Value of Computed Tomography of the Chest in Subjects With ARDS: A Retrospective Observational Study.

BACKGROUND: The value of computed tomography (CT) of the chest in the management of patients with ARDS is poorly defined. The aim of this study was to assess the clinical utility of thoracic CT scans in subjects with ARDS using the Berlin definition. METHODS: This was a retrospective, observational...

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Publicado en:Respiratory Care Vol. 61; no. 3; pp. 316 - 324
Autores principales: Simon, Marcel, Braune, Stephan, Laqmani, Azien, Metschke, Maria, Berliner, Christoph, Kalsow, Maria, Klose, Hans, Kluge, Stefan
Formato: diagnostic images research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Mar2016
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Value of Computed Tomography of the Chest in Subjects With ARDS: A Retrospective Observational Study.
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          Simon, Marcel
          Braune, Stephan
          Laqmani, Azien
          Metschke, Maria
          Berliner, Christoph
          Kalsow, Maria
          Klose, Hans
          Kluge, Stefan
        affil: Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
      sug:
        subj:
          Respiratory Distress Syndrome, Acute Radiography
          Tomography, X-Ray Computed
          Radiography, Thoracic
          Respiratory Distress Syndrome, Acute Therapy
          Intensive Care Units
          Lung Pathology
          Transportation of Patients
          Retrospective Design
          Descriptive Statistics
          P-Value
          Two-Tailed Test
          Data Analysis Software
          Chi Square Test
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          Aged
          Aged, 80 and Over
          Female
          Male
          Human
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          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: BACKGROUND: The value of computed tomography (CT) of the chest in the management of patients with ARDS is poorly defined. The aim of this study was to assess the clinical utility of thoracic CT scans in subjects with ARDS using the Berlin definition. METHODS: This was a retrospective, observational study in a university hospital ARDS center on all subjects with ARDS in whom a CT scan of the chest was performed immediately before or during an ICU stay between January 1, 2007 and June 30, 2013. RESULTS: During the study period, a total of 1,781 thoracic CT scans were performed, of which 204 cases met inclusion criteria. The most common pathologic findings of the lung parenchyma were consolidations (94.1 % of cases) and ground glass opacities (85.3%). Furthermore, CT scans showed pleural effusions (80.4%), mediastinal lymphadenopathy (66.7%), signs of right ventricular strain and pulmonary hypertension (53.9%), pericardial effusion (37.3%), emphysema of the chest wall (12.3%), pneumothorax (11.8%), emphysema of the mediastinum (7.4%), and pulmonary embolism (2.5%). Results of CT scans led to changes in management in 26.5% of cases. Mortality was significantly increased in subjects with involvement of lung parenchyma of >80% (P = .004). Intrahospital transport was associated with critical incidents in 8.3% of cases. CONCLUSIONS: Systematic evaluation of thoracic CT scans yielded information useful for making a diagnosis, predicting prognosis, and recognizing concomitant disorders requiring therapeutic interventions. Results obtained from CT scans led to changes in management in 26.5% of cases.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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