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Thought Leader Session

Guidelines Session

Aging Adult Track

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Research Snapshot Theater: Quality and Patient Safety/Future of Critical Care, Adult I

Questionnaire Survey of Esophageal Pressure Measurement Use in Adult Intensive Care Units

Sunday, March 22, 2026

12:15 PM - 1:15 PM Central Time

Location: Connections Central - RST 11

HQ

Harley QIN, MS,MBA (she/her/hers)

Illinois

Disclosure(s): No relevant financial relationship(s) to disclose.
JIE LI, PhD, FCCM

Rush University

Disclosure(s): AARC: Grant/Research Support (Ongoing), Salary (Ongoing), Speaker/Honoraria (includes speakers bureau, symposia, and expert witness) (Ongoing); COPD foundation: Grant/Research Support (Terminated, November 5, 2025); Fisher & Paykel: Speaker/Honoraria (includes speakers bureau, symposia, and expert witness) (Terminated, November 5, 2025); MEK ICS Ltd: Grant/Research Support (Ongoing)
Eduardo Mireles-Cabodevila, MD, FCCM

Cleveland Clinic Foundation, Ohio

Disclosure information not submitted.
Andrew G. Miller, MSc, RRT, RRT-ACCS, FAARC, FCCM

Duke University Medical Center

Disclosure(s): Aerogen: Advisory Board (Terminated, October 18, 2025)
DL

DONNA Lynch-Smith, DNP, ACNP-BC, APN, NE-BC, CNL

Professor
University of Tennessee Health Science Center, Tennessee

Disclosure information not submitted.

Introduction: Esophageal pressure (Pes) monitoring can optimize mechanical ventilation by estimating pleural pressure, guiding PEEP titration, and detecting patient-ventilator discordance. We aimed to investigate the current practices and barriers to Pes implementation among ICU clinicians.

Methods: We distributed an anonymous online survey to ICU clinicians with at least one year of ICU working experience. The questionnaire collected demographic information and covered three sections of clinical practices regarding Pes utilization, training, and devices.

Results: 98 respondents completed the survey and were included in the final analysis. Most respondents were respiratory therapists (65%) and worked in academic hospitals (66%). 31 participants (32%) reported using Pes. It was more often used for lung mechanics assessment (84%) and PEEP titration (77%). Most users reported performing fewer than 25 Pes procedures annually (71%), typically lasting 30–60 minutes (65%). The most commonly used tools were traditional balloon catheters (81%) and ventilator-integrated ports (74%). Training was primarily provided through workshops or online modules, led by respiratory therapists or physicians. Clinicians with >15 years of ICU experience were significantly more likely to have used Pes (p = 0.0006). Among non-users (n = 67), lack of training was the most frequently cited barrier, particularly in non-academic institutions (63% vs. 35%, p = 0.045). Other barriers, including budget constraints, perceived lack of clinical need, and patient safety concerns, were more common in non-academic settings.

Conclusions: Esophageal pressure monitoring was used by nearly one-third of respondents, predominantly in academic centers with access to formal training programs and clinicians with over 15 years of ICU experience. Lack of training is the most prominent barrier among non-users. Increased access to education may help expand adoption across diverse clinical environments.