Changes in lung parenchyma after acute respiratory distress syndrome (ARDS): assessment with high-resolution computed tomography

2001 ◽  
Vol 11 (12) ◽  
pp. 2436-2443 ◽  
Author(s):  
Iris-M. Nöbauer-Huhmann ◽  
Klemens Eibenberger ◽  
Cornelia Schaefer-Prokop ◽  
Heinz Steltzer ◽  
Werner Schlick ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Respiratory Distress Syndrome ◽  
High Resolution ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Parenchyma ◽  
High Resolution Computed Tomography

scholarly journals Association of high-resolution computed tomography score with ventilator weaning and 28-day mortality of patients with acute respiratory distress syndrome

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052091296
Author(s):  
Kun Zhao ◽  
Shu-juan Bai ◽  
Zhi-tao Wang ◽  
Yu-he Zhang ◽  
Chao Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Regression Analysis ◽  
Acute Respiratory Distress Syndrome ◽  
High Resolution ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Ventilator Weaning ◽  
High Resolution Computed Tomography ◽  
Multifactor Regression

Objective This study was performed to explore the association of the high-resolution computed tomography (HRCT) score with ventilator weaning and 28-day mortality of patients with acute respiratory distress syndrome (ARDS). Method In total, 197 patients treated for ARDS from October 2004 to December 2015 were retrospectively analyzed. Univariate analysis and multifactor regression analysis were used to determine the relationship of the HRCT score with ventilator weaning and 28-day mortality. Curve-fitting analysis and threshold analysis were further used to explore the association of the HRCT score with ventilator weaning and 28-day mortality. Results The multifactor regression analysis showed that the HRCT score was significantly associated with a lower rate of ventilator weaning and a higher risk of 28-day mortality in patients with ARDS. HRCT scores of 257.0 and 243.2 were the thresholds for ventilator weaning and 28-day mortality, respectively. When the HRCT score was below the threshold, every 1-point increase in the HRCT score was associated with a 4.6% decrease in the ventilator weaning rate and a 4.6% increase in the 28-day mortality rate. Conclusion The HRCT score was associated with ventilator weaning and 28-day mortality with a threshold of 257.0 and 243.2 points, respectively.

scholarly journals Compressive Forces and Computed Tomography–derived Positive End-expiratory Pressure in Acute Respiratory Distress Syndrome

2014 ◽  
Vol 121 (3) ◽  
pp. 572-581 ◽  
Author(s):  
Massimo Cressoni ◽  
Davide Chiumello ◽  
Eleonora Carlesso ◽  
Chiara Chiurazzi ◽  
Martina Amini ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Ct Scan ◽  
Distress Syndrome ◽  
Peep Level ◽  
Transpulmonary Pressure ◽  
Lung Parenchyma ◽  
Positive End Expiratory Pressure

Abstract Background: It has been suggested that higher positive end-expiratory pressure (PEEP) should be used only in patients with higher lung recruitability. In this study, the authors investigated the relationship between the recruitability and the PEEP necessary to counteract the compressive forces leading to lung collapse. Methods: Fifty-one patients with acute respiratory distress syndrome (7 mild, 33 moderate, and 11 severe) were enrolled. Patients underwent whole-lung computed tomography (CT) scan at 5 and 45 cm H2O. Recruitability was measured as the amount of nonaerated tissue regaining inflation from 5 to 45 cm H2O. The compressive forces (superimposed pressure) were computed as the density times the sternum-vertebral height of the lung. CT-derived PEEP was computed as the sum of the transpulmonary pressure needed to overcome the maximal superimposed pressure and the pleural pressure needed to lift up the chest wall. Results: Maximal superimposed pressure ranged from 6 to 18 cm H2O, whereas CT-derived PEEP ranged from 7 to 28 cm H2O. Median recruitability was 15% of lung parenchyma (interquartile range, 7 to 21%). Maximal superimposed pressure was weakly related with lung recruitability (r 2 = 0.11, P = 0.02), whereas CT-derived PEEP was unrelated with lung recruitability (r 2 = 0.0003, P = 0.91). The maximal superimposed pressure was 12 ± 3, 12 ± 2, and 13 ± 1 cm H2O in mild, moderate, and severe acute respiratory distress syndrome, respectively, (P = 0.0533) with a corresponding CT-derived PEEP of 16 ± 5, 16 ± 5, and 18 ± 5 cm H2O (P = 0.48). Conclusions: Lung recruitability and CT scan–derived PEEP are unrelated. To overcome the compressive forces and to lift up the thoracic cage, a similar PEEP level is required in higher and lower recruiters (16.8 ± 4 vs. 16.6 ± 5.6, P = 1).

Sign in / Sign up

Export Citation Format

Share Document