Figure 1.

Monitoring of esophageal and transpulmonary pressure during PSV. Waveforms of airway pressure (Pao), airflow, tidal volume (Vol), esophageal (Pes) and transpulmonary pressure (P_L) recorded in a severe acute respiratory distress syndrome patients undergoing protective PSV while on ECMO. Positive end expiratory pressure is set at 15 cmH₂O, support is 8 cmH₂O, obtaining tidal volume ≈340 mL (≈5 mL/kg IBW) and respiratory rate 16 bpm. The dashed line on the left denotes maximal dynamic driving PL (∆P_L,dyn) during inspiration, while the second, positioned at end inspiration (zero flow), identify end-inspiratory PL (∆P_L,ei). PSV, pressure support ventilation; ECMO, extracorporeal membrane oxygenation.