstract

Background: Respiratory failure following COVID-19 can lead to the death of COVID patients. Monitoring these patients during their ventilation is essential. The present study investigated the effect of measuring esophageal pressure in preventing barotrauma while receiving Noninvasive Positive Pressure Ventilation (NIPPV) in patients with COVID-19.

Methods: The present study is a single-blind clinical trial conducted on patients with COVID-19 hospitalized in the Intensive Care Unit (ICU). The patients were divided into two groups; one group had their esophageal pressure measured while receiving NIPPV, their ventilation was adjusted based on this pressure, and the second group was only ventilated according to anesthesia protocols. Finally, the data was entered into SPSS V.23 software and analyzed according to the study’s objectives.

Results: The results of the present study showed that the incidence of subcutaneous emphysema-type barotrauma in the Esophageal Pressure (EP) monitoring group was lower than in the non-Esophageal Pressure (nEP) monitoring group. Also, the IPAP level in the EP group was lower than in NEP. The incidence of complications such as abdominal bloating and gavage intolerance was lower in EP than in NEP. The blood oxygen level in NEP was higher than in EP, but there was no significant difference between them.

Conclusion: Esophageal pressure measurement in patients with COVID-19 receiving NIPPV can reduce barotrauma in the patients.