Sitting and Supine Esophageal Pressures in Overweight and Obese Subjects

Robert L. Owens, Lisa M. Campana, Lauren Hess, Danny J. Eckert, Stephen H. Loring, Atul Malhotra

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Esophageal pressure (P Es) can be used to approximate pleural pressure (P pl) and might be clinically useful, particularly in the obese e.g., to guide mechanical ventilator settings in critical illness. However, mediastinal artifact (the difference between true P pl and P Es) may limit acceptance of the measurement, and reproducibility of P Es measurements remains unknown. Therefore, we aimed to assess the effect of body posture on P Es in a cohort of obese, but healthy subjects, some of whom had multiple measurements, to address the clinical robustness of esophageal manometry. Twenty-five overweight and obese subjects (BMI > 25 kg/m 2) and 11 control lean subjects (BMI 25 kg/m 2) underwent esophageal manometry with pressures measured seated and supine. Twenty overweight and obese subjects had measurements repeated after ∼1 to 2 weeks. Anthropometric data and sitting and supine spirometry were recorded. The average end-expiratory P Es sitting and supine were greater in the overweight and obese group than the lean group (sitting 0.1 ± 2.1 vs. 3.3 ± 1.2 cmH 2 O, supine 9.3 ± 3.3 vs. 6.9 ± 2.8 cmH 2 O, respectively). The mean differences between repeated measurements were small (0.3 ± 1.7 cmH 2 O sitting and 0.1 ± 1.5 cmH 2 O supine). P Es correlated with a number of anthropometric and spirometric variables. In conclusion, P Es are slightly greater in overweight and obese subjects than lean subjects; but changes with position are similar in both groups. These data indicate that mediastinal weight and postural effects on P Es are within a clinically acceptable range, and suggest that esophageal manometry can be used to inform clinical decision making across wide range of body types.

Original languageEnglish
Pages (from-to)2354-2360
Number of pages7
JournalObesity
Volume20
Issue number12
DOIs
Publication statusPublished - 31 Dec 2012

Keywords

  • esophageal pressure
  • obese patients
  • ventilator settings

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    Owens, R. L., Campana, L. M., Hess, L., Eckert, D. J., Loring, S. H., & Malhotra, A. (2012). Sitting and Supine Esophageal Pressures in Overweight and Obese Subjects. Obesity, 20(12), 2354-2360. https://doi.org/10.1038/oby.2012.120