Bertoni M, Telias I, Urner M, et al. - In view of the lack of non-invasive methods to reliably identify raised transpulmonary driving pressure and increased respiratory muscle effort during assisted ventilation, researchers investigated whether the swing in airway pressure produced by respiratory muscle effort under assisted ventilation when the airway is briefly occluded (ΔP_occ) could serve as a highly feasible non-invasive method to screen for these conditions. Daily measurements of respiratory muscle pressure (P_mus), dynamic transpulmonary driving pressure (ΔP_L,dyn, the difference between peak and end-expiratory transpulmonary pressure), and ΔP_occ were obtained among patients on mechanical ventilation in two ICUs in Toronto, Canada. They derived a conversion factor to predict ΔP_L,dyn and P_mus from ΔP_occ, and cross-validation was used to obtain validation. Findings revealed that accurate non-invasive identification of elevated respiratory muscle pressure and transpulmonary driving pressure was achieved by measuring ΔP_occ. Spontaneously breathing ventilated patients may often have excessive respiratory effort and transpulmonary driving pressure.