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Volume 360:831-833 February 19, 2009 Number 8
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Esophageal Pressure in Acute Lung Injury

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by Talmor, D.
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To the Editor: Although Talmor et al. (Nov. 13 issue)1 observed an improvement in oxygenation in patients with acute lung injury that was managed by estimating transpulmonary pressure, there was an extrapulmonary (i.e., abdominal) cause of the acute respiratory distress syndrome (ARDS) in a high proportion of patients in their study (39%). To our knowledge, this feature has not been observed in any previously published randomized studies involving patients with ARDS.2,3,4 The respiratory mechanics in pulmonary ARDS and extrapulmonary ARDS are different.5 The elastance of the lung is higher in pulmonary ARDS, and the elastance of the chest wall is . . . [Full Text of this Article]



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