Adjusting the ventilation settings to the respective clinical situation is demanding and time-consuming. This includes continuously determining the necessary PEEP and the avoidance of end-inspiratory overdistension. The effects of pressure and volume on the ventilated lung is associated with ventilator-induced lung injury. We now know that it’s not the plateau pressure but the transpulmonary pressures which are decisive for the prevention of ventilation-induced lung injury. We now know that it’s not the plateau pressure but the transpulmonary pressures which are decisive for the prevention of ventilation-induced lung injury. In many cases, the patient's condition does not allow compliance with lung protective ventilation such as a driving pressure of less than 15 centimetres water column; a tidal volume of less than 6 ml per kilogram of idealised body weight and an end-inspiratory plateau pressure of less than 30 centimetres water column. Oesophageal and transpulmonary pressure monitoring are now considered bedside methods when classical ventilation settings cannot be maintained. The first available catheters often resulted in compromise and were less suitable for prompt pressure transmission. Löwenstein’s PesoCath was specially developed for oesophageal and transpulmonary pressure monitoring. Its special oesophageal balloon facilitates an excellent response to rapid pressure changes under ventilation and is designed for the dynamic requirements of transpulmonary pressure measurement. Simplified placement of the modified gastric tube is supported by a special coating. Easier retraction of the insertion wire due to an innovative wire-in-wire solution, so the inner wire can be removed first. The integrated Enfit safety adapter allows direct connection to feeding pumps without additional connectors or accidental disconnections during ongoing operation. The combined feeding and emergency channel permits auscultation during catheter placement despite the Enfit connection. In an emergency, this can be used as a direct channel for rapid suctioning or for draining gastric juice. Because of the non-metallic X-ray markings, the oesophageal catheter does not have to be removed prior to MRI diagnosis.
