High PEEP extubation as guided by esophageal manometry

Kathryn M. Pendleton, Jacob Fiocchi, Julia Meyer, Alexandra Fuher, Sarah Green, William M. LeTourneau, Ronald A. Reilkoff

Research output: Contribution to journalArticlepeer-review


The ventilatory management of morbidly obese patients presents an ongoing challenge in the Intensive Care Unit (ICU) as multiple physiologic changes in the respiratory system complicate weaning efforts and make extubation more difficult, often leading to increased time on the ventilator. We report the case of a young adult male who presented to our ICU on two separate occasions with hypoxemic respiratory failure requiring intubation. Esophageal manometry (EM) guided positive end expiratory pressure (PEEP) titration was utilized during both ICU admissions to improve oxygenation and aid in extubation with spontaneous breathing trials performed on higher-than-normal PEEP settings and successful liberation on both occasions.

Original languageEnglish (US)
Article number101985
JournalRespiratory Medicine Case Reports
StatePublished - Jan 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors


  • Esophageal manometry
  • Morbid obesity
  • Obese
  • Positive end expiratory pressure (PEEP)
  • Spontaneous breathing trials (SBT)
  • Ventilator weaning

PubMed: MeSH publication types

  • Case Reports


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