EXPEDITING ESOPHAGEAL MANOMETRY THROUGH CREATION OF A SLEEVE FOR A NASOGASTRIC TUBE

Acute Respiratory Distress Syndrome (ARDS) is an acute inflammatory condition that causes impaired oxygenation and is almost always treated with mechanical ventilation. Positive End-Expiratory Pressure (PEEP) is an extrinsic pressure applied in ventilation to maintain alveolar opening. Esophageal manometry is a useful tool in titrating PEEP to ensure adequate ventilation is being provided in cases of increased chest wall pressure. However, few pulmonologists or critical care specialists utilize esophageal manometry routinely because of the required additional procedure, sparse training opportunities, and esoteric calculations required to perform the procedure and evaluate the results. We have designed, prototyped, and tested a device to simplify and reduce the time necessary to perform esophageal balloon catheterization. This device contains a balloon sleeve to be placed over a standard nasogastric tube which is capable of measuring the esophageal pressure while ventilation is being provided. Based on the esophageal pressures, a web based app created in tandem with the device calculates the desired PEEP for the ventilator settings to ensure adequate oxygenation of the patient. Statistical analysis demonstrated adequate similarities in trends compared to existing devices along with significance in pressure variability.