Esophageal and gastric pressure measurements.

The measurement of esophageal and gastric pressures with balloon-tipped catheters has been used with great success over the past half century to delineate the physiology of the mechanical respiratory system. Pleural pressure and abdominal pressure values estimated from esophageal and gastric pressure measurements allow analysis of lung and chest wall compliance, as well as work of breathing, respiratory muscle function, and the presence of diaphragm paralysis. Although much of the use of these measurement techniques has been in the clinical laboratory, to improve the understanding of basic physiologic mechanisms, the techniques have also been used in clinical situations to diagnose diaphragm paralysis, assess the work of breathing during mechanical ventilation, and estimate pulmonary compliance. In this article I review the historical background, physiology, placement techniques, and potential clinical applications of esophageal and gastric pressure measurements. In addition, I will briefly review the measurement of bladder pressure, which is a related topic.