Intraesophageal pressure monitoring and the severity of respiratory distress syndrome

The intraesophageal pressure difference (P_es) was measured in 46 preterm infants, 36 with respiratory distress (RDS). It was 12.7±2.9 mm Hg (mean±SEM) in severe RDS, 9.6±3.2 mm Hg in moderate RDS, and 5.2±1.6 mm Hg in infants with mild disease, measured at the age of 8 h. These intergroup differences were highly significant (P<0.001). During the first 96 h of life the P_es decreased to 6.1±1.1 mm Hg in severe RDS and to 4.8±1.2 mm Hg in moderate RDS. These changes were also highly significant (P<0.001) when compared with respective initial values. In infants with mild disease and in healthy preterm infants, the P_es did not alter significantly during the first 96 h of life.The correlations between gastric aspirate L/S ratio and the P_es at the age of 8 h (r=-0.65, P<0.001) and at the age of 24 h (r=-0.73, P<0.001) were highly significant.It is concluded that intraesophageal pressure monitoring is a valuable tool in the intensive care evaluation of the severity of RDS.Supported by grants from the Foundation for Paediatric Research and from the Medical Research Council, Academy of Finland