They assert that our esophageal pressure measurements do not reflect transmural pressure. We performed our experiments on pigs that had undergone a thoracotomy, and therefore the extraesophageal pressure was atmospheric. As mentioned in our Methods section, we subtracted atmospheric pressure from our intraesophageal measurements to arrive at pressure measurements that were transmural and not merely transmitted pressures. In a patient with a closed chest, positive pressure ventilation would result in higher pleural pressures, reducing transesophageal pressure.,, Our experimental environment generated much higher transmural pressures than would be expected in the clinical scenario of a closed chest. Given our findings, increased transesophageal pressures during noninvasive positive pressure ventilation (NPPV) are not likely to threaten an anastomosis. However, our data are from an animal model and we hope they will provide the basis for future clinical trials.