Lutana Haan, associate professor and chair, Jeff Anderson, associate professor and director of Clinical Education, and Grace Hofmann, 2015 graduate, all in the School of Allied Health Sciences Department of Respiratory Care, published an article in the October issue of Critical Care Nurse.
The article, titled “Esophageal Pressure Measurements in Patients with Acute Respiratory Distress Syndrome,” explains how esophageal balloon catheters are used in the respiratory monitoring of critical care patients.
Esophageal balloon catheters are used to measure the pressure outside of the lung, in the space between the lung and the chest wall. When patients require very high pressures to breathe, it is often difficult to determine if the lungs are stiff or if there are high pressures outside the lungs. Putting in the esophageal balloon catheter allows separation of the pressure to ventilate the lung, versus pressure to “inflate the chest wall.” It is important not to use too high of a lung pressure in order to avoid lung damage, so the balloon helps to determine the cause of high pressure.
During expiration (breathing out) pressure is used to prevent lung collapse, but high pressure outside the lung may result in insufficient pressure to keep the lung open. Think of alveoli, tiny sacs within the lungs that allow oxygen and carbon dioxide to move between the lungs and bloodstream, like balloons. One could maintain pressure in a balloon to keep it from collapsing, but if it’s being squeezed from the outside there could be very little air in the balloon despite the pressure inside. Esophageal balloon pressure measurements also help respiratory care practitioners to select effective expiratory pressure levels.
The authors believe that the publication of this article will assist both critical care nurses and respiratory therapists to better understand the utility of lung pressure measurements being performed in some critically ill patients at Saint Alphonsus Regional Medical Center.
Haan holds a bachelor of science degree and a master of health science degree from Boise State. She is a registered respiratory therapist and a registered polysomnographic technician. Before coming to Boise State, Haan worked in sleep medicine primarily diagnosing obstructive sleep apnea in the pediatric through geriatric populations. Haan’s creativeness has involved her in several medical device innovation opportunities. She has collaborated with engineering students on the redesign of a crash cart that’s used in healthcare settings when advanced life support is needed.
Anderson has been a respiratory care practitioner since graduation from Madison Area Technical College in Madison, Wisconsin. After graduation he worked at the University of Wisconsin Hospitals and Clinics for six years in the trauma and life support center, burn unit, cardiac surgery and medicine intensive care units, hematology, oncology, pediatrics, and pediatrics intensive care units. Anderson’s primary areas of interest include adult critical care, critical care monitoring, pulmonary function testing, and exercise physiology. He is also recognized as an effective teacher for diverse groups of students via his Physiology course and Medical Terminology and Cardiopulmonary Renal Anatomy course.
Hofmann graduated in the summer of 2015 with a bachelor of science in Respiratory Care. While at Boise State, Hoffman completed an internship at Massachusetts General Hospital, which resulted in her employment there as a respiratory care practitioner. She plans to attend medical school in the future.