Journal article
Impact of Baydur Ratio Correction on the Reliability of Esophageal Pressure Measurement
Journal of applied physiology (1985)
07/07/2026
DOI: 10.1152/japplphysiol.00364.2026
PMID: 42412685
Abstract
Tidal changes in esophageal pressure (ΔPes) are used as a surrogate for pleural pressure changes (ΔPpl) to assess chest wall mechanics. The Baydur ratio evaluates pressure transmission and guides catheter positioning. The effects of correcting ΔPes using the Baydur ratio on the accuracy of ΔPpl estimation and its dependence on ventilation mode, spontaneous inspiratory effort, and body position, remain unclear. In ten pigs, ΔPpl was measured using intrapleural balloon catheters, while Pes was recorded at three esophageal locations in supine and prone positions. Animals underwent controlled and assisted ventilation. Baydur ratios were derived during assisted ventilation and from external chest compressions during controlled ventilation. ΔPes before and after correction was compared with ΔPpl using mixed-effects models and Bland-Altman analysis. Additionally, we quantified the proportion of values with (ΔPes-ΔPpl) ≤ 1 cmH₂O. During assisted ventilation, ΔPes showed good agreement with posterior ΔPpl. Baydur correction improved scaling and association (slope 0.76 vs 0.50; r 0.81 vs 0.79, p<0.01) and increased values within ±1 cmH₂O from 29% to 45% when the Baydur ratio fell outside the accepted range. During controlled ventilation, ΔPes showed weaker association and wider limits of agreement, without improvement after correction. Similar patterns were observed in prone position. ΔPes more accurately reflected posterior ΔPpl during assisted ventilation. Baydur correction improves scaling and association, particularly when the Baydur ratio falls outside the accepted range, but does not improve and may worsen agreement during controlled ventilation.
Details
- Title: Subtitle
- Impact of Baydur Ratio Correction on the Reliability of Esophageal Pressure Measurement
- Creators
- Andrea Restivo - University of Milano-BicoccaMichele Delle Vergini - University of Milano-BicoccaGenevieve McCormack - Harvard UniversityTimothy G Gaulton - Harvard UniversityGlasiele Alcala - University Health NetworkDavide Raimondi Cominesi - Hospital for Sick ChildrenElisa Mereto - Harvard UniversitySarah E Gerard - University of IowaRehab Khalid - Massachusetts General HospitalRajiv Gupta - Massachusetts General HospitalLorenzo Berra - Harvard UniversityYi Xin - Harvard UniversityMarcus Henrique Victor Jr - Federal Institute of São PauloEmanuele Rezoagli - Azienda Ospedaliera San GerardoMarcelo B P Amato - Universidade de São PauloJason H T Bates - University of VermontMaurizio Cereda - Harvard University
- Resource Type
- Journal article
- Publication Details
- Journal of applied physiology (1985)
- DOI
- 10.1152/japplphysiol.00364.2026
- PMID
- 42412685
- NLM abbreviation
- J Appl Physiol (1985)
- ISSN
- 8750-7587
- eISSN
- 1522-1601
- Publisher
- American Physiological Society
- Grant note
- R01HL177025 / HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI) R01HL171199 / HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)
- Language
- English
- Electronic publication date
- 07/07/2026
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering
- Record Identifier
- 9985180969202771
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