Kudos to Deborah H. Allen, director of Nursing Research and Evidence-Based Practice and DANCE member with Duke University Health System, and Jonathan McGee with Duke Raleigh Hospital for the submission of their Duke Institute for Health Innovation (DIHI) proposal entitled: “Exploring COVID-19 Related Transpulmonary Pressures Using Esophageal Manometry." This study proposes the use of esophageal manometry as a novel strategy for improving care by monitoring respiratory mechanics and pulmonary risk of non-intubated COVID-positive patients.

Current applications monitoring PL through a surrogate of esophageal pressures (PES) from esophageal manometry have largely focused on optimizing ventilator settings in intubated patients to be as lung protective as possible. While it is known that patients who fail HFNC to require intubation have worse outcomes than if intubated earlier, we are not clear who can successfully avoid intubation; thereby, patient selection for best care is critical. This technology can provide practitioners meaningful data through monitoring PL in COVID-positive patients as a means to provide quality care.