Additional file 1: of Detailed measurements of oesophageal pressure during mechanical ventilation with an advanced high-resolution manometry catheter
Creators: name: Persson, Per
name: Ahlstrand, Rebecca
name: Gudmundsson, Magni
name: Leon, Alex
name: Lundin, Stefan
Publisher: name: figshare
Year: 2019
Subjects: subject: Space Science
subject: Medicine
subject: Physiology
subject: FOS: Biological sciences
subject: FOS: Biological sciences
subject: Pharmacology
subject: 39999 Chemical Sciences not elsewhere classified
subject: FOS: Chemical sciences
subject: FOS: Chemical sciences
subject: 111714 Mental Health
subject: FOS: Health sciences
subject: FOS: Health sciences
subject: 110309 Infectious Diseases

description: Table S1. M = male, F = female, ICU = intensive care unit, OR = operating room. TBI = traumatic brain injury, ICB = intracerebral haemorrhage, SAH = subarachnoid haemorrhage. PaO2 measured in mmHg. LH = lung-healthy. In patient 5, information about length is missing. Figures presented as n (%) or mean (SD). Figure S1. Oesophageal pressures measured with high-resolution manometry. Right panel: an illustration of the oesophagus with a red line representing the pressure measured 1 cm apart at a chosen time. Number and dots next to the oesophagus represent cm from the nostril. UES = upper oesophageal sphincter. LES = lower oesophageal sphincter. Left panel: pressures measured 2 cm apart along the oesophagus 24–46 cm from the nostril. Number on the left represents cm from the nostril, and bold numbers next to pressure curves is the pressure (in mmHg) measured at that level at a chosen time. Line representing the chosen time is not visible in the figure. Figure S2. Individual curves for each patient showing end-expiratory oesophageal pressure along the oesophagus at different PEEP levels. Measurements performed with the high-resolution manometry catheter. Table S2.Intra-individual variation in oesophageal pressure described with coefficient of variation, calculated as within-subject standard deviation divided by the mean (SD/mean). Values in the table represent the mean and median from all patients. Coefficient of variation is presented for end-expiratory pressures at different PEEP levels and for tidal variations in oesophageal pressure at different tidal volumes. 22 cm of oesophagus (ESOTOT) and oesophagus 30–42 cm from the nostril (ESOLOW) are presented separately, see the “Methods” section. Figure S3. Figure shows how an increase of PEEP effects oesophageal pressure in two representative patients. When PEEP is increased, cardiac oscillations decrease which at some levels causes oesophageal pressure to decrease, black arrows. At other levels the oesophageal pressure increases, red arrows. Figure S4. Change in end-expiratory oesophageal pressure after an increase of PEEP of ≈ 7 cmH2O. Oesophageal pressures measured with balloon catheter and HRM catheter respectively. Number in the centre of figure represents cm from the nostril. Measurements from representative patient. Figure S5. Change in end-expiratory oesophageal pressure and end-expiratory lung volume after an increase of PEEP of ≈ 7 cmH2O. End-expiratory airway pressure (PEEP), red curve, and end-expiratory oesophageal pressure, blue and black curve, increases and reaches the new level after the first breath when PEEP is changed on the ventilator. The end-expiratory lung volume, green, continues to increase for several breathes. The curve with oesophageal pressure measured with HRM (black curve) is from a chosen level (28 cm from the nostril) with a large increase in end-expiratory oesophageal pressure in contrast to the other levels in the patient, see additional Figure S4. Figure S6. Tidal changes in oesophageal pressure (ΔPES) along the length of the oesophagus during different sizes of tidal volumes. Measurements performed with the high resolution manometry catheter. Tidal inspiration starting from baseline PEEP level, see the “Results” section. Figure S7. Tidal changes in oesophageal pressure (ΔPES) along the length of the oesophagus at the same tidal volume (≈ 6 ml/kg IBW) but different PEEP. Measurements performed with the high-resolution manometry catheter. Figure S8.End-expiratory oesophageal pressure. Comparison between measurements from HRM catheter and balloon catheter. Figure S9. Tidal variation in oesophageal pressure (ΔPES). Comparison between measurements from HRM catheter and balloon catheter. Tidal inspiration starting from baseline PEEP level, see “Results” section. Red dotted line represents mean tidal change in oesophageal pressure calculated from pressures measured between 30 and 42 cm from the nostril with the high-resolution manometry catheter. Table S3. Difference between end-expiratory oesophageal pressure and between tidal variations in oesophageal pressure measured with HRM and conventional balloon catheter. In order to compare pressures in the same part of oesophagus, the values from HRM are a mean of the pressures 30–42 cm from the nostril which is the part of oesophagus where the 10 cm long balloon on the conventional catheter is placed. Figure S10. Comparison between end-expiratory oesophageal pressures measured with HRM and conventional balloon catheter in 10 patients according to Bland and Altman. Mean PEEP during measurements 10.4 cmH2O. Panel A) comparison between pressure from balloon catheter and HRM mean values 30–42 cm from the nostril. Mean bias 0.10 cmH2O (solid line), limits of agreement (± 2 SD) 9.14; − 8.94 cmH2O (dashed line). Panel B) comparison between pressure from balloon catheter and HRM at 40–41 cm from the nostril. Mean bias 3.30 cmH2O (solid line), limits of agreement (± 2 SD) 13.74; − 7.14 cmH2O (dashed line). Figure S11. Change in oesophageal pressure during a manual chest wall compression (used in positive pressure occlusion test to confirm correct placement of balloon catheter). Measurements performed with HRM catheter. Figure S12.End-expiratory oesophageal pressure in spontaneously breathing patient. Comparison between sitting and supine positions. Measurements performed with HRM catheter. Figure S13. Figure shows how a change from sitting to supine position affects oesophageal pressure in a representative patient. In supine position the oesophageal pressure is higher and the cardiac oscillations are larger. (PDF 873 kb)