Adult respiratory distress syndrome profiles by computed tomography

Gattinoni, Luciano; Presenti, A.; Torresin, A.; Baglioni, Stefano; Rivolta, Massimo W.; Rossi, Fabiana; Scarani, F.; Marcolin, R; Cappelletti, Gioia

doi:10.1097/00005382-198607000-00005

Cited by 271 publications

(139 citation statements)

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“…In parallel with these clinical observations, patho-anatomical and computerized tomographic studies in the 1970s/1980s informed physicians about the uneven distribution of aerated areas and dense consolidated regions of the lung [71]. In adult patients with ARDS, the remaining alveolar surface for gas exchange (i.e., functional residual capacity, total lung volume) was largely reduced.…”

mentioning

confidence: 87%

Pediatric acute lung injury

Dahlem

Aalderen

Bos

2007

Paediatric Respiratory Reviews

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mentioning

confidence: 87%

Pediatric acute lung injury

Dahlem

Aalderen

Bos

2007

Paediatric Respiratory Reviews

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“…56 Chiumello et al 25 investigated a group of ARDS subjects managed with protective ventilation previously enrolled in a randomized multi-center trial to test the long-term outcomes of patients receiving prone compared with supine positioning. The mean extent of reticular pattern was Ͻ10 -15% of total lung volume 1 y after ARDS in both supine and prone groups, and there were also no differences in the amount of collapsed (8.1 Ϯ 3.1% vs 7.3 Ϯ 3.4%), poorly aerated (15.3 Ϯ 3.6% vs 17.1 Ϯ 4.9%), and well aerated (64.0 Ϯ 8.4% vs 70.2 Ϯ 8.4%) tissue between the 2 groups.…”

Section: Radiological Findingsmentioning

confidence: 99%

What's Next After ARDS: Long-Term Outcomes

et al. 2016

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SummaryARDS is a life-threatening organ failure due to several pulmonary and extrapulmonary injuries with an incidence between 5 and 60 cases/100,000 persons/y. Patients with ARDS have non-cardiogenic pulmonary edema and dyspnea often requiring invasive mechanical ventilation and intensive care admission. Although the short-term mortality rate has significantly decreased in the last decade, mainly due to the widespread application of lung-protective ventilation and better general support, long-term outcomes are still unsatisfactory. Besides simply evaluating the outcome at hospital discharge, several recent studies have assessed the health-related quality of life, neuropsychological disability, radiological findings, and pulmonary dysfunction up to 5 y. This paper reviews the literature regarding the long-term outcomes in patients with ARDS. Key words: ARDS; long-term outcomes; health-related quality of life; neuropsychological disability; pulmonary function; lung imaging. [Respir Care 2016;61(5):689 -699.

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“…Most commonly, regional mechanics are defined by relating regional lung air volume change, derived from CT total volume and density changes as described above, to estimates or measurements of distending or inflation pressure. This approach has been used successfully to provide insight into the pathophysiology of acute lung injury, particularly with respect to recruitment and ventilator management (18)(19)(20)(21)(22). However, as pointed out in a Critical Care Perspective (23), CT analysis based on density cannot detect volume changes of lung units that are flooded and that may expand as more fluid enters.…”

Section: Ct Measurement Principlesmentioning

confidence: 99%

“…They showed that there were significant regional differences in lung aeration and recruitment behavior with tidal volume and positive end-expiratory pressure, and that these differences in regional parenchymal mechanical properties helped determine whether the local response to different management strategies was beneficial or potentially injurious. Although initial patient studies were limited by radiation exposure and slow imaging technology to a single or a few representative slices (18,20), the basic principles relating regional density to regional aeration and partitioning air and tissues volumes were applied in a series of elegant studies of critically ill patients. Regional aeration patterns from CT data were used to shed light on the distinct shape of the whole lung pressure-volume curve in patients with ALI (19), and a classification scheme for different types of ALI based on CT and other characteristics with different therapeutic and prognostic features has been proposed (46,47).…”

Section: Ct Studies Of Aeration Distribution In Acute Lung Injurymentioning

confidence: 99%

Computed Tomography Studies of Lung Mechanics

Simon

Christensen²,

Low³

et al. 2005

Proceedings of the American Thoracic Society

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The study of lung mechanics has progressed from global descriptions of lung pressure and volume relationships to the highresolution, three-dimensional, quantitative measurement of dynamic regional mechanical properties and displacements. X-ray computed tomography (CT) imaging is ideally suited to the study of regional lung mechanics in intact subjects because of its high spatial and temporal resolution, correlation of functional data with anatomic detail, increasing volumetric data acquisition, and the unique relationship between CT density and lung air content. This review presents an overview of CT measurement principles and limitations for the study of regional mechanics, reviews some of the early work that set the stage for modern imaging approaches and impacted the understanding and management of patients with acute lung injury, and presents evolving novel approaches for the analysis and application of dynamic volumetric lung image data. Keywords: computed tomography; mathematical modeling; physiologyThe phenomena covered by the word "respiration" are very diverse. When a person is seen to breathe, what is observed is a movement of the chest and abdomen by which air is alternately drawn into his lungs and again expelled. This constitutes the mechanical aspect of respiration.-August Krogh, 1941 In the 60-odd years since A. Krogh (1) opened his treatise on the comparative physiology of respiration with these words, an enormous amount of work has explored the relationship between lung expansion or deformation and the forces that drive such changes. Most recently, advances in imaging techniques have extended the study of lung mechanical behavior to the regional level, and currently evolving technologies permit the threedimensional characterization of dynamic lung volume changes in intact subjects. X-ray computed tomography (CT), because of its speed, widespread availability, high-resolution anatomic visualization, and unique ability to quantify regional air and tissue volumes, provides a particularly powerful tool for the noninvasive measurement of lung mechanics in experimental models as well as human subjects. This review presents relevant CT measurement principles for regional mechanics, presents examples of static and dynamic approaches to lung mechanics, and emphasizes some exciting and promising new high-resolution, vol-

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Adult respiratory distress syndrome profiles by computed tomography

Cited by 271 publications

References 0 publications

Pediatric acute lung injury

Pediatric acute lung injury

What's Next After ARDS: Long-Term Outcomes

Computed Tomography Studies of Lung Mechanics

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