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Pleural Pressure Working Group
PROMOTING MONITORING IN RESPIRATORY FAILURE
REGISTRATIONS ARE
NOW OPEN HERE
Abstract submission deadline: April 30
See guidelines
Dear colleagues and members,
It is with great sadness that we announce the death of our dear friend and colleague
Jordi Mancebo. He passed away on the night of August 6th.
Jordi was a co-founder of the PLUG and this group was very dear to his heart especially regarding the transmission to the next generation.
We'll miss him enormously.
Laurent Brochard,
Tommaso Mauri
WHO
WE ARE
The Pleural Pressure Working Group (PLUG) is an international network of physicians and investigators working on advanced monitoring of mechanical ventilation and respiratory failure. Our goal is to promote research and use of advanced monitoring, discuss study results, and provide educational tools. PLUG working group is open to anybody interested in this topic and is independent from any manufacturer or private company.
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PLUG has been created as a working group of the European Society of Intensive Care Medicine (ESICM) by Dr. Laurent Brochard in 2012 and became an independent group in 2021. The first focus was to promote research and use of esophageal pressure in mechanically ventilated patients. The focus was later extended to advance monitoring including electrical impedance tomography, lung ultrasound, electromyography, etc.
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The group gathers more than 600 members from all over the world. The organization is structured in an executive committee, a scientific committee and an educational committee.
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The main activities of the PLUG working group are:
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Publication of review articles about esophageal pressure monitoring and other advanced monitoring techniques in respiratory failure. The PLUG members published numerous research articles
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Organization of multicenter trials
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Organization of scientific meetings throughout the year in Europe and North America
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Creation of educational tools
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Executive committee:
Chair: Laurent Brochard, Toronto, Canada
Tommaso Mauri, Milano, Italy
Leo Heunks, Rotterdam, The Netherlands
Scientific committee:
Chair: Daniel Talmor, Boston, US
Ewan Goligher, Toronto, Canada
Claude Guerin, Lyon, France
Stefano Nava, Bologna, Italy
Educational committee:
Chair: Jean-Michel Arnal, Toulon, France
Davide Chiumello, Milano, Italy
Alberto Goffi, Toronto, Canada
Francesco Mojoli, Pavia, Italy
Oriol Roca, Barcelona, Spain
Lisanne Roesthuis, Nijmegen, The Netherlands
Carlo Alberto Volta, Ferrara, Italy
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Website/newsletters:
Annemijn Jonkman, Rotterdam, The Netherlands
Bertrand Pavlovsky, Angers, France
MEETINGS
Next meeting
First Jordi Mancebo meeting
September 28-30, 2023, Barcelona
More information can be found here
Past meetings
5th ONLINE PLUG MEETING
April 20, 2022, Online
4th ONLINE PLUG MEETING
October 25 and November 8, 2021, Online
GO TO VIDEOS
ESICM PLUG THEMATIC SESSION
October 3-6, 2021, Online
Search in the ESICM program for the session 'PLUG: novelties in respiratory physiology of the critically ill'
3rd ONLINE PLUG MEETING
April 16th, 2021, Online
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ESICM ARF SECTION MEETING
December 8th, 2020, Online
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2nd ONLINE PLUG MEETING
Critical Care Canada Forum (CCCF)
October 5th, 2020, Online
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1st ONLINE PLUG MEETING
“Respiratory physiology of COVID-19 patients”
April 29th, 2020, Online
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CRITICAL CARE CANADA FORUM (CCCF) 2019 - criticalcarecanada.com
Toronto, Canada
11th November 2019
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2019 ESICM LIVES Meeting
Berlin, Germany
30th September 2019
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29th ARGENTINIAN MEETING OF INTENSIVE CARE MEDICINE
Mendoza, Argentina
4th-6th September 2019
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GO TO VIDEOS
41st ANNUAL MEETING OF THE JAPANESE SOCIETY FOR RESPIRATORY CARE
Osaka, Japan
3rd-4th August 2019
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LUNG and DIAPHRAGM-PROTECTIVE
VENTILATION CONSENSUS CONFERENCE
MiCo Milano, Milan, Italy
6th-8th May 2019
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Members of the Pleural Pressure Working Group gathered from around the world for a state-of-the-art meeting on an important new challenge in the management of patients with acute respiratory failure: integrating the traditional focus on lung-protective ventilation with the emerging paradigm of diaphragm-protective mechanical ventilation. The meeting involved two days of extensive discussion and debate about the best available mechanistic and clinical evidence supporting various facets of lung and diaphragm-protective ventilation strategies. Over the two days, a genuine consensus emerged over the importance of addressing the new issues raised and the need for advances in monitoring and intervention to target mechanisms of lung and diaphragm injury during ventilation. Participants agreed that the meeting was a great success; in particular, it was a phenomenal opportunity for junior investigators in the field to interact with more established leaders. The importance of this meeting for clinical practice and for research in the field will emerge over years to come.
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Results from the two-day discussion have now been published on the Am J Respir Crit Care Med. The manuscript discusses how the current approach to mechanical ventilation might be revised to prevent ventilator-induced diaphragm atrophy, injury, and resulting weakness while maintaining lung-protective ventilation, an approach we refer to as lung and diaphragm-protective ventilation.
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https://www.atsjournals.org/doi/abs/10.1164/rccm.202003-0655CP
ESICM Paris Meeting 2018
RESEARCH
RecruitmEnt assessed by eleCtRical impedance tomography: feasibility, correlation with clinical oUtcomes and pIloT data on personalized PEEP selection: RECRUIT project
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Objectives
The RECRUIT study is a multicenter physiological observational study associated with specific lung (de)recruitment maneuvers
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to verify the feasibility of measuring the potential for lung recruitment in ARDS by electrical impedance tomography (EIT)
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to describe the range of lung recruitability in ARDS
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to develop methods for real-time and personalized PEEP selection based on EIT
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to assess the association between PEEP selection by EIT-based methods and the potential for lung recruitment
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to explore the association between potential for lung recruitment, clinical PEEP setting and clinical course of ARDS in the first week after the test and 28-day mortality
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Duration of study measurements: 1.5-2 hours on a single day.
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Current status
Recruiting
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Principal investigators
Laurent Brochard (laurent.brochard@unityhealth.to)
Tommaso Mauri
Marcelo Amato
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Link to clinicaltrials.gov
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Incidence of dyssynchronous spontaneous Breathing Effort, breath-stacking and reverse triggering in early ARDS -
The BEARDS project -
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Objectives
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To describe the incidence of spontaneous breathing efforts, reverse triggering, breath stacking and short cycles, as well as other asynchronies like wasted efforts in the first week of ARDS and AHRF.
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To analyze the presence of main dyssynchronies with its corresponding changes in transpulmonary pressure swings, plateau pressure and volume delivered by the ventilator in those breaths, and quantify the breathing efforts generated.
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To associate the incidence of dyssynchronies (including reverse triggering) during the early phase of ARDS and AHRF, with outcome (ventilator free days, intensive care unit (ICU) stay, mortality, pneumothorax as secondary outcome).
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To understand the relationship between sedation levels and regimens and the different types of dyssynchronies.
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Current status
Completed
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Principal investigator
Laurent Brochard
email: laurent.brochard@unityhealth.to
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Link to clinicaltrials.gov
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PRessure suppOrT vEntilation + Sigh in aCuTe hypoxemIc respiratOry failure patieNts (PROTECTION): a pilot randomized controlled trial
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Objective
This pilot RCT will serve to test the hypothesis that application of PSV+Sigh in spontaneously breathing intubated patients with mild to moderate AHRF and ARDS is feasible and to collect preliminary data on the safety of such an approach.
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Current status
Completed
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Principal investigators
Tommaso Mauri (email: tommaso.mauri@unimi.it)
Laurent Brochard (email: brochardl@smh.ca)
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Link to clinicaltrials.gov
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VIDEOS
01. How to measure driving and transpulmonary driving pressure
03. How to inflate the esophageal balloon
05. How to insert the esophageal balloon
07. How to measure
PEEPi
09. How to measure
transpulmonary pressure
in a passive patient
02. How to recruit the lung with transpulmonary pressure
04. The different pressure in the thorax
06. How to calculate
WOB & PTP
08. How to set PEEP
using transpulmonary pressure
10. Why measuring esophageal pressure in a spontaneously breathing patient?
11. How to perform esophageal manometry in children
RESOURCES
& PUBLICATIONS
Interested in publications or websites that may assist in the management and monitoring of patients with respiratory failure? Click on the icons below!
Do you have any recommendation for a publication or a website you think we should add to the list? Email us at: plug.workinggroup@gmail.com
IN MEMORIAM
Brian Kavanagh, 1962 to 2019
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Robert Kacmarek, 1949 to 2021
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Göran Hedenstierna, 1941 to 2021
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Joseph Milic-Emili, 1931 t0 2022
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EVENTS
The PLUG group meets regularly during international intensive care medicine conferences.
