TPP

Q: What is the recommended end-expiratory transpulmonary pressure (TPP)? (select one)

A) -5 and zero

B) Zero and 5

C) Zero and 10

D) > 10

E) < 15

       

Answer: C

       

Transpulmonary Pressure (TPP) can be estimated by the formula

Transpulmonary pressure = airway pressure - pleural pressure

       

At the bedside airway pressure is measured from applied PEEP as its surrogate, and esophageal pressure is an estimate of pleural pressure. 

Recommended end-expiratory transpulmonary pressure is between zero and 10 cm H2O and an end-inspiratory transpulmonary pressure ≤25. Optimum end-expiratory transpulmonary pressure reduces cyclic alveolar collapse, and optimum end-inspiratory transpulmonary pressure reduces alveolar overdistension.

       

#ventilators

       

       

Reference:

Talmor D, Sarge T, Malhotra A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med 2008; 359:2095.