Photo Credit: Phomkham

The following is a summary of “Solid-state esophageal pressure sensor for the estimation of pleural pressure: a bench and first-in-human validation study,” published in the January 2025 issue of Critical Care by Oosten et al. 

Esophageal pressure (Pes), measured invasively via balloon catheters, is a valuable tool for guiding mechanical ventilation, but its clinical use is hindered by complex calibration and susceptibility to various influencing factors, prompting the exploration of more robust solid-state pressure sensors as potential alternatives.  

Researchers conducted a retrospective study to investigate the accuracy of a new solid-state Pes transducer (Pes_solid) and hypothesized that its measurements were non-inferior to those obtained with a properly calibrated balloon catheter (Pes_bal).  

They compared absolute and relative solid-state sensor Pes measurements to a reference pressure in a 5-day bench setup, and with balloon catheters placed simultaneously in 15 healthy volunteers and 16 patients who were mechanically ventilated in ICU. Bland–Altman analysis was conducted using mixed-effects modeling with bootstrapping to estimate bias, upper and lower limits of agreement (LoA), and confidence intervals.  

The results showed the solid-state pressure transducers had a positive bias (P_solid – P_ref) of approximately 1 cmH₂O for both minimal and maximal pressures, with no bias for pressure swings. In healthy volunteers, the solid-state transducer revealed a bias (Pes_solid – Pes_bal) [upper LoA; lower LoA] of 1.59 [8.21; −5.02], −2.32 [4.27; −8.92], and 3.91 [11.04; −3.23] cmH₂O for end-expiratory, end-inspiratory, and ΔPes values, respectively. In ICU patients, during controlled/assisted ventilation, the bias (Pes_solid – Pes_bal) [upper LoA; lower LoA] was −0.15 [1.41; −1.72]/−0.19 [5.23; −5.62], 0.32 [3.45; −2.82]/−0.54 [4.81; −5.90], and 0.47 [3.90; −2.96]/0.35 [4.01; −3.31] cmH₂O for end-expiratory, end-inspiratory, and ΔPes values, respectively, LoA were ≤ 2 cmH₂O for static measurements in controlled ventilation.  

Investigators concluded the novel solid-state pressure transducer demonstrated good accuracy on the bench, in healthy volunteers, and in patients on ventilation in ICU, potentially aiding in the implementation of Pes as an advanced respiratory monitoring technique. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-025-05279-w