A NEW METHOD FOR P0.1 MEASUREMENT USING STANDARD RESPIRATORY EQUIPMENT

The airway occlusion pressure, P0.1, is an index for the neuro-muscula r activation of the respiratory system. It has been shown to be a very useful indicator for the ability of patients receiving ventilatory su pport to be weaned from mechanical ventilation. Since the standard mea surement technique for P 0.1 determination is technically complex, it is not widely available for clinical purposes. For that reason a P 0.1 measurement technique was developed as an integrated function in a st andard respirator (Evita, Drager, Lubeck, Germany). This technique is easy to use and does not need any further equipment. We validated this new technique by comparing it to standard P0.1 measurements in a mech anical lung model as well as in ventilated patients. In the lung model we found a correlation between the Evita measurement and standard mea surements of r = 0.99. In 6 ventilated patients the correlation was r = 0.78. Since the Evita P0.1 and the standard measurement had to be pe rformed during two different breaths, this little poorer correlation i n patients may be due to a significant breath-by-breath variability in P0.1. Comparing the Evita P0.1 and the standard measurement within on e breath resulted in a clearly better correlation (r = 0.89). We concl ude that this new measurement technique provides an easy and accurate P0.1 measurement using standard respiratory equipment when tested in a lung model. In patient measurements the method is less precise, which is probably due to the variable waveforms of the inspiratory driving pressure seen in patients, for example when intrinsic PEEP is present. However, the new method makes the P0.1 measurement as a ''bed-side'' method clinically available, although the values should be interpreted cautiously.